In a message dated 5/19/2004 9:04:32 PM Eastern Daylight Time,
[log in to unmask] writes:
I'm sure some combination of manual expression
and hosp. grade pump  would be the most effective, but we compromise to get
the best result we can. I would love to see a study comparing the two but we'd
have to be very careful to make sure the hand expression was done correctly.
It
would also be interesting to see how much time it takes to teach effective
manual expression to nurses and mothers v the amount of time it takes to get a
mother to use the electric pump correctly. No flames, please. In the real
world
of short staffing these things matter.
Kathy, I promise no flames.  I do want to comment about teaching and learning
hand expression Vs pumping.  After 24 years I am finally feeling confident in
teaching hand expression.  When I had my children no one taught me how to do
this and I just assumed it was too difficult to learn.  Over years of reading,
conferences, and opening my mind, hand expression has become very easy.  Now,
every mother I see is taught how to hand express.  True, there are women who
would prefer not to touch their breast but you will not know who they are
without first attempting the teaching.
Pumping is not without it's own problems.  I have seen staff set pumps up
incorrectly, poor or no instructions to mothers, nipple trauma due to pumps, and
some mothers giving up due to these issues.  We do pump inservices yearly but
that does not eliminate the above issues.
We really do need to approach hand expressing Vs pumping on a case by case
basis.  We should not assume that women prefer pumps over hand expressing
especially in the first days unless we do the teaching and assessments.
Ann Perry RN, IBCLC
Boston, MA

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