Hi all, While I agree hand expressing should always be the first method tried, it doesn't work with all women, and I am an example here. I have never been able to hand express except by squeezing the nipple itself, which is far too uncomfortable to use as a method of BM collection. If I'd been forced to use manual expression for a newborn, I might have come to the unwarranted conclusion that I had no milk! Jennifer Landels, BA, CE Vancouver BC