>I wonder why this mom was pumping at 1 AM to begin with!  So many
>breastfeeding problems today can be directly related to use of pumps.  I
>wish I had time to study the matter further, as I see so many more
>problems - the huge increase in the incidence of mastitis and mastitis
>occuring earlier and earlier in the breastfeeding timeline, for example -
>with the common denominator being inappropriate and unneccessary pump use. 
>Have those of you from countries outside the United States noticed this
>phenomenon?  I strongly suspect this is unique primarily to the US, as we
>seem to be so technology-oriented mover here.
>
>Pam Hirsch, RN,BSN,IBCLC
>Clinical Lead, Lactation Services
>Advocate Good Shepherd Hospital
>Barrington, IL   USA


Over the years, I have noticed that more mothers use pumps these days 
than before, but my impression is that most women in the UK don't 
possess a pump unless they have had a baby in special care or if they 
intend to go back to work when their baby is still quite young, or if 
they have major problems with latching the baby on, or a baby with a 
cleft etc etc. A number have a pump for convenience, but I would say 
most people don't use it very often. A popular baby book here 
recommends expressing daily from the start, but even the people who 
follow the book don't seem to do this very much.

Pumps are advertised in the magazines and the vol orgs have agents 
who hire them,  but most of our hirings are to mothers whose babies 
are in special care.

The word we use is 'expressing' and we tend not to say 'pump the 
milk' which probably reflects the lesser emphasis on the equipment. A 
few women hand express, and they are supposed to be taught how to do 
this in Baby Friendly hospitals, but most women are given a leaflet, 
if that. I can understand that there isn't a good opportunity when 
most women are in hospital no longer than 2 days.

Midwives tend to teach mothers not to express before 4-6 weeks, while 
we (vol orgs) are not as prescriptive as this. I do ask mothers why 
they want to express, and point out that there is often no real time 
saving, if they express to get a longer sleep (someone else feeds the 
baby EBM), this is not good physiologically for the breasts or milk 
supply.

My personal feeling is that learning to hand express is a useful 
skill which supports long term breastfeeding, and it's handy for 
mothers to know how to do it, as over the length of time they might 
breastfeed, there are bound to be some occasions when someone needs 
to give EBM....there is no real need to buy or hire a pump to do 
this. There is a technique to hand expressing, and when women 'can't 
anything out by hand' they are almost always  helped if they are 
taught to do it differently.

I would hate it if the use of a pump was thought to be indispensable 
-  we are not at that stage here. Note also that few women go back to 
work, even part time, before about six months, and our maternity 
leave provisions are improving all the time.

Heather Welford Neil
NCT bfc, tutor, UK

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