Thanks, Jane.

<That means the job of the pump is to stimulate let-down, then "do no harm" - don't squeeze down on the areola and prevent the milk from ejecting - keep the milk flowing outward as fast as possible. >


Having originally in my hospital days had access only to "bicycle-horn" breast pumps (that required a doctor's order before we could use them), I can in no way claim any direct expertise in the matter of electric breast pumps, except by hearsay from co-workers and others. We all have something to contribute to "the cause" by sharing our specific experiences and insights.


I appreciate the suggestion from several on this list to have my granddaughter try a smaller flange (rather than a larger flange which I had suggested to her) after a few weeks of successful pumping, then suddenly beginning to have one side drain only a certain amount and then stay partly full, needing a massage break and then resuming pumping. The smaller flange did the trick of continuing to drain the breast in a single session, after the initial swelling was long gone, and more elasticity of the ducts had developed.


All that having been said, I want to share that many mothers have reported success to me, no matter what the brand of their pump,  no matter the baby's age, despite any stressful conditions, perhaps utilizing what I think the veterinary sources call the "tap" reflex???, by using the following sequence and repeating it 1-3 times during the pumping: 
 

1) Do RPS for the slow count of 20-30 on one side (50 or so,slowly, if edema is still present in the nipple-areolar complex) to stimulate the neural arc of the MER, then WAIT 60 seconds (perhaps using the time to assemble the pump, etc.) till the hormonal arc, (oxytocin) can reach both breasts through the circulation, then 

2) Pump for 5-7 minutes or so depending on when the flow slows down noticeably.

3) Take a short break to do 1-2 minutes of gentle, alternate breast compression or massage, especially from the axillary and upper areas.


Then, repeat the 3 steps again, as needed, 1-3 more times to quickly get sometimes more than they were previously getting in a longer pumping period. It's all part of helping nature "push" more milk toward the area where it can help nature "neutralize" or try to balance the area of negative pressure in the flange tunnel (just like the weather forecasters tell us daily of the "high (barometer) pressure areas moving toward the low pressure areas." 


Somehow, we need to re-educate HCP's, especially in the NICU, that there are centuries of scientific evidence about how vacuum "works". Let's all make it widespread knowledge which they can then teach mothers (and fathers! I bet many of them will catch on quickly, depending on engineering expertise used in their work experiences), that what's actually "working" is NOT the vacuum, but really other positive forces moving toward the low pressure area to try to equalize or neutralize the vacuum. Breast pump engineers and manufacturers all know this full well. But WE are going to have to be the ones to advertise THAT to our moms!


Maybe we should enlist local support groups to contribute wall plaques to be hung in the local NICU's, stating: 

"Vacuum DOES NOT PULL; other forces PUSH" ????

http://en.wikipedia.org/wiki/Vacuum


K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC     Dayton OH

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