My MLCA friend, Cindy Turner-Maffei [Hi, Cindy! I miss
seeing you!] lamented:

"It sounds as if pumping may have become the second line
of treatment after application of hot/cold for many
practitioners.  Why is this--where is the baby in the midst of
all this treatment?"

To which I reply: AIN'T IT THE TRUTH!?!

Pump marketing has been as subtle and effective as formula
marketing. I see pumps listed on layette lists in magazines
aimed at pregnant women. Most of the prenatal patients I
see ask me about which pump they should have on hand
before the baby arrives :-0

Patients who call me about engorgement often tell me their
doctor, or a hospital nurse, or a friend, told them to get a
pump. (I hear the same thing from women with mastitis, who
get the impression from their HCPs that they should pump
after the baby nurses on the mastitic breast -- lest a drop
remain in the breast?).

I've always had positive results by treating engorgement with
cryotherapy and massage/hand expression. Even when a
woman can't express any milk she can usually massage to
the point where the tissue is "soft" enough that baby can
latch. My message to women is "get the baby to help you."

Now, I KNOW there are times women need pumps in the
early days. However, for most women, in most engorgement
situations, IMO it sends the wrong message when we tell
them they need technology to conquer a bump on the
breastfeeding road. I try to find ways to bring new moms to
see the baby as a solver of breastfeeding issues ("Let the
baby be the Captain.")

Some women later admit their partners stepped up to the
plate to help with engorgement...but that is another subtopic
;->

Technology is seductive. Be strong. Resistance is not
useless.

Margery Wilson, IBCLC
(Not really a Luddite)
in freeeeezing Cambridge, Massachusetts
Happy 1999 to all!