This is strange considering the movement is towards hand expression in the first 24 hours if there are problems and then "hands on pumping" is problems persist.  If you Google "Hands on pumping", Dr. Jane has written a piece for ILCA. It's posted in their Lactation Matters section.

Actually, here is the link.

http://lactationmatters.org/2011/09/06/is-pumping-out-of-hand-why-hand-expression-in-the-first-3-postpartum-days-is-important/

Linda Bubeck IBCLC
Naval Hospital Camp Lejeune, NC

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