I would be interested in hearing from some of you in other parts of the
world who are working with moms who do not have ready access to breast
pumps.  I am of the understanding that in many areas of the world, pumps
are not widely available and that most moms hand express for their NICU
babies and that this practice is accepted as the norm and that the majority
of moms do quite well in bringing in and keeping in adequate milk for their
babies.  Of course, the use of Kangaroo care instead of incubators, I am
quite sure, also helps with milk production.
I am a huge fan of hand expression.  Fortunately, I was never in a NICU
situation with any of my 3 children, but I did exclusively hand express for
each of my babies when I returned to work full-time and I think, when done
correctly, is more efficient than any pump currently on the market.
Instead of plastic on the body and a machine that makes noise, there is wet
skin-to-skin contact, just as there is when a baby's mouth is on the
breast, creating a much more normal, natural thought process for the mother.

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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