The finding that all of the mothers in a study were pumping is indeed unusual, at least to anyone who lives outside the US.  It seems that pump mania has hit the US big time. Many other developed countries are just not so enamoured of this technological fix, and many women find it just too awkward.  However it is likely to increase and certainly the pervading atmosphere that seems to emanate strongly from the US, that this is some how an "essential" part of breastfeeding will impact elsewhere too.

Beware of cultural imperialism. There are many ways of doing things and the variety around the world is quite amazing.

Mary E Black 
MB BCh BAO FAFPHM MFPHM MRCP(UK) MPH DTM&H DObst DCH
University of Queensland, Cairns, Australia

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