In regard to hand expressing, a study was published in the May 2001 JHL,
entitled, Randomized Study Comparing the Efficacy of a Novel Manual
Pump....in Mothers of Term Infants. This study quoted earlier studies by
Garza et al (1982) that found significantly lower milk volumes and a 25%
lower fat content from hand expression compared to electric automatic
pumps. Also Zinamin et al (1992) compared hormonal response to
breastfeeding, hand expression and expression using 3 different pumps. The
electric pump most closely reproduced prolactin responses seen during a
normal breastfeeding session as well as higher volumes of milk than in hand
expression.

This is very significant information for any mother, most of all to a
mother with a baby in the NICU. These babies need the volume as well as
similar fat content that normal breastfeeding would cause. Our mothers who
pump need to appproximate the hormonal situation of normal breastfeeding as
closely as possible as well. In light of this data, I can't suggest hand
expression for my clients in any but the most extreme situations.

A low tech solution, in this situation, may not always be in the best
interest of our clients.

Mary Jozwiak IBCLC, LLLL, AAPL
Private Practice

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