In my area of Houston, moms are being taught to use the old Medela 
Manual Pump wrongly and it is not working effectively. If you remember 
this pump, the old piston style one, we used to screw the piston onto 
the back of the flange. Remove the tubing  and yellow connector piece 
used for the Lactina and screw the piston into the flange. Like the 
pictures in the little booklet. What I am seeing now is moms are using 
the piston screwed into the yellow piece that connects the tubing to 
their flanges (like for a Lactina). Mom uses the tubing and piston set 
up like for the Lactina and tries to hold one or two flanges while 
pumping the piston.

Sometimes they get their husbands to pump the piston while they hold the 
flanges and this is painful they say. Or, they hold one flange and pump 
the piston -- I heard yesterday mom was using her feet. Last week, mom 
was putting it between her knees which didn't work! The mom today said 
her manual wasn't working, no suction, and when I got to her house, she 
had this same rig set up.

I believe that this is being promoted as a double manual pump but unless 
one has the old pedal thing, moms can not use this by themselves. So 
they cut down to pumping 2-3 times a day for a NICU baby while waiting 
to contact WIC for their loaner electric pump because they have no 
helper all day and in the night. PLUS, and this is the worst part -- I 
am hearing moms are only removing 1/2 to 1 ounce total whereas before 
when they'd use it singly without the tubing, they would get 2-3 ounces 
total.

We all know that poor milk removal in the early days leads to poor milk 
supply and this is what I am seeing once they get an electric loaner 
pump. I literally never have anyone using this manual pump correctly 
anymore.

Kathy Eng, BSW, IBCLC

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