Hello all,
 
 
Phyllis writes: "How did we get stuck on the term "hospital  grade"? and 
Liz wrote: 
"There is no such thing as a "hospital-grade  breastpump", which is a suave 
marketing term (that absolutely *works* because I  used that phrase for 
years). This link is to a nice, accurate article from the  U. S. Food & Drug 
Administration (which oversees pump safety/effectiveness).  Pumps are better 
described as single- or multi-user."
 
~~~
I've been thinking about this every day  since the original post. From the 
hospital point of view, the terms "single  user" vs. "multi-user" make 
sense. From the point of view of moms at home, not  so much. The point in 
suggesting a "multi-user" pump to a mom at home with  little or no milk, or a baby 
who cannot transfer it, is not that she is using a  pump that can be used by 
different mothers safely ( closed system) although  that is a good thing of 
course, but more about using a pump that is strong  enough to  support, 
maintain, or especially, build a supply that  the baby cannot/has not for some 
reason.  These are pumps that can not  only be rented and used safely by 
different mothers over time, but  have  been designed to work well when used as 
often as baby might nurse(  8-14/24ish.) Personal use or "single-user" 
pumps seem to be designed to remove  milk well and comfortably when used a few 
times a day, or even more  occasionally, while a healthy, efficiently nursing 
baby drives the supply. These  are not the moms I see, or the babies they 
have. So even though the "single  user" pumps are only being used by one 
single mom, they don't have the oomph,  either right away, or over time, to do 
the job these moms need them to do. I may  be alone, but the term 
"hospital-grade" makes a kind of sense to me. IF our  world actually viewed 
breastfeeding as truly normal, then no baby who could not  breastfeed comfortably and 
effectively, either for their own reasons, or because  their moms supplies 
have not been "normal" in a timely fashion, would be  discharged from the 
hospital without supportive interventions, including  appropriate pumps if 
needed,  to help them get there and support them  on the way. We don't normally 
send adults home after being in a hospital if they  cannot eat safely and 
comfortably, without some interventions to help them, but  every day we send 
infants home who cannot get enough to eat safely, comfortably  and/'or 
effectively.  ( Yes most of them can formula feed from  a bottle, which is  a 
substandard feeding skill, pattern,  and "substitute," biologically speaking in 
the view I am  proposing. I am not talking about infants who could not under 
any circumstances  be in healthy, exclusive breastfeeding relationships for 
some reason any more  than I would talk about every baby will grow up to 
walk freely and functionally  without assistive devices. Some won't, but 
walking independently still remains  the normative goal for most.) If we truly 
viewed breastfeeding as the  expected and always worked-for norm, then no 
mother/baby pair would be  discharged if the feeding relationship was not well 
established, without some  support interventions to help them, like a 
"hospital"-grade pump, the kind  hospitals have. In a way it would be like sending 
home a child of walking age,  who isn't walking, without a wheelchair. For 
children who need it, a  "casual stroller" would not do, they need a 
"hospital-grade" assistive device. 
 
Anyway, just more thoughts on things that circulate in my head. Can we come 
 up with better terminology that actually meets the needs of mothers and 
others  by being clear,  as well as descriptive of the reasons pumps differ in 
 terms of the single mother/baby dyad's needs ( building vs maintaining a 
supply,  taking a baby's place a few times a day for separation or  
non-medical reasons vs taking a baby's place at most/all feedings because  the 
feeding relationship doesn't "work" yet., etc.)
 
Peace,
 
Judy

Judy LeVan  Fram, PT, IBCLC, LLLL
Brooklyn, NY,  USA
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