Most of my experience of the last 3 years is with the long-term pumping
moms with super-premies born 24-28 weeks gestation with 4-6 month NICU
stays. This is purely anecdotal based on my own observation and
experience of lots of babies, but I have developed a healthy skepticism
of the Lactina's helpfulness even with a double kit for *these
particular* moms (please don't generalize this statement to all NICU
moms or any other circumstance other than >28 weeks gestation).

Janet Simpson did not mention the gestation birth age of this baby in
question, but if the mom delivered a super-premie, it's possible that
part of her supply problem *may* be the pump. I have seen this over and
over to the point that, should a super-premie mom call me immediately
after delivery for consult, I don't even mention other options, but
suggest she "go for the gusto" and get the Classic (with a double kit)
right away. The two pumps work on very different principles of physics
with real differences; these differences are not usually noticed except
in these moms, IMO.

At a conference inservice several years back, it seems that I recall an
excellent description of the piston-type pumps vs. the diaphragm-type
pumps (because of the rubber diaphragm inside which creates the
suction)(most everybody's little electric pumps are in this category).
Although Lactina hadn't come out at that time, IMHO, the Lactina "feels"
and "acts" more like a diaphragm-type pump in terms of its efficacy. The
Lactina works great in the short run to bring in a supply and also over
the long haul for the working mom whose baby, not the pump, is really
maintaining the supply.

The obnoxious NICU nurse needs a lesson in diplomacy and teamwork, but
unfortunately I'll have to agree with her. I have seen supply increase
rather nicely over about a week after minimal-to-no results *just* by
changing to a Classic. In fact, I would have switched mom to a Classic
double before starting Reglan. I would also investigate her fatigue,
nutrition, the pump routine itself (does she pump at different times and
frequencies every day, is she over-pumping with a dbl-kit or
underpumping with a single?) etc (see my posting on Low Supply- non-Rx
suggestions) before starting Reglan.

Incidentally, Dr. Marcovich's work on these super-premies in Vienna has
shown a relationship between supply and Kangaroo care - will the NICU
let mom provide several hours/day of Kangaroo care as part of the
therapeutic regime? That might work better than anything. BTW, the
Austrian NICUs don't provide comfy chairs for the parents any more than
ours do, so the parents brought in - catch this - beach chairs!! You
know the kind: wooden chaise-type with bright striped canvas "hammock"
type seats. Is this great or what?! Inexpensive, VERY comfortable, and
can be folded up behind the incubator when parents aren't visiting!

Anyway, I doubt the Classic is "2/3 greater suction power", but I
believe the *quality* is different. If suction power were all that
mattered, then the adapted gastric-suction machines would beat them all
hands down (let-down?), but we know how dangerous those pumps are to the
integrity of breast tissue. Medela, Egnell, and White River all have
excellent data on this from their Research & Development people. The
original pump (a piston-variety) was designed by a dairy farmer after
all, who started by measuring these very suction pressures in order to
help his wife with engorgement (he knew cows so..) The dairy industry
has fabulous data... that human babies should be so lucky... Anyway,
what can it hurt to try the Classic? Deal with the NICU nurse in another
way.