I always at least touch on the basics of hand expression and tell
moms that even if they use a pump, it's helpful to do a little by
hand first to get the milk flowing.  They also need to do some
skin-to-skin nipple stimulation before applying a pump flange or
even nipple shield.  Any artificial barrier between baby's mouth and
the breast or any artificial substance against the breast just can't
give the same stimulation as baby's mouth does.
I like to encourage hand expression over a pump if mom needs to
soften the breasts a bit before latching when the milk volume first
"kicks in".  This isn't the time to express primarily for the
purpose of stockpiling milk for later use, although whatever she
expresses can certainly be saved for later use.  With a pump she may
tend to pump longer than needed for softening and that can lead to
it taking a little longer for the breasts to "figure out" how much
they are supposed to be making.

On a related topic-I firmly believe that everything that our bodies
do has a purpose.  If so, then what is the purpose of the swelling
that accompanies the initial increase in milk production?  I observe
that every mother has at least a little swelling.  In most cases it
doesn't seem to interfere other that giving her some concern when it
goes away and she feels a little softer.  In other cases it can be a
major factor in baby having trouble latching/maintaining latch until
it is resolved.  So other than "making a pest of itself" for those
few days, does it serve any useful function?  If so what?

Winnie

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