I am responding to 3 posts at the same time--hope you don't mind.  It's kind
of a general all-purpose response to the posts by Sharon, Maureen, and Marian.

Sharon, I absolutely agree that using equipment is not an "either/or"
situation.  I also recognize that some moms have enormous difficulties
learning hand expression but there are also some moms who can have a hospital
grade pump and get barely any milk.  We need LC's who work well with the
technology and we need LC's like myself--I hope--who see things a little
differently.  The technology can be a blessing and it can be a curse.  It can
keep a milk supply going during long separations but what happens when the
mom and baby finally get together?  I see alot of difficulties with mothers
who finally get the premie baby home and try to wean from the pump to
breastfeeding.

Marian, The modern dairy farmer recognizes the efficiency and the limitations
of pump technology.  The reason machines are used is because there is a herd
of animals to be milked not one, hundreds.  So machinery is efficient.  Yet
despite that need for efficiency, they have still found that hand milking
each animal before using the pump increases production.  So it is worth their
time to use their hands.

One might assume that I only suggest hand expression to mothers of premies
and that would be absolutely incorrect.  I do suggest for those who have to
pump for long term that they "at times" use hand expression because our
bodies respond better to skin contact.  If the mother is interested in
learning the technique, I teach it.  I do believe that hand expression is
often not taught or taught incorrectly.

Maureen, I do not think mothers who use breast pumps are second-rate mothers.
 (I don't even think mothers who use infant formula are second-rate mothers)
Hand expression does not work for some mothers but breast pumps don't work
for some mothers either.  So in essence we work with what works for the
mother.  But one should not disregard the use of hand expression just because
one perceives it to be unrealistic.  It can be an important complement to the
electric breast pump and for some mothers its the only thing that works well.

Sharon mentions, "Why there are so many wrecks [trainwrecks in breastfeeding]
is a whole different discussion."  I actually don't think this is a whole
different discussion.  In fact I think these discussions are one and the
same.  A recent post mentioned that in their hospital that 60% of their
mothers with full term babies could not get their babies to latch.  I nearly
fell of my chair.  We have an enormous problem if 60% of healthy full-term
babies are not latching on and breastfeeeding.   And this is with all our
state of the art equipment.  Maybe we do need to think about the Amish Life...
Valerie W. McClain, IBCLC




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