I agree with Kathy Dettwyler in regard to engorgement and use of a
breast pump.  Engorgement is not normal.  It is related to either
hospital policies and practices that separate mother and baby or to the
mother's lack of knowledge of breastfeeding. I can speak from personal
experience.  I never was engorged with my last two babies.  They were
born at home and nursed freguently.  Breast pumps are an intervention
that can back fire on the mother.  I have had mothers have an
over-supply problem that I believe was directly related to the use of a
breast pump.  I have seen women quit breastfeeding because they pumped
and very little milk was expressed--which maybe perfectly normal early
postpartum. Or the pump damaged their nipples or caused their milk to be
bloody.  End result, mom quits or adds another problem unto the original
problem.  Have any of you seen the article about using an sns for
engorgement?  I am sorry but I believe that"takes the cake." Are we
going to make routine breastfeeding problems that are readily resolved
by teaching simple practices into medical problems that require
expensive and cumbersome devices? Valerie W. McClain, IBCLC

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