Hi, I'm Christine Raasch, RN, BSN, IBCLC, CLE working in a community hospital with approximately 1000 births per year and new to the LACTNET. I've been on the Lactnet about 10 days. The question about breast pumps at discharge has prompted me to add my thoughts. At our hospital we used to give most moms the double pump kit at discharge. We discontinued that practice over one year ago because of cost. Now it's only given to mothers whose infants aren't nursing and we can document need for insurers. It also justifies the cost. What we do is give mothers a sheet of breast pump recommendations that I compiled because our staff wanted a reference sheet, which is based on what we have in our pharmacy. I know, conflict of interest, except that I tell them what other area stores carry them. We have a case management program in place so that when I'm not on, the other case managers and the staff, instruct the mothers on options. I do tell them to become comfortable with hand expression since they would find that helpful with engorgement, should it occur. But we are a society of "convenience" and speed and efficiency, so don't hold out much for them in trying to learn "how to" when their baby is screaming, their breasts are sore and possibly leaking and their bottom doesn't feel much better. This is where I think I lose moms, so I'll go the route of convenience and hope they don't go to the cheaper model. We are also a rental station and have been one for years so that we didn't have to send a mom to "another place" at the time of discharge which helped us provide a continuum of care. It's working out well and primarily used by moms who are struggling with breastfeeding. It doesn't even begin to cover my salary but the patients appreciate the convenience and the personal service. Chris Raasch, RN, IBCLC <[log in to unmask]>