In my opinion, the milk removal is the key and so the hand expressing is
perfectly fine as the sole means of expressing (in addition to any bf she
is doing). As a bonus, it is free. However, if she wants to increase the
frequency of milk removals, and is short on time or needs her hands for
some other task, that is where the pump might be beneficial. Certainly not
mandatory when hands do the job just fine.
Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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