Back again and now I have some questions for you all:

There are various researchers studying alternatives to formula for  moms
who are HIV+.  People much more knowledgeable than I are studying viral
loads, ways of testing milk, then alternatives of treatment to milk moms
have expressed.

One question that was just brought up was if we have any studies on how
much milk a mom can hand express, how long can she keep this up, etc... 
There have been concerns that the research would not be very useful if it
is impossible for moms to keep up hand expression for extended (weeks,
months) periods of time.  There is very little possibility of providing
good pumps to the populations we are talking about throughout the world.

My experience in hand expression is very limited.  In fact, I commented
that  in the various videos I have seen lately - the one from Norway and
ones from Chile and UNICEF - that moms stimulate the nipples in a way which
would, in many of our US-culture women, be considered x-rated.  My question
is whether I may not be teaching correct hand expression due to  discomfort
with women touching their own breasts, nipples, etc.

So - do any of you have any comments on this - and any logs which would
show something like:
        day 1 - hand expression - 8 am  30cc
                                                                       10
am  20 cc
         etc, etc,

Jeanette Panchula, BSW, LLLL, IBCLC, RN
Vacaville, CA 
Glad to be here where there is running water and electricity - but very
much feeling like I abandoned my friends and family when they needed me
most - after Hurricane Georges.

I will be no mail  again due to travel to Michigan to help my father-in-law
after a complicated heart surgery - so please answer me directly as well as
to the list:

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