Jean, Thank You so much for all you do, I really believe your technique is worthwhile and I use it often now. I had been out of Lactation for the Past 8 years, Midwifery school, than a Job in the OBGYN clinic at Kaiser, and this October took a job at a Large Military Hospital, Post Partum Lactation, and unfortunately, things have not changed. Still the same issues I was dealing with years ago,  mother infant separation, get them discharged within 24  hours, etc.  I am noticing the same variation in terms of ability of some Mother's to express colostrum and some no matter how much I try to help her Manually express not one drop comes out.  I had a patient the other day that on day 2 was able to obtain 1 ounce colostrum with the Harmony hand pump, after I showed her how to apply RPS,  and she was a C/section, although planned, so not as much IVFluid given as laboring then C/sec, and yet another patient the same week, on day 2 with not one drop coming out,  via manual or electric expression, that patient was a longer labor, vag delivery.  The point I wanted to make is that I def. see in my  practice that most Women obtain more colostrum with massage/RPS and hand expression than a Mechanical pump. Sometimes I am reluctant to put the pump into the equation too soon, because they are seeing the drops with Manual expression, then I have them use the electric pump and nothing comes out, or 1 or 2 drops after 10 minutes of pumping, versus many drops flowing out with RPS ands manual expression, then they say to me, " I don't think I have enough", no matter that I tell them the pump is not the best reflection of what is in the Breast, I do not think they believe that.  Lisa Mooney CNM MSN IBCLC 		 	   		  
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