I had a mother tell me today that she gets more, and more easily, hand
expressing (she seems to have taught herself) than with a pump.  This is
*not* a region where hand expression is considered standard at all.  She
said it at first in almost the tone people use when they "confess" to
sleeping with the baby -- as if she wanted me to understand she knows she
is really "supposed" to pump.  Once I showed my acceptance and interest she
told a story of a time when she'd just gotten her first child to take the
occasional bottle of her milk at 3-4 months old, just before they took a
long overnight car trip, 16 hours or more.  She would pop a bottle in the
warmer she'd brought, give it to the baby, and while the baby drank that,
mom would express another 4 oz into a fresh bottle and stash it in the
cooler, to come out in another 3-4 hours.

Is teaching hand expression considered part of the BFHI in some
areas?  Teaching mothers how to maintain lactation even if separated from
their babies is, but it can be done with pumps.  (Which are free from WIC
here, and at-cost from the hospital.)

Elise

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