Breast pumps

What should I know about getting a breast pump?

Pumping means using a machine or other device to remove milk from the breast. Choosing a pump can be confusing. Pumps can be expensive and sometimes ineffective. Mothers need to decide whether they want to pump both breasts at once or one at a time. Then, they must choose a type: a handpump, a constant suction pump, or an electric pump. All have a piece that goes over the nipple and areola (the breast shield), a collection bottle, and a way to create suction. The choice depends in part on the reason for pumping. Mothers need to ask themselves: How often do I want or need to pump? When and where do I want to pump? What type of speed and suction control do I want? and How easy is it to clean the pump? In general, mothers who are pumping regularly should use a high quality double electric pump. Such pumps can be rented. Before purchasing a pump, mothers need to consider the cost of the pump, whether the pump can be serviced locally, and what type of warranty it has. 

A) Describing pumps

In order to pump, mothers need to know how to pump and to decide on a type and brand of breast pump (pump). The choice of pump type depends in part on the reason for pumping. Pumps can be expensive and sometimes ineffective. While some countries will track safety concerns, most do not regulate the quality of breast pumps.

All pumps consist of:

  • A part that is placed over your nipple and areola (breast shield)
  • A collection bottle
  • A way to create suction

The ideal suction strength is between -150 and -250 mmHg. (A mmHg is a millimetre of mercury and is a unit of pressure.)

Mothers who wish to pump will need to know how to:  

B) Choosing a type of pump

You can choose from one of the following types of pumps:

1) Hand pumps

A hand pump has a handle that you need to operate and a one-way valve.

2) Constant suction pumps

A constant suction pump has a bulb that you need to squeeze once to create the suction that holds it onto the breast.

3) Electric pumps

An electric pump has a motor. When purchased, they come with the necessary accessories.

Rental and hospital pumps have multiple users. To prevent cross-contamination, each user needs their own pump kit which consists of breast shields, bottles, tubing, and valves. Pump kits are made by a company to specifically fit their pumps.

In general, the more regular the pumping, the more important it is for mothers to use a high quality double electric pump (Meier et al. 2016).

4) Comparing types of pumps

The following table compares the three kinds of pumps. 

Table: Comparing Hand, Constant-Suction, and Electric Pumps

Hand pumps are mostly used if a mother is breastfeeding and pumps only occasionally or as a backup to an electric one. Their suction strength is adjusted by the user. They may be difficult to use if the mother has very small or painful hands.

If you find your hand pump is very effective but you wish to double pump, you can buy another hand pump and use both at the same time to decrease your pumping time. This may be easier than carrying around a bigger, heavier electric pump and being dependent on having power. 

Constant-suction pumps share some characteristics with hand pumps. They are the newest type of pump and there is very little research about their effectiveness. In online reports, many mothers find them very effective in obtaining milk from one side when the baby breastfeeds from the other. Some mothers report that they are less effective when expressing and not breastfeeding.

Electric pumps are most effective for mothers who pump exclusively and are not breastfeeding regularly or are frequently away from their babies. Recently, electric breast pumps specifically designed to be hands-free have become available. 

C) Choosing a pump

Pump quality varies a lot. Avoid the cheapest pumps, which are generally not effective or durable or may injure you. You can look at the websites of various companies for details about their products and other pumping tips.

We cannot recommend a particular pump brand as mothers and babies are unique and can respond differently to a pump. Pump availability varies from country to country.

 1) Considerations when choosing a pump

Here are some questions to ask yourself before choosing a pump. Start by defining your needs:  

  • How often do I want or need to pump?
  • When and where do I want to pump?'
  • Do I want to pump both breasts at once or one at a time?
  • Why do I need to pump?
  • Should I rent or buy a pump?
  • Do I have an insurance plan that will cover the cost of renting or buying?

2) Which features are important

Decide on which features are important to you:  

  • What type of speed and suction control do I want?
  • Can the speed and suction strength be adjusted separately or are they locked together? The former is preferred (Larkin 2013).
  • What is the best size of breast shield for me?
  • Can I change the breast shield size?
  • What accessories can be bought to make the pump more effective?
  • Do I already have pump accessories that can be reused?
  • How easy is it to clean?
  • Can it be used hands-free?

3) Choose the brand

Choose the brand:

  • Has a certain type of pump worked or not worked for me in the past?
  • Do I have a particular reason for choosing a certain brand?
  • What is the price?
  • How durable it is?
  • Can the pump be serviced locally?
  • What type of warranty does it have?

References

Larkin T, Kiehn T, Murphy PK, et al. Examining the use and outcomes of a new hospital-grade breast pump in exclusively pumping NICU mothers. Adv Neonatal Care. 2013;13(1):75‐82

Meier PP, Patel AL, Hoban R et al. Which breast pump for which mother: an evidence-based approach to individualizing breast pump technology. J Perinatol. 2016 Jul;36(7):493-9