Dear Valerie,

Using equipment is not an "either/or" situation.  I teach all of my moms how to hand express - both in my classes and in my consults.  I believe very strongly that it is a very basic technique and in many women, including myself, is a most efficient and easy way to get milk out of the breast.  That said, there are some women who cannot hand express.  Case in point, a friend of mine, longtime LLLL and mother to three breastfed sons who was unable, in spite of many tries, to ever express milk from her breasts.  Other moms just don't like doing it.  Some moms find pumping to be quicker, and in some situations that is very important.  I always strongly encourage my pumping moms to include hand expression in their routine, even if they are unable to produce much milk in doing so.  Hand expression in the beginning can help stimulate the MER and at the end it can extract milk still lingering in some parts of the breast.

Yes, some of it is a fascination with technology.  I love to ride horses, but I don't long to join the Amish in their buggies for all my transportation needs.  I hate to repeat this, as it has been said so many other times by those more eloquent than myself, but many of us see mostly trainwrecks anymore.  Why there are so many wrecks is a whole different discussion, but I feel obligated to use anything I can get my hands on that I think may help a baby to stay at or get back to the breast.  This is almost always in addition to a lot of skin-to-skin contact between mother and baby.  Again, one does not preclude the other.  If there are LCs out there who are helping moms in these situations by simply putting suggesting hand expression and putting baby to breast, more power to them.  Their skills are obviously superior to mine and many others in this field.

Well, I am late for a fireworks display at the Sauerkraut Festival, so that is all for now.  I hope that we can all work together to share knowledge and support each other as we strive to help our moms and babies endure as happy and healthy breastfeeding dyads.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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