> The research of Peter Hartmann's PhD students has kept us all on our toes
> and constantly thinking about how to apply their research to our practice,
> and how our practical experience is reflected in their research.
Yes indeed- fascinating  though I often have to read things 3 or 4 times
before I feel like I have even a little of a handle on it.

Have you
> read the research of Donna Ramsay

Haven't read but have seen Peter present some of it.

> I guess in your case you could ask whether you were able to stimulate as
> many MERs as the pump did;  or maybe whether you were able to get as much
> milk out by hand expressing in the time that it is available for removal.

The thing was that I did maintain the same level of milk removal it was just
that it got more difficult to get out over a period of a week or so. It
wasn't that it was immediately more difficult, it wasn't. I didn't have any
trouble initially and actually packed away the pump but slowly it got more
difficult. Hand expressing was actually quicker than pumping for me.

> I have great faith in hand expressing.   Our mothers would all hand
express 3-hourly
> around the clock and provide all the milk their babies needed.

I think that what I describe could quite likely be related to the fact that
I was relactating and may not have a wider significance (though the
conversation comparing pumps did seem to be alluding to what might be a
similar phenomenon). I was actually quite chuffed that I taught myself how
to hand express (hadn't been taught with my first child) and had my
technique checked out by a couple of friends (Hi Di!). I too think that it
is a skill that women should be encouraged to develop before they think
about pumping. Just the fact that they become more familiar with their
breasts through (shock horror!) touching them is significant. Anyway, I
wonder had I switched to hand expressing later whether my milk supply would
have been more established and whether this would have made a difference? On
the basis of my experience I would suggest to women who were
relactating/inducing lactation to use hand expressing to remove small
quantities of milk but also to use a double breast pump.

Karleen Gribble
Australia

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