I realize this is a late posting on the pump thread, but nobody has
mentioned this, so I thought I would.

I'm a pediatrician that sees newborns at a community hospital. I ask that
all my breastfeeding moms be given a  hand pump [we use the medela] and
shown how it works before leaving. Why? Lots of reasons. Many moms are d/c'd
after about 36 - 48 hours and we follow up a day or two or three after that.
Often times mom's milk "comes in" and there are transient latch problems.
Ideally, the baby would be nursing frequently and effectively enough that
mom wouldn't get very engorged, or if she did she could simply hand express
to soften the breast for a chance at a good latch.

Well, the reality of the situation is that our LC is only there 3 days a
week.  The nursing staff - when it's not somebody that been floated from
who-knows-where is not that skilled in teaching in teaching hand expression.
I don't have the time to do much "hands on" teaching of moms during hospital
rounds and like any skill, some people learn it quickly and others don't.

We see a lot of sleepy 36-37 weekers that just don't "have what it takes" to
do the whole job themselves.

The pump is covered if given while in the hospital. Many of my patients
don't have the $ to purchase one afterwards. I have had a number of women
get sore/damaged nipples and little or no milk from the "buy off the shelf /
high brand recognition" pumps as well. Those pumps do emotional damage as
well as physical. As soon a mom thinks she's got no milk it's a losing
battle. Not to mention that a lot of the crises happen at 11 pm when you
can't get anything but one of those awful pumps from the 24 hour store.

So those are my reasons for trying to send a pump home with every
breastfeeding mom. It may be encouraging "pump dependence" but if they run
into trouble later at least they'll have a way to get themselves out of it,
rather than to give up and give formula as many of them do despite being
told to call the office for help. Our hospitals still give out formula packs
[for now] so without the pump it seems to them like that's the only
solution.

I see the pumps the same as the jack and spare tire in my car. I know how to
use it, hope I don't have to, but I'm more comfortable knowing it's there if
I need it.

Gail S. Hertz, MD, IBCLC
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