Hi, Cindy: I like your transportation analogy except for one thing. I would not compare hand expression to walking. I think it's way past time to seriously look at the value of hand expression. I was at a Medela Grand Rounds yesterday, that was unfortunately poorly attended due to the weather/time of day, at which Leon Mitoulas (colleague of Peter Hartmann) spoke regarding the ongoing Medela pump research. Medela's research looks at how a baby breastfeeds and compares this (with bar graphs) with different patterns of pumping (manual and electric, also comparing speed of milk expression and vacuums). It was quite interesting. He did briefly mention hand expression, but immediately made the assumption that hand expression is barely worth mentioning. He did say after I asked a question about any research being done on hand expression, that Medela is trying to set up a research project in Japan, where hand expression is almost exclusively practiced. He seemed quite surprised when I said, based on my personal experiences with hand expression as well as in talking with other successful hand expressers, that I would rate the baby as number 1, followed by hand expression, then the hospital-grade pumps, in efficiency. He did have a slide showing this rating, but unfortunately did not include hand expression. We just cannot ignore hand expression as a very viable and efficient method of milk extraction, especially in situations where a pump is not financially feasible, or electricity is not available. How many mothers in the tsunami affected areas of southeast Asia do we think are using hospital-grade electric breast pumps? I strongly suspect that many of these mothers who need to express their milk and have no access to a pump have been instructed on how to "safely" prepare formula for their babies, rather than having been taught hand expression. Unless their relief worker happened to be Japanese, maybe. (tongue-in-cheek) I will be the first to agree, that especially in the US,hand expression is a hard sell because it is free and no-tech, in direct contrast to the American way which is expensive and high-tech. Once a mom learns hand expression, she is a convert for life! Sorry for the length, but this is obviously a subject I feel very strongly about! Pam Hirsch, RN,BSN,CLC Clinical Lead, Lactation Services Advocate Good Shepherd Hospital Barrington, IL USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html