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Saturday
Mar122011

Not all breast pumps are made equal (OUCH!)

When I was pregnant with my first baby, I remember picking out items for the baby registry and purchasing things we wanted to have before he arrived. Most things were easy to pick out. However, there were a few items that I felt uneasy about choosing. In particular, the two things that I found most difficult to choose were a stroller (we didn't end up buying one until after he was born) and a breast pump. None of the strollers seemed to meet all of our requirements and I didn't want to spend that kind of money on something that wasn't just right. When it came to a breast pump, they all looked scary and although I knew there were probably things I should consider when choosing one, I didn't know where to go to get good information or to understand what was important and what was marketing fluff.

Since then, I've learned a lot about pumps. I had to exclusively pump for a while, I pumped at work for about 18 months, I moderated a pumping and relactating forum, and I've blogged about pumps, including reviewing breast pumps and looking at issues with breast pumps and breast pump companies. Through that experience, I've realized how important for moms to get good information on pumps rather than trying to decide which breast pump to buy based on potentially misleading information provided by manufacturers or others endorsing products on their behalf. That is why I'm sharing this story with you.

Playtex "Nursing Necessities" Pump Tears Skin Off Mom's Nipple


In 2009, Kristen Brunton purchased a Playtex "Nursing Necessities" Petite Double Electric breast pump from Babies R' Us. She had considered a number of different pumps, but chose this one because it was affordable and because it was advertised as "creating minimal tugging and stretching."

According to Kristen, she read the instructions carefully before using the pump and did use it successfully about three times on the lowest suction setting. The next time she used it, things didn't go as smoothly. Once she was finished pumping, she broke the seal between the cup and her skin and then removed the silicon cup from her breast. As she attempted to remove it, the cup stuck to her breast and tore a layer of skin off of her nipple and areola as she pulled it away.

The tear in her skin created a "painful open area of raw skin" that started "oozing and bleeding" (picture here). Kristen tried to nurse her son later, but was unable to because of the extraordinary pain resulting from the open wound.  Because she couldn't nurse, pump or hand express on that side, her breast got engorged which exacerbated the pain as her skin tightened and stretched. Kristen ended up working with her midwife to care for the wounded breast, but she went through several weeks of excruciating pain that radiated through her whole breast and suffered a significant amount of stress.

Although she was eventually able to nurse her son again on that breast several weeks later, Kristen did have to supplement with formula for a while. More than one year later, she still experiences loss of  sensation in the injured nipple.

The Lawsuit: Playtex, Dr. Sears, Babies R' Us


Kristen is now suing Playtex, as well as Dr. Sears (as an apparent consulting doctor on the pump) and Babies R' Us (the retailer), for failing to adequately ensure the product's safety before putting it on the market. Kristen, who is represented by attorney Brent Lampiasi, is seeking "damages in excess of $25,000 for physical and mental anguish" and is "asking for a court order forcing the defendants to adequately warn future consumers of the product’s potential dangers."

According to Mr. Lampiasi, one of the safety issues relates to clinical trials (or the lack thereof). In its pre-market notification to the FDA, Playtex said that it did not conduct clinical trials for the product. However, on its website, Playtex talks about benefits of the pump (in particular the Soft Comfort(R) massage and suction cups) that were "clinically" proven. Lampiasi questions not only whether these claims were clinically proven, but also whether the cups truly are beneficial. Playtex claims that 77% of moms need a wider nipple opening (like the one provided by its pump), but Lampiasi asks "What about the other 23% of women who allegedly need a smaller nipple opening? Is the product safe for them?"

I was intrigued by the inclusion of Dr. Sears in the lawsuit. I knew that he endorsed a pump, but couldn't remember which one. When I checked the Dr. Sears website, it said that he endorses the Playtex Embrace pump (which is no longer being marketed on the Playtex website). Dr. Sears is, however, profiled on Playtex's website as one of its consulting doctors. So, the extent to which he was involved in the design and endorsement of the pump that injured Kristen appears to be unclear at this point in time. However, I'm sure it will be clarified through the lawsuit.

What pump should moms buy?


If you are a mom who is planning to buy breast pump, do your research. A bad pump can do a lot of damage.

If you are buying a double-electric pump, I would recommend looking  at a Hygeia pump. It is a a high quality, BPA-free, closed system (most hygienic), double electric pump from a company that supports breastfeeding and complies with the WHO Code. You can read a review of the Hygeia pump on the Motherwear blog.  I don't think the Hygeia is available yet in Canada, so would probably recommend an Ameda Purely Yours for Canadians. As a hand-pump, for moms who do not need to pump on a regular basis, I did like my Medela Harmony (however, Medela does not comply with the WHO Code).

If you are unsure about which pump to buy, talk to an International Board Certified Lactation Consultant (IBCLC) or you can opt to initially rent a hospital grade pump if needed (find out in advance of your baby's arrival where you can get one and how much it will cost). Having a bad pump risk your ability to breastfeed your baby because it either injures you or compromises your milk supply is simply not worth it.
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Reader Comments (46)

I'm a stay-at-mom and decided to purchase a hand pump to express an occasional bottle of milk for my son. In the fall of 2008, the Avent Isis was still made with plastic containing BPA. I opted for the Medela Harmony pump. I wasn't impressed with it: the membrane in it seemed to need frequent replacing despite the fact that I was not pumping frequently. It also took quite a while to pump enough milk out for a bottle. When Avent released a BPA-free version of the Isis, I decided to purchase it. I've been very pleased with it and am currently using it as I recently had my second child. I recommend it whole-heartedly over the Medela Harmony for moms that want a hand pump.

March 12, 2011 | Unregistered CommenterAllison

I used a hospital grade Medela Symphony to exclusively pump for my daughter who refused to latch after months of failed attempts. I also had the same problem with the Medela pump tearing skin from my breast. I looked at the picture posted by Kristen and my injuy was a lot worse so I can feel her pain. But I persevered and continued to pump and dealt w/ mastitis/infections/broken skin, etc. I learned through a suggestion on my EPing support group to apply a small amount of olive oil to the flange prior to pumping...the lanolin was great for soothing the breast after pumping but too thick for the proper motions during pumping and not using any sort of lubricant tore the skin apart!. But I am happy to report I am successfully nursing my son who is going to turn 11 months son and shows no signs of slowing down!

March 12, 2011 | Unregistered CommenterRachel C

I agree that not all pumps are made equal and a lot of the problems I encountered came because the breast sheild are not large enough for my nipples. The fact that I could not get a pump, even a hospital grade pump, that fit EXCEPT a Medela makes me question wheather the pump in the lawsuit actually fit Kristen? As much as breastfeeding and pumping are encouraged, most breastfeeding activists never mention that you may have problems with the fit. It seems to me that big breasted women are expected not to breastfeed their children for any length of time given the difficulty in finding any breastfeeding accessories. I just recently stopped breastfeeding my 2.5 year old and I still have not found anywhere in North America that sells a nursing bra that is big enough.

March 12, 2011 | Unregistered CommenterGwen

I have a hygeia pump. It's great except the parts are a little difficult to clean. Maybe that's true of all pumps?

March 12, 2011 | Unregistered CommenterLisa

Lisa:

How are they difficult to clean?

I know with my Medela, I just rinsed the parts with water between pumping sessions at work and then threw them in the dishwasher at home at night.

March 12, 2011 | Unregistered Commenterphdinparenting

I've been scared to throw them in the dishwasher but maybe that's what I should do. Even with the dishwasher, I find that things don't get 100% clean, especially the bottle nipples.

March 12, 2011 | Unregistered CommenterLisa

One other idea to keep in mind is to learn how to hand express effectively. Whether it's to complement pumping or to express enough for the occasional bottle, hand expression is a valuable technique to learn.

As an aside, I'm totally cringing at the mental image of the damage done to Kristen's nipple. Ouch!

March 12, 2011 | Unregistered CommenterKim

I used the Ameda Purely Yours with both my children, and anticipate using it with my 3rd. I worked fulltime and loved its small profile and efficiency. By using tandem pumping techniques and an extra weekend pump session, I was able to provide plenty of milk for my sons.

After the concerns about BPA were raised, I threw out the original collecting bottles that came with the pump. I'll be purchasing new tubing and Ameda's BPA-free bottles in time for the new little one.

Ameda is a less well-known brand, but I have really loved their product.

March 12, 2011 | Unregistered CommenterCarina

Kristen recently tried the Hygeia for Cool Mom Picks and loved it. High praise from a woman on her fourth kid who's tried a LOT of pumps. I was just fine with a Medela pump in style myself. Gotta be honest though, hand pumps made me miserable. They were fine in a pinch but...yeah. Pinch. Exactly.

March 12, 2011 | Unregistered Commentermom101

I apply olive oil to my plastic horns before pumping, too! I feel so sorry for any Mom who was injured by her pump.

March 12, 2011 | Unregistered CommenterAlina

I totally agree on the question of fit... while overcoming nursing difficulties with my 3rd child, I worked with a top-notch IBCLC. She specialized in preemies and getting babies back to the breast as well as supporting pumping Moms. She actually created her own handout complete with photos to demonstrate what a correct fit and feel should be for a pumping Mom. I was really impressed with her handout. Turns out the size I used while pumping for my first 2 childrens was not optimal for me and that my breasts actually require two different sizes for best fit.

March 12, 2011 | Unregistered CommenterAlina

timely post! i'm contemplating pumps now. after reading about mold problems with medleas that have been in storage (as mine has), i'm hesitant to use it for baby number 2 due next month.

March 12, 2011 | Unregistered CommenterSara

It's really a shame that you can't try before you buy! I had two pumps when my daughter was little - an Avent Isis, and then I bought a Medela Pump in Style for going back to work when she was 6 months.

It turned out that the Isis worked better for me in terms of actual milk expression - I could pump 8+oz at a sitting with the Isis, so it turned out I took that to work instead of the PiS. But it really did pinch! They're too expensive for mums to buy a bunch of different ones - perhaps LCs could keep some on-hand for trying? But even then, how many mothers would know about or use that service?

March 12, 2011 | Unregistered CommenterJuliette

I find a lot of people use Medela simply because they contract with hospitals and WIC to sell their (good quality) pumps to them for decent prices - in return, hospitals can allow them to be used over and over (like with the multi-user) or given away (the WIC I work at gives away tons of Harmonys and Pump in Styles for free to moms. Kinda hard to care about WHO code violation when you're low income and being handed something you can't otherwise afford.) From what I understand, no other pump company has offered such generous deals to WIC - and I remember reading literature suggesting that they had looked into it more than once.

I think knowing how to use a pump is key, and unless you're working with someone like an IBCLC, most moms are flying blind there. :/ Not that I'm saying that was Kristen's deal at all, mind you.

And, Juliette, that idea has been tossed around before, but many pumps are one user only, and even the ones that are rated multi-user would require new kits every time to protect the women - financially, I can't see that being feasible.

March 12, 2011 | Unregistered CommenterStar

I loved the symphony and purchased a medela pump in style and was very disappointed with the quality of these pumps. My first one switched randomly between the stimulation and let down modes while I was pumping and there was no way to stop it. After they replaced that pump the next one started skipping a beat while pumping at almost a year old. I pumped a lot due to a horrendous oversupply issue in the beginning which choked my baby and then later at work for 11 months. I've heard such good things about the ameda I wish I had gone with that one.

March 12, 2011 | Unregistered CommenterNepsi

[...] Not all breast pumps are made equal (OUCH!) [...]

March 12, 2011 | Unregistered CommenterSunday Surf 3/13

Wow. I had a Pigeon electric and used to joke that it only had two settings...useless or rip-your-nipple-off. I didn't realise that there actually was the potential for that to happen! I bought it before I had my bub and figured that they would all be much of a muchness. Yeah, how wrong was I. It went to it's rightful place after 3 attempts of use - into the bin.

http://www.productreview.com.au/p/pigeon-battery-electric.html
Some awful reviews for a similar product to the one I had. Makes you wonder how widespread the issue is for women getting damage. This will make an interesting lawsuit and hopefully raise standards.

In absolute desperation I went up to the shops and grabbed the highest rated pump on a review site I googled 5 minutes previously - an Avent Electric. Best $190 (AUD) I have spent in a long time. Only used it about 10 times but it got me through those crucial moments in the early days and gave my nipples a chance to heal.

March 13, 2011 | Unregistered CommenterAnna

I used a hospital grade Medela pump briefly after Elizabeth was born. It was quite possibly the most helpful thing I can point to for learning how to nurse. Everyone kept saying that my baby's latch was "fine" and everything was "perfect" but clearly something wasn't right. After getting an idea of what it was 'supposed' to feel like with the pump I had a MUCH easier time. So I'm a big fan of these. But it makes sense to me that not all pumps are equal and that fit is probably way more important than mist people who are selling or renting them realize!

March 13, 2011 | Unregistered CommenterMary @ Parenthood

Mary @ Parenthood:

My pump was a big help to me in so many ways. However, I wouldn't say that it compared at all with the way that it felt when my baby was latched on. I found the sensations to be significantly different.

March 13, 2011 | Unregistered Commenterphdinparenting

I bought the Ameda Purely Yours and didn't have any problems with it. I used it for 11 months while pumping at work and it's still in good condition. The only thing I didn't like what how loud it is, but I don't know if other pumps are any quieter.

March 14, 2011 | Unregistered CommenterOlivia

That's interesting because when I clicked on the hygea site they mentioned providing pumps for WIC. But maybe they aren't offered as much as the Medala? I don't have experience with this so I don't know for sure.

I wish I had know about WIC offering pumps before I gave birth. I had no idea I even qualified for WIC until I was in the hospital after giving birth and had already purchased a pump. Oh well, I think I got a good pump anyway.

March 14, 2011 | Unregistered CommenterOlivia

I LOVE my Ameda Purely Yours pump - love it! But have also heard great things about the Hygeia pump -- wonder when/if they are coming into Canada.

Surprised you didn't mention the medela pump in style, thought that was well used - it has worked well for me. But I hadn't heard of the Hygea. I got the PiS in 2006 and it's worked very well for me. I went back to work when kid#1 was 7.5 months old and I used it to pump at 2-3 x at work for about 13 months, and used it to pump around the clock for business trips of up to a week during that time to maintain my supply. I went back to work when kid#2 was 12.5 months old and I used it to pump 2-3 times a day for about 6 months. I am about to have bub #3 and hope that it will still be in good shape when I go back to work after my maternity leave in May 2012. I did get some blood in the milk shortly after I started, but quickly resolved with a moving up in flange size. I really don't like pumping, I do it hands free so I can distract myself with doing something else and forget how much I dislike it, but it's a tool to get me where I want to go, which is breastmillk only for my kids, working full time and travelling. I have great respect for moms who persevere through so much and who exclusively pump, seriously it's amazing!

Great post on pumps, but one thing I would add is that pumps are not a necessity for every woman. I think they are becoming a bit normalised, where many pregnant moms buy one before their baby is born, with the expectation that it is needed. Yes, in many cases it makes the difference between full breastfeeding and not, but in others I have wondered if it is being used as simply another way to sell moms more stuff that for the most part you don't really need. I think pumps are second best, best left to when you do need the extra help (illnesses, working schedules, trips away, etc.) and many moms don't need it, or at least not all the time to warrant a pump. In some cases, better support and baby-led feeding could do the trick rather than pumping. And so, it should be rented/purchased when you do need it. After all, these things are expensive! and not as good as a baby is in getting the milk out.

March 14, 2011 | Unregistered CommenterCarla

Carla:

I didn't mention the Medela Pump in Style for 2 reasons:

1) It is an open-system pump, which means that moisture, bacteria, etc. can get into the pump.
2) Medela violates the WHO Code with the way that it promotes bottles. If there was another quality hand-pump from a company that wasn't also a code violator, I wouldn't have mentioned it as a recommended hand pump either.

March 14, 2011 | Unregistered Commenterphdinparenting

That poor mama! I can't even imagine. :(

All breast pumps look kinda scary & uncomfortable to me though-I'm definitely a straight-from-the-tap kind of mom!

March 14, 2011 | Unregistered CommenterMaman A Droit

I found J cups from Motherwear.com & they had bigger sizes too I think. Or is it the band size that's the problem?

March 14, 2011 | Unregistered CommenterMaman A Droit

It is usually a combination of the 2. I am regularily a 38 J. There is nothing in Vancouver that fits as a nursing bra. Anything that has come even close is usually a torture device. Since I am finished nursing and I am not planning on a 3rd child it isn't as big a deal for me, but in general it is very difficult to find nursing clothes and accessories for bigger breasted women.

March 14, 2011 | Unregistered CommenterGwen

We have done an exchange program for the dreaded bicycle horn pumps which are regularly reimbursed by Medicare. In less than a year we have collected over a 100 and have gotten at one pharmacy to stop purchasing them.

March 14, 2011 | Unregistered CommenterLea

Hi,
I have used and tried a lot of pumps, as I have three kids, and always have problems with getting the milk flowing the first weeks after birth. I have used hospital pumps, Avent, different Medela ones, and borrowed others from friends. Besides the professional one at the hospital, I rented one from the national breastfeeding association that I was very content with. But as these were incredibly expensive, I tested several cheaper ones, but they were incredibly time-consuming, and I ended up buying a Medela electric one that can be used for one or two breasts at a time. I got the portable one that comes in a backpack. As the extraction was way more efficient, and way less time-consuming when I used the dual extraction set, I hardly ever used it for one breast at a time. The lactation reflex is so easily triggered when both breasts are milked at the same time. This came in super-handy when I started working when my youngest was 3 months, as I think I could never have breastfed her for a year without this efficient pump. I washed the parts in the dishwasher after rinsing, then popped them in a sterilising basked for the microwave, and put the airtight basket right in my pump backpack. The full bottles were placed in the backpack thermo container in the fridge at work, the container was transferred to the backpack as I went home. Easy-cheesy!

March 15, 2011 | Unregistered CommenterKristin

I have an Ameda Purely Yours and it's worked great for us. I like that it's a closed system. I need to get new membranes for after this babe is born, I think. I'm not planning on having to pump much for this upcoming little one, but I'm hoping to do one pumping session a day once bf is established so I can donate.

March 15, 2011 | Unregistered CommenterLindsay

For those looking for recs and opinions, I also used the Medela Harmony manual pump. I had no problems with it and used it almost every morning. (I would have considered an electric pump, but found the cost intimidating in case I didn't like the product.) In hindsight, a hospital rental makes great sense.

March 15, 2011 | Unregistered Commentercoffee with julie

Hi Lisa,

You can definitely throw the Hygeia parts in the dishwasher to clean, which is probably the easiest cleaning method. Bottle nipples (of any brand) can be a bit trickier to clean, so if you find they aren't getting clean enough in the dishwasher, you should soak them in hot water for 5-10 minutes to remove any caked on breastmilk. Do you have a dishwasher rack to keep all of the small parts separated? Feel free to email me with any hygeia questions at Kate.gulbransen at hygeiababy .com, or you can find me on twitter as @hygeiakate. I'm always happy to help out. :)

March 15, 2011 | Unregistered CommenterHygeia Kate

I completely agree. I have ended up wearing a too small and ill-fitted but still comfortable cotton bra from Walmart for the past nine months. As a regular sufferer of thrush, I found it was most important for me to wear a 100% cotton bra and change it every 24 hours. This meant I needed quite a few bras in the rotation and I just wasn't willing to pay the big bucks for the more expensive nursing bras. I'm usually a 34G (or H, can't remember) but am bigger when breast feeding. I bought the biggest cheapest bras I could find in a larger band size with a smaller cup and just am grinning and bearing it. While it will be sad to wean someday, I will definitely be having a bra burning party alone. I can't wait to get back to wear my underwired nice bras that don't give me a una-boob and make me feel huger than I already am.

I love the Avent Isis pump when traveling. I also have a used Medela pump in style, but I tend to get more milk from the hand pump.

March 15, 2011 | Unregistered CommenterJill

Do you mean that moisture can get into the plastic tubing that attaches to the motor? I guess now that you mention it I have noticed little bits of water in my tubes. But I still don't see why you can't give your pump to someone else and buy new tubing without voiding the warranty. That just seems greedy on the part of Medela to insist that each mom buy a new pump. I think mine has been passed around to at least three women, but I received new tubes and other parts at the hospital.

March 15, 2011 | Unregistered CommenterJill

Doesn't the Playtex only come with one-size flanges? Every mother is different. Chances are her the flanges were too tights for her nipples.

March 16, 2011 | Unregistered CommenterAmy

For what it's worth and for reference in case anyone reads this far, I got a very similar sort of injury with a Medela Pump-In-Style. But it was the flanges that caused it not the pump per se - there is (or was at the time) a hard plastic kind of flanges (worked well) and a more flexible plastic sort (injured me). My kiddo was close to 1 when it happened, and I switched back to the other flanges almost immediately, so it wasn't that big a deal for me, but I thought I'd share the data point.

March 17, 2011 | Unregistered CommenterMedley

I bought an Ameda Purely Yours based only on recommendations online. Luckily it has turned out to be a great pump for me. Because of a local group that I participate in, I have people asking me about pumps on a regular basis. I generally avoid using any brands or name dropping. I try to stick to the description of a hospital grade, single-user double electric, manual, and hand expression. Maybe I should be more specific in the future.

March 22, 2011 | Unregistered CommenterCasey

Just curious, is the WHO code violation concerning Medela just because they sell bottles? If so, that seems a pretty modest offense. I mean, if you're pumping milk to begin with, you're going to need a way to get the expressed milk into your baby. Speaking as a working mom who breastfed two babies for a total of almost four years (19 months for #1, a bit over 2 years for #2), I wouldn't have been able to do it without a pump AND bottles.

March 23, 2011 | Unregistered CommenterKari

Kari:

The violation isn't selling bottles. It is the way they market and promote those bottles. There is more info on that here: http://www.phdinparenting.com/2010/01/25/information-advertising-spam-medela-crosses-the-line/

March 23, 2011 | Unregistered Commenterphdinparenting

I had a problem with the flanges being the correct size too. In fact, I own the largest special order flanges you can buy for the pump I own, and they're still too small. It would damage the nipples and skin if the wrong size. It's really hard to tell what size you'll need beforehand too because your nipples swell during nursing or pumping-usually for about the first 5 minutes. And that size change is on top of whatever last minute breast changes happen after birth. If the nipple rubs on the tube of the flange at all during pumping, you need a bigger flange. Even lubricating the tube with lanolin or something only partially solves the problem.

Unfortunately, that means I can't pump without hurting myself. Luckily, I've only had 1 occasion with my second baby where I've needed to be gone for work for more than 2 hours. I was able to use a hand pump with a too small flange to create enough gentle stimulation (I didn't create a seal) for my let-down to trigger on one side, and I hand expressed simultaneously on the other side. The pump was handy for catching the milk anyway :P It was a blast. Not.

March 29, 2011 | Unregistered CommenterSarah

Carla-

I was thinking the same thing! Having information about and access to good pumps is important to many women, but not to everyone. I think that by promoting pumps and bottles to every mother regardless of employment status or ability to nurse at the breast we are reinforcing multiple cultural messages including the idea that exclusive feeding at the breast is an impossibility for any mother.

From there it's a pretty short leap to multiple correlaries such as "it's bad to nurse in public", "all mothers MUST spend time away from their infants in order to be healthy and those that don't want to have something wrong with them", or "it is unlikely that breastfeeding will work out anyway".

That being said, thank you for continuing to spred the warning about the playtex pump.

April 10, 2011 | Unregistered Commenterjessica

Suing Dr. Sears too? That's ridiculous.

Why not sue the maker of the car you drove to go buy the pump? Come on people. I question this whole story.

August 25, 2011 | Unregistered CommenterMeg Collins

[...] comfortable, top-notch double pump:  your boobs, baby and boss will thank you!  Remember, Not All Pumps Are Created Equal–OUCH!.  Consider one that is certified as multi-user so you can re-sell or recycle.  Feel good about [...]

[...] Here’s an interesting blog that intelligently discusses breastpumps from a real mom’s perspective, with a dash of humor thrown in: : http://www.phdinparenting.com/2011/03/12/not-all-breast-pumps-are-made-equal-ouch/ [...]

[...] comfortable, top-notch double pump:  your boobs, baby and boss will thank you!  Remember, Not All Pumps Are Created Equal–OUCH!.  Consider one that is certified as multi-user so you can re-sell or recycle.  Feel good about [...]

I just had the same thing happen using the Ameda purely yours. Baby is 3 weeks old and this is about the 5th time I've pumped and I had skin come off from the bottom of my nipple from pumping. It seems to be a lot more common with different pumps as well. After reading the comments I think I will try a larger flange size to prevent it again in the future, but let me tell you the pain is excruciating every time I go to feed baby. Thinking I will also try the olive oil trick as well.

February 16, 2015 | Unregistered CommenterAngela
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