Is there clinical documentation that a PIS is not working as well?  From one who has personally used PIS, PY, the older Medella hospital grade, the Ameda hospital grade and the Symphony, I have to say, my best results came from a PIS.  Secondly, this is what was recomended for the years I was intensly involved in relactation and adoptive breastfeeding.  If it was not a pump that could do the job, then the hundreds of women we worked with would not have gained a significant supply. I realize that PJ Limerick is what is recommended mostly now, however, for years these pumps were sufficient and suddenly we are pushing that they are not good enough?  As one who has plenty of anectdotal evidence that they are indeed fine, when used properly, I can not get behind this thought process until I see bonified clinical evidence pointing the other way. 
 
Susan Smallwood current nursing student former lactation educator for pregnancy.org and one of the originals to use the protocols as outlined by Lenore Goldfarb (who, gave me that push to take all those lactation classes way back when)

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