Hi to all- I had to respond to the comments regarding how we have lost the art of hand expression (here in the U.S. anyway). I nursed all 3 of my girls for more than a year each, and I could never get the "hang" of hand expression! ie, the milk squirted everywhere, I never felt completely relieved, and I usually expressed less than an oz. after 10 minutes of massage, etc. I am not uncomfortable touching myself, and I certainly would have loved not having to rent a machine to do the job, but hand expression did not work for me. I do know mothers (like many of you who have written) who were successful with this method. I think the adage "There are lots of ways to skin a cat" applies here. What's important is that we show mothers ALL of the options, and then let them the method that works best for them. And even though pump rental is revenue generating for us, I do hate to see mothers D/C with one! And I Think most LC's agree--the patient demands it!! Great topics for discussion! Therese in Grand Junction, CO--it's snowing in the mts.!