I would like to make some comments about the pump issues brought up recently
on Lactnet. I agree with both Maureen and Kathy and have, as many of you
have also, seen both sides of this debate.
        I have been involved with breastfeeding and breastfeeding mothers
for over 20 years. The island upon which I live has a population I would
estimate at 500,000, maybe a little more, centered in 2 medium sized cities
with the rest spread sparsely along the east coast.   At the time I became
involved we had an electric pump which had been jury rigged from a simple
water pump which a league dad had put together. We sold it to be used for
decanting wine when hand pumps became available for rent at a local
pharmacy.  There was one other electric pump on the entire island and the
hand pump for rent was a pistol grip pump.  About ten years ago me--la and
Am---Eg---- became available through LCs.  Until then even the hospital only
had a GO- (ancient and dangerous). In the past 3 years there has been an
explosion in the number and availability of pumps.  Every health unit has
several for loan (free), and there is competition between pharmacies. On our
island there are now hundreds perhaps thousands of good quality electric
pumps.  Hand pumps are also widely distributed.
        I did sell hand pumps and rent electric pumps when I went into
private practise because they simply were unavailable without a 4 hour trip
off the island.  3 years ago I passed the business on to a pharmacy, partly
due to the ethical issues involved.  I wasn't needed as a depot.  Did I lose
economically YES, do I make a living wage, absolutely not.  Am I comfortable
with my decision, yes but I acknowledge it is not the right one for everyone.
        Since the proliferation of pumps I am seeing a tremendous increase
in the use of them. Where we used to hand express now people use pumps.
Pumps are often being used as a crutch by uninformed health professionals.
They can't help with latch on or... but they can give the mom a pump.  At
the same time there has been a significant increase in breastfeeding rates
with initiation rates over 90% and a large majority of babies receiving some
breastfeeding beyond 6 months.  We are now focussing on getting a majority
to breastfeed over 1 year and we are surprisingly close.  Almost everyone in
this community has heard of older children (over 3 years) breastfeeding
which is the first step to acceptance.
         I agree with Maureen that the focus should be on all infants
getting breastmilk. I also see pumps as sometimes saving breastfeeding from
the ignorance of health advisors. I absolutely agree with Kathy about the
dangers of treating gadgets as a necessity. Our hospital gives no gifts and
has not done so for years.  The impact of dispensing a pump to all mothers
is vast and dangerous.  Breastfeeding is supposed to be simple. Take one
mother add one/two/three.. infants teach them to latch on without causing
pain, ensure milk is tranfering freely and do frequently. Pumps are
technologizing a non technological process.  However, women vary, some LIKE
technology.. so let them be educated consumers.  Other women are intimidated
by technology let them know they don't need it.  I don't feel comfortable
fitting everyone into the same box.
        Life on this island was not better without pumps.  I do not wish to
go back to the 'old' days and ways.  I do hope sincerely that the current
over reliance on pumps is another phase in breastfeeding education.  We have
convinced health care professionals the babies should be fed breastmilk.
They rarely order/recommend weaning.  Now it is our responsibility to
provide the education they need in order to ensure the breastmilk feeding
takes place at the breast.  I see it as an interim step not the final end
result.
        In summary, ALL babies need breastmilk ALL mothers do not need pumps.
>"Without interest and passion, nothing great has ever happened in history.
GWF Hegel"
             Rhoda Taylor, B.A., IBCLC, Duncan, B.C., Canada<