Constant-suction hand pumps

What is a silicone pump?

A constant-suction hand pump is a silicone unit with a bulb-shaped milk collection reservoir (bulb) at the bottom and a breast shield at the top. It attaches to the breast by suction created when the reservoir is squeezed, then placed on the breast and released. Constant-suction pumps are easy to wash, cheap, portable, and do not require electricity or hand action. Some mothers find that constant-suction pumps remain attached without support. Others need to hold it in place. It depends on the size and shape of the breast. Mothers can use this pump on one breast while breastfeeding on the other. It is best for a mother with a good let-down and a large milk supply. There is not much research to recommend it to mothers who are only pumping and not breastfeeding but there are positive reports online. Mothers who have painful breast problems can add clean, warm water to the pump to aid milk removal and decrease swelling of the area just behind the nipple.

A) Describing constant-suction pumps

A constant suction pump (Haakaa®).

Pumps may be expensive or ineffective. Review your needs and pump choices if you are considering using one.

Until recently, all hand pumps were piston-type, designed to increase and decrease suction in a way that mimics a baby’s sucking. Now, constant-suction pumps are available which apply constant suction to the breast with no pumping or piston action. There is virtually no research on the use of such pumps but they are becoming very popular.

Constant-suction pumps are a one-piece silicone unit consisting of:

  • A breast shield.
  • A bulb-shaped collection bottle (bulb) that when squeezed, creates suction.

This type of pump is also called a silicone or Haaka® pump which refer respectively, to its makeup and a brandname.  We have chosen to use the term constant suction as this describes its function.

They are easy to wash, cheap, and portable, and do not require electricity or hand action.

B) Choosing and buying a constant-suction pump

Constant-suction pumps have only one breast shield size. The bulb can come in different sizes.

When buying a constant-suction pump, consider buying one that will remain upright when put down. Some have a round bottom requiring that they are placed in another container to keep from spilling.

There are several manufacturers. Ensure that the silicone is food-grade to avoid the risk of contaminants such as BPA, lead, and phthalates. 

C) How to use a constant-suction pump

If the pump is new, sterilize it by boiling it in water for several minutes. It can be scratched if cleaned with a brush that has sharp, hard bristles. It can turn cloudy if washed with bleach-based detergent.

To use a constant-suction pump:

  1. Squeeze the bulb.
  2. Place the breast shield over the nipple and areola.
  3. Slowly release the pressure on the bulb as you continue to hold it.
  4. Expect a vacuum to form. Do not use the pump if no vacuum forms.
  5. Once you release the bulb, the pump may not stay in place.
    1. If it does, you can let go of the pump.
    2. If it does not, you will have to hold the pump or a hands-free system to keep it in place.

Some mothers find that the pump remains attached without support. Others need to hold it in place. It depends on the size and shape of the breast. If you are breastfeeding on one side and pumping on the other, the baby may kick the pump and dislodge it. It is also more likely to fall off as the pump fills with milk and becomes heavier.

Suction strength may vary between manufacturers. Mothers can adjust the level of suction by increasing or decreasing how hard they squeeze the bulb before attaching it.  

D) When to use a constant-suction pump

A constant-suction pump can be used:

Many mothers use this pump on one breast while breastfeeding on the other. The baby stimulates the let-down while the pump is in place. Other mothers find the pump works well even when not breastfeeding. It depends on the individual.

A constant-suction pump works best for a mother with a good let-down and a large milk supply. 

E) Warm water breast bath

Mothers with mastitis, a breast abscess, plugged ducts, or engorgement often benefit from gently removing extra milk and decreasing swelling of the area just behind the nipple (the nipple root).  

This can be done using a constant-suction pump filled with warm water. When the pump is attached to the breast, the nipple and central areola sit in warm water. This method uses the comfort of warm water to relieve pain and bring on a let-down and the suction created by the pump to draw out the milk. This is very gentle and, when done properly, is unlikely to add to a mother's pain.

There is, however, no research to support this technique.

In order to use a warm water breast bath in a constant suction pump:

  1. Half fill the pump with clean water that is slightly above body temperature. 
  2. Sit and place a towel on your lap to catch any spilt water.
  3. Squeeze the bulb so that the water rises to the top of the pump. 
  4. Place the pump on the breast and ensure the nipple and part of the areola sits in the water. A small amount of water may spill over the edge.
  5. Slowly release the bulb. 
  6. The milk should start to flow into the water.
  7. Stop when the milk no longer flows. 
  8. If the breast still feels full, consider getting another let-down and repeating steps 1-7. 

Some mothers choose to use salt water (saline).

Milk expressed in this way cannot be used by the baby as it is mixed with water.

F) Reasons not to use a constant-suction pump

There is not much evidence to recommend this pump to mothers who are only pumping and not breastfeeding. Because of the lack of pumping action and limited range of suction strength, it may not be as effective at stimulating let-downs, resulting in poor milk removal and a decreasing milk supply in some mothers.

Nevertheless, in online comments, mothers have reported using them when exclusively pumping and much preferring them to electric pumps. Mothers who use this pump regularly and frequently must ensure that the amount of milk they express does not go down.

Do not use this pump if it is not effective or cannot be used without pain.

It should not be relieved upon to establish a milk supply if the baby is not breastfeeding.