Nature never planned ahead for pumping.  The pump isn't just sucking the 
milk out-- it's stretching and stimulating the nipple to trigger the 
oxytocin rush of a let-down, which can be blocked by stress hormones.  
Some people are natural-born pumpers, while others need to find their 
tricks to letting down milk to equipment.  I described this quandary to 
one mother, and left the room for some reason.  When I came back, she 
was cradling a teddy bear, and milk was flowing to the pump.  It seemed 
that her body needed the cue of something cute and soft (albeit furrier 
than her baby) looking expectantly up from her arms.  Parents are so 
ingenious!

Once someone has faced  disappointing pumping sessions, it's hard not to 
enter subsequent attempts in a defeated, stressed state.  Pumping can be 
very stressful, as it wraps up primal fears about your baby being hungry 
with this unpredictable technology.

So, yes, because pumping parents have very individual reactions, 
continue to experiment with the speed and suction settings, flange sizes 
and shapes. The current trend is toward smaller flanges, and sometimes 
that tight focused pull is helpful, but also try larger.  (Paula Meir's 
research from way back -- and is there anything more recent? -- found 
that a big percentage of pump-dependent parents did better with the 
27mm)).  The newer product of soft silicone "nipple cushions" may help 
if someone has very stretchy nipple/breast tissue.

The hands-free rig is helpful, and as someone said, try a stretchier 
bra, a homemade version, or unzip a little at the top, so the pumper can 
reach in and periodically be very hands-on.  Try putting a warm gel-pack 
inside the bra.

But hands-free, they can also ignore the pump sometimes, and be 
distracted and watch happy movies, read a trashy novel, and eat and 
drink hot,( and favorite) foods, not staring at the bottles. (There were 
Internet pictures of people putting a cute baby-bootie over the 
bottles).  Or get something else done, if it makes them feel productive 
and happy.  Try pumping in complete darkness, or by candlelight -- very 
hormonal!  Put on earphones with favorite music or an audiobook so they 
don't hear the pump grinding away.

Try feeding the baby on one side while pumping the other side. (Kathleen 
McCue's "Clinical Lactation" article had one idea for hands-free 
"parallel pumping,"https://connect.springerpub.com/content/sgrcl/10/2/68 
Or at least holding the baby skin-to-skin if one is exclusively 
pumping.  See if the cute baby triggers the let-down.  Perhaps seeing 
some milk flow to the pump will create more positive feelings for this 
tool, that the parent probably views as just a source of frustration.

Our work has become very pump-focused, (and let's keep celebrating what 
parents can give the baby with the normal act of breastfeeding too).  
But families often have to rely on  this tool to maintain their  nursing 
relationships in the modern world.  So it's difficult that these 
products are not a well-regulated piece of medical equipment where we 
can look at a lot of independent research.

Good luck to all.

Margaret Wills, IBCLC, Maryland

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome