The pump is not a problem with BFHI…

It is more :

1. Is it needed really? Why not manual expression?

2. Was the pump given or bought at regular price?

3. Does it come with bottles and teats which means less breastfeeding because of nipple confusion and because we also know that the expression by the baby is better than the expression with a pump.

BFHI is to protect breastfeeding mothers and support the development of breastfeeding-friendly environments/policies/procedures. 

So the only question is why in the world do we need gadgets like pumps….unless for an infant who has difficulty to express enough milk from the breast for growth and development, and then I would prefer an electric pump and not a manual one. Manual pumps are not so easy; I would prefer to support a mother to express manually. It is faster and doesn't require any gadget and it is easier to clean hands than to clean pump during emergencies.

 But unfortunately, the actual tendency in some places is to pretend that breastfeeding at the breast is the same thing as giving expressed breastmilk by bottle… breastfeeding is much more than the content of milk, and especially in emergencies. It is safety and comfort for both mother and baby. 

To sum up my comment, BFHI is about mother and infant and less about gadgets which are usually coming from formula companies or other companies so…financial gains. Hand or electric pump are not needed most of the time and it is better and safer to support mother to hand express. BFHI and the Code are more about protecting the breastfeeding relationship and avoiding marketing gadgets.

Dear all,

Thank you for approaching this topic (Pandora Box) with such nuance and sensitivity. 

Indeed, encouraging and supporting exclusive breastfeeding is essential for the well-being of mothers and children. However, this should always be done with respect for each mother’s choice, considering her individual circumstances and professional situation.

Depending on the context, it is crucial at all times to promote exclusive breastfeeding, especially in cases where it is not a common practice, by informing mothers about its benefits for both themselves and their children. Of course, we may emphasize breastfeeding, but ultimately, it’s vital to respect their final decision and ensure they have all the necessary information to make an informed choice and act in cautious way.

Beyond this, it’s also important to provide support to mothers who choose to breastfeed but face multiple logistical or other constraints, by offering practical options to help them balance their professional lives with their choice to feed their baby with breast milk. This is where lactation counselors play an essential role in ensuring mothers are not left alone with this challenging decision. And yes manually should be the first step, but not always easy, to much time consuming and sometimes not working well sadly.

Using a manual breast pump, for instance, can play a key role in supporting exclusive breastfeeding, particularly for mothers who must return to work very soon after giving birth. Whether they work in manual jobs, offices, NGOs, or other fields, it’s essential to present safe and secure options for extracting and storing their milk if a need arises, for any reason.

The goal, in all cases for le, is to enable these mothers to continue providing their children with breast milk even in their absence. A breast pump can ease extraction, reduce the time needed, and help mothers manage their schedules with greater flexibility and encourage them to continue.

Moreover, the possibility for fathers or secondary caregivers to feed the baby with expressed breast milk in a cup, adapted to the child’s age, can increase their involvement in breastfeeding. 

Of course, adequate training / sensibilisation / shadowing is essential, especially regarding hygiene for storage,  cleaning equipment (pumps, bottles, cups) to ensure the child’s safety.

Rather than judging the tool or its usage, the goal should be for me to establish clear criteria for donation and usage, considering this solution as a potential complement to other breastfeeding support methods, and ensuring it is used in a thoughtful and regulated manner. 

Evaluating the risk-benefit of a donation for each individual  with strict and precise criteria, along with personalized support, is key.

The questions posed are an excellent starting point, and developing additional selection and donation criteria could further enhance support for mothers while honoring their personal choice in a safe and structured environment. 

All of this should be accompanied by guidance, avoiding the promotion of artificial milk, and provided under strict supervision manual breast pump or any support.

Best regards,

Chantal

Hello

The competencies of HCP IN BFH should  everywhere in all countries cover how to teach hand expression. 

This is linked to the following steps: 

2. Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding.

Key clinical practices

3. Discuss the importance and management of breastfeeding with pregnant women and their families. 

5. Support mothers to initiate and maintain breastfeeding and manage common difficulties.

9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers. 

Hand expression is available once learned  everywhere in all circumstances 

Breastfeeding at the breast allows microbiome exchange between mothers and babies and availability at the next feed of anti-infectious agents in breastmilk, produced by the mother.

Hand expression into a cup or bowl once learned can be practiced everywhere.  Hand expression needs no electricity and no complicated cleansing and sterilizing process followed by putting the different parts of the pump again together. In emergency setting hand expression and cup feeding is the best hygienic solution. 

BF hospitals are not opposed to mothers choosing pumps and many with NICUs have hospital grade pumps for mothers to use as long as needed. See also the reply of Louise Dumas above.