Suggestions: Use reverse pressure softening, then manual expression at the start of each expression. Switch to the pump in the expression phase once mom has manually elicited a letdown. If she is using a "working moms pump" instead of a hospital grade pump, switch to hospital grade. Even though, I think, the new working moms pumps have the stimulation/expression technology, I still favor hospital grade pumps over those. I have seen good results with the Medela Symphony or Classic. If she is already using one of those 2, this is a moot point. Laurie Wheeler RN MN IBCLC Mississippi USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome