Breast Pumps

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The 411 on Breast Pumps

We are asked a LOT of questions about breast pumps at Lactation Care. It can be hard for a consumer to know and the differences between various brands and types of pumps. They tend to look very similar and the packaging prevents the consumer from playing with the bells and whistles before making a purchase. Usually families want to know: “What’s the best pump I can buy?” With each family having different needs, the answer to this simple question is often a bit complicated.

To get to the bottom of the matter, we need to put on our pump geek goggles and examine the differences between the pumps with the discriminating eye of our Board Certified Lactation Consultants. Breasts are our business, and, as such, all things related to the lactating breast are of interest to us. We’re trained in the art of evaluating a pump and rating the pump in terms of functionality. So let’s consider some of the other ways that pump geeks like the LCs at Lactation Care categorize pumps…

Single vs. Double

This is a fairly straightforward comparison. How many breasts can it drain at one time?

  • A single pump can drain just one breast at a time.

If you have ambition to drain both of your breasts, you can bet it will take TWICE the pumping time of a double pump.

  • A double pump drains both breasts simultaneously.

In addition to being more efficient, double-pumping also stimulates more of the milk-producing hormone, prolactin, and is therefore more supportive of a nursing mother’s milk supply. It has also been our experience that most double pumps are capable of better maintaining optimal suction levels and cycling rates. Higher quality double pumps will also provide the option of single-pumping.

Manual vs. Electric

  • Manual Pumps operate on the energy you provide.

        • Good for only occasional or limited pumping

        • Very portable, you can pump wherever you can travel with your pump

        • Use with caution if you have a repetitive stress injury of the hand/wrist/arm

  • Electric Pumps operate on electricity provided by batteries or power supply cord.

        • Good for more frequent pumping

        • Easier on the user

        • Only as functional as the power supply, pumping could be effected by a power outage or dead battery.

        • Seek out a pump with a battery power option if you will be inconvenienced by the need to tether yourself to a wall socket.

Hospital Grade Pumps vs. Personal Use Pumps

The pump geeks at Lactation Care also categorize breast pumps as Hospital Grade pumps, which we generally rent to the consumer, vs. Personal Use Pump, which we sell to the end user. We sometimes use the shorthand: Rental vs. Purchase. Hospital grade pumps are heavy duty pieces of durable medical equipment designed to be used for years by multiple users. Personal Use pumps are pumps suited to an individual user/consumer. They are lighter duty construction and generally cuter to look at than the hospital grade pumps. To muddy the issue, none of these terms are recognized by the FDA, the agency charged with regulating these devices. The FDA recognizes pumps as either Multiple-User or Single-User and the distinction between the two types is based exclusively on system design. Multiple-User pumps feature a closed design and Single-User pumps feature an open design. I’ll expound upon the virtues of these design elements in a moment…

So, with some exceptions to the rule, you can greatly simplify things this way:

Hospital Grade = Rental = Multiple-User

Hospital Grade pumps are the pump of choice for families experiencing mother-baby separation or breastfeeding challenges in the early weeks

and

Personal Use = Purchase = Single-User

Personal Use Pumps are more suitable for women with well-established milk supplies who need to maintain their supply during regular periodic or occasional separation from baby.



What you can expect from a Hospital Grade Pump:

  • It will be powerful and efficient enough to establish and maintain a milk supply, even in the case of complete mother-baby separation

  • A shorter pumping time than with a personal use pump

  • FDA recognized “closed system design” safe for multiple users.

  • You will need your own kit to operate the pump.

  • Heavy duty construction designed for years of daily use

  • Quieter operation

  • An affordable rental rate somewhere in the neighborhood of $1.00-$3.00 per day. Many rental stations will require a cleaning or security deposit.

  • Peace of mind: If you are pump-dependent (a daily user) the rental station will replace the pump for you, usually the same day, if you suspect mechanical failure. No mailing the pump back to the manufacturer for a diagnosis, which might leave you in a lurch.

  • Use of this type of pump may be covered with restrictions by your insurance



What you can expect from a Personal Use Pump:

  • It’s suitable for a mother with a well-established milk supply

  • The pumping time will likely be longer than with a hospital grade pump

  • Lighter duty construction that’s geared toward cuteness and portability

  • Everything you need to pump will be included in the box: collection containers, tubing, valves, flanges, etc.

  • Increased price with increased bells and whistles

  • An open system

  • A limited warranty on the parts and motor

  • A basic model may be covered by insurance with out-of-pocket upgrades available for more bells and whistles

 

Open System vs. Closed System

If you’ve already read this far, you’re probably able to figure this out. Some pumps are designed for just one user, kind of like a toothbrush, whereas others are designed to be safe for multiple users, kind of like a dialysis machine. Another way of conceptualizing this is by asking, “is this an open system or a closed system?” An open-design system, while desirable in modern residential architecture, is not always a good thing with a pump.

Open System = Safe for Just One User

An open system does not have a barrier to prevent bodily fluids (think: milk, blood, sweat, saliva) from entering the pump motor. The FDA regulates these pumps as single-user devices. Once vaporized fluids are in the motor, they are there to stay, and that is fine, safe and adequate so long as only one person ever uses the pump. Many families erroneously believe that a popular model of purchase pump can be made safe for another user by replacing the original kit (the kit are the bits and pieces used to collect the milk). While all multiple-user pumps require each mother to use her own personal use kit for hygienic purposes, this practice alone is not adequate to provide protection against disease transfer with an open-system pump. This is because contamination occurs at the level of the pump motor and, regardless of how new or squeaky clean your kit is, the contamination in the motor is only going to be sucked into your tubing and collection kit. And, while there has yet to be any documented cases of disease (think: HIV, Hepatitis, CMV, etc.) transfer from one family to another this way, it is possible.

Closed system pumps are designed with barriers such as silicone diaphragms or bacteriostatic filters that make it impossible for bodily fluids to reach the pump motor and therefore subsequent users. The pump geeks at Lactation Care are happy to report that better quality purchase pumps are available with closed system design.

But what’s the right pump for me?

So where to start? Let’s remember that all these pumps are designed to mimic what a baby nursing at the breast would do. It’s a stand-in for when mom and baby are separated or when either half of the nursing dyad (or triad, or quad…) is not capable of participating in a feed for some reason. Some pumps are great stand-ins, some not-so-great. No pump is going to drain your breast as well as a baby nursing well. If baby isn’t able to go to breast or mom and baby are struggling with breastfeeding in the early weeks postpartum, a hospital grade, multiple-user, rental pump is the best option. ONLY hospital grade rental pumps are guaranteed to be effective enough to be used to both establish and maintain lactation in the early weeks. If you are struggling with breastfeeding please consider getting yourself some help from a Board Certified Lactation Consultant near you.



Now that you are an expert in classifying different types of pumps, you may be wondering how to tell if a pump is an effective pump. Since we’re asking the pump to do the work of a baby nursing well, we’ll need to understand what a baby nursing well does during a feed in order to answer this question.

Babies do some very important things when feeding at the breast:

  1. Babies suckle, applying negative pressure or vacuum. The vacuum pressure created by a baby nursing well has been measured by scientists. A highly functional breast pump will be able to achieve and maintain this vacuum level, generally accepted to be approximately 240 mm Hg. Better pumps will allow the user to adjust the pressure to their comfort level, allowing them to gradually work toward the optimal pressure. All hospital grade rental pumps will meet this standard. But what about a personal use purchase pump? Unfortunately, there is a great deal of variability from one brand to another and even within a brand. To further muddle the issue for the consumer is that you are unlikely to see this feature mentioned or printed on the retail cartons of a personal use pump. So how is one to know? We’re here to help. We’re pump geeks at Lactation Care, so we use pressure gauges to measure this functional aspect of all the pumps we sell.

