Becky, << Ok, cynical Jan B. :-) and others, if the hospital has no monetary incentive when giving out pumps, does everyone still think this is an awful thing to do? >> I struggle with this -- yes, giving out pumps (free) to all the bf moms which costs the hospital money & isn't making a profit for said hospital is a heck of a lot better than attempting to either (a) rent a lactina to all the moms before they go home, or (b) sell them a PIS. Or do either on the home visit. BUT, the question remains, do all moms need a pump to breastfeed? Is a manual pump the best for severe engorgement, or are they going to have to come back and rent a pump anyway? What message are we giving when we imply that you need more than a breast and a baby to breastfeed? I DO know that the nurses aren't going to teach hand expression -- do they teach the mom exactly how to use the pump and (particular peeve of mine) how to clean it prior to discharge? Does that information get lost in the myriad of other information that comes their way? I've had moms ask me about pumps less than 12 hours after the baby is born. My usual comment is "let's get the bf off to a good start first before we start adding mechanical thingys to the mix. If you need one later, call me." Yes, there are times and circumstances where a mom truly needs a pump (since most won't hand express). But what percentage of moms (in the US) is this? How many really need pumps for engorgement? Would I rather see a mom get a good pump for free from the hospital than a cute (?) diaper bag filled with formula? ABSOLUTELY! As for Barbara's comment about nurses/LCs/pump rental stations who are giving out their cards to the moms in the hospital to come and get a pump from them -- or the ones that have a captive audience in prenatal classes -- I think this is unethical. If anything is given out, it should be listing of ALL the rental stations in a 50 mile radius (or whatever is reasonable) so the mother has a choice. Jan