Several good comments have been made on this issue. Yes, we must not lose sight of the value of hand expression before it bocomes a "lost art". I believe it is still the pirmary means of expression in much of the world. In our industrialized countries, we tend to over rely on mechanical/technological solutions when more natural ones may be as good if not better. On the other hand, this is a lot easier for some moms than others. Some are able to express as quickly if not more so than a pump, while for others it is a real struggle to get an adequate amount out. The question often arises-Doesn't the "poorer" mom deserve the same kind of help as her more fortunate sister. Yes, in some families they will spend what to some of us is an extrordinary amount on the fanciest cribs etc, but balk at the cost of an effective breast pump. I'm talking about the mom who truly has to stretch every penny as far as it will go. An option I haven't seen mentioned in this current thread (although I am a couple digests behind) is the pedal pump. The Medela one at cost is just a little over $25. (I know there is at least one other one available that claims to work on any piston type pump setup, but I haven't heard how well it works.) These can be loaned to moms-should be no concern about contamination-or "rented" for a $25 deposit that is returned when the pump is returned. That way, the agency or hospital or whatever is only "out" the small difference over $25. Or you could charge $30 deposit and the cost is covered it the pump isn't returned. In the case of a NICU, if baby goes home completely breastfed, the pump comes back when the baby goes home. I know one WIC clinic did this a few years back and found it to be a very viable alternative. Winnie *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html