  2. Babies also do a thing called “cycling” while at the breast. That is, they coordinate sucking, swallowing and breathing. When actively feeding at the breast, a baby nursing well will achieve a cycling rate of between 50 and 60 cycles per minute. So, an effective pump will be able to reach and maintain this cycling rate over the course of a pumping session. Once again, hospital grade rental pumps will do this while a personal-use pump may not. Sadly, you are not likely to see this feature marketed on a breast pump retail box either. That’s where the pump geeks at Lactation Care and our handy-dandy stopwatch come into play. We’ve measured the cycling rates of all the pumps we sell.

  3. Babies vary their suckling pattern during the feed. At the beginning of a feed, babies latch onto the breast and suckle very rapidly, stimulating the release of oxytocin which then triggers the milk ejection reflex. The milk ejection sends milk traveling from the back of the breast, forward toward the nipple pores where it is delivered to baby. Once the buffet is open, baby changes to a slower rate of suckling. Better pumps will have any adjustable speed control, either infinitely variable or a toggle switch to jump back and forth between different speeds. Happily, this feature is usually marketed on breast pump retail packaging.

Other bells and whistles…

Optimal and adjustable pressure levels and cycling rates are must-have features for an effective breast pump. Convenience features can also have an impact on the quality of experience one has with a pump. Convenience features worth considering:

  • Size, weight and overall portability. If commuting or travel is part of your life, portability matters. Does the pump come with a tote bag, how much does it weigh, how bulky is it, are the components modular to streamline luggage for air travel? Is the motor hard-mounted into the bag is it modular. Does the pump come with or have the option of being powered by battery power? Are rechargeable batteries an option?

  • Hands Free: Double pumping requires two flanges to be held firmly against the body in order to collect milk. Holding two flanges against your breasts and operating the control switches on some pumps requires two hands and a trained monkey. To simplify things for users, some manufacturers design pumps that empower a mother to pump hands-free, sans monkey. Yay for the ingenuity! Some of these designs are elegant, some downright awkward and clunky requiring previous training as a dominatrix. Happily, high-quality hands-free pumping bustiers are compatible with most breast pumps. Simple Wishes is one of our favorites:

  • Noise. Size is one thing to consider when shopping for a discreet pumping experience. The sound generated by a pump operating at maximum pressure sometimes comes as quite a surprise. After all, the pumps are all so cute and quiet when sitting on a retail shelf behind a wall of Plexiglass. Buyer beware that some of the loudest pumps on the market are also some of the most portable. This is because the reduced bulk was achieved by reducing sound insulation. If you have visions of yourself at the office pumping during a conference call, do give some consideration to the sound the pump is going to make.

  • Milk Storage. If you are pumping in the comfort of home, storage for your expressed milk is probably available in your refrigerator, but what if you’re on the go? Many manufacturers have thoughtfully included integrated or portable cooler bags and cold packs in their pump design. Does the pump include extra storage bottles or bags?

  • How “Green” is the pump? Sadly, most retail pumps are designated as single-user devices and are destined for a landfill once their productive days are over. Some pump manufacturers are designing their pumps with an eye toward the environment. Packing and accessory components consisting of recycled, post-consumer content, multiple-user design, and recycling programs are ways that manufacturers are redirecting pumps and their components away from the landfill. Hygeia is a brand that has really taken the lead in this area.

  • Compatibility with other gear. Wondering if you can use your storage bags with a certain pump or if you could pump directly into your feeding system? Sometimes sticking to one brand of products makes sense, but it’s wonderful to have some flexibility.

What’s the right pump for you? As you can see, the answer depends on both your needs and your wants, the age and stage of your baby and your particular life circumstances and breastfeeding goals. That’s a lot to consider. We can help you answer that question. We’re staffed by 6 Board Certified Lactation Consultants that are trained to help you make the best choice for your situation. If you are a first time mom with twins in the N.I.C.U. or an experience pumper planning to pump during business travel abroad, we will take the time to match the right product to your needs AND provide ongoing phone support while you are providing your mother’s milk to your baby. Contact us directly and let’s start talking about it!
 

Happy Pumping!

Andrea Jorgensen, IBCLC