What is the best breast pump for you?
When trying to pick the best breast pump for you, consider what you need from your pump. Do you need industrial strength and long motor life? Should your pump be easily portable or is it only for occasional use? Do you need something quick, cheap, and quiet? Learning all the pump lingo and options can feel overwhelming, so lets start from the beginning. To understand how to use your breast pump, lets examine the features and how do they serve you?
Closed or Open System
Breast pumps are composed of either an open or closed system. A closed system pump has a barrier separating the motor and the collection kit protecting your milk from any potential bacterial exposure. The barrier (a filter or membrane) prevents inadvertent uptake of milk or condensation into the motor leading to mold growth. Open system pumps do not have this barrier so there is no way to completely clean and disinfect this style of pump. This is why they are considered “single user pumps.” All multi-user style pumps are closed system. The term is sometimes used interchangeably so be sure when purchasing a pump you are clear what the term “hospital grade” is implying.
Double or Single head pump
Double or single pumps refer to whether there are one or two collection heads. I highly recommend a double if you are going to spend any appreciable amount of time pumping. If you only have a pump as a back up for the infrequent occasion you need to express a milk, then single pumps are an affordable option.
Manual or Electric
Electric pumps are powered by a motor where as manual pumps are hand operated by squeezing a handle or pumping a cylinder. There is also another variety that is gaining notoriety called a silicone manual pump. These are small silicone pumps that are squeezed tight and then placed on the breast to create suction. Suction holds the hand pump on and expresses the milk.
If you are planning on returning to work and pumping to collect milk while you are away, the electric option tends to be the best fit. Electric pumps are more efficient at collecting milk and tend to yield better results for maintaining a milk supply. Some women do not respond well to the stimulus of electric pumps and prefer hand pumps, but this occurrence tends to be the exception instead of the rule. If you are planning on exclusively pumping, pumping to establish a milk supply, or to pump regularly throughout the week, an electric pump will probably be the best fit for you.
Manual pumps are well suited for moms looking to relieve fullness or pump a little extra on the side. They are quiet and can be easily stashed in a bag for quick use or when electricity is not available. It is very difficult to maintain a full supply with just a hand pump, but they are a handy tool to be used in conjunction with breastfeeding or an electric pump. See below for more about the Haakaa!
What does hospital grade really mean?
While the distinction between hospital grade and personal use seems like it should be rather clear, it seems the term is somewhat open to interpretation making the definition somewhat grey.
Hospital grade pumps are dual electric pumps with industrial sized motors. This is what enables a longer motor life and more “power.” These pumps are closed system pumps allowing them to be multiuser and compatible for rent. Hospital grade pumps are recommended for any mom who is intending to exclusively pump or is establishing her milk supply with a pump (baby is in the NICU, unable to latch, has feeding difficulties).
Because of the industrial sized motor, hospital grade pumps are large and not very portable. They do not come in a carrying case and are best suited to stay in one location and are very expensive (upwards of $1000) or can be rented at a much more cost effective price. Many pump rental agencies have means of testing the vacuum power of their rental pumps to ensure they are still up to standard.
CAN MY PUMP BE HOSPITAL GRADE?
Most consumer grade pumps (or personal use pumps) are meant to be single user pumps. The life expectancy of the motor is limited to about a year or so. This is one reason buying a used breast pump is not recommended. A motor that is near the end of its life will be less efficient at expressing milk and may be detrimental to milk supply. Some of these pumps are open system pumps allowing for potential contamination between users. Most consumer pumps have the same abilities and features as the “hospital grade” pump but these pumps are smaller and more portable.
It was once considered that consumer grade pumps did not have the same “power” as hospital grade and were therefore not sufficient for establishing/maintaining a milk supply for moms exclusively pumping. The FDA has recently cautioned buyers to be wary of this term as it has no standard definition and is being freely used. Always clarify what “hospital grade” means when purchasing your pump. Do they simply mean it is a closed system? Are they referring to the increased motor power? Do they mean it has a longer motor life?
There are now consumer grade personal use pumps available for purchase that boast a closed system and the same power as their larger “hospital grade” counterparts. The Spectra Dew 360, S1 and S2 are all classified as hospital grade pumps that are covered by most insurance plans. So the lines are beginning to blur between consumer and hospital grade pumps. Understand what you need from your pump and make sure the pump you choose fits those qualifications.
Paying for your pump
According to the Affordable Care Act, breastfeeding mothers are eligible to receive lactation support and breastfeeding equipment and supplies through their insurance plan. Breastfeeding equipment is under the discretion of the mother’s healthcare provider but most providers are more than happy to provide a prescription for a breast pump if it a stipulation of mom’s insurance plan. This all sounds wonderful (and it mostly is) but the details can sometimes be difficult to iron out with individual insurance plans. Insurance is not the only way to get a pump. There are multiple options that help ensure pumps are available to all mothers who need them.
HOW DO I GET INSURANCE TO PAY?
Insurance companies have the right to interpret the Affordable Care Act as they see fit which allows for a large continuum of what is covered and what you must do to be eligible. Your best bet is to call your insurance plan and be clear about their expectations. Do you need a prescription from your doctor? Where can you purchase the pump? Is the pump covered by insurance at purchase or do you have to purchase the pump and submit reimbursement? What type of pumps are covered by your plan?
These are all questions you should ask when speaking to your insurance provider. While you have them on the phone, be sure to clarify what type of lactation support you are eligible for. You maybe covered for multiple visits from a lactation consult. All of which is nice to know before you are home with baby.
Once you iron out the details, most families can get a variety of double electric pump completely covered by their health insurance plan (EACH PREGNANCY… since consumer grade pump’s motor life expectancy is about one lactation cycle). Some of the bells and whistles may not be included (you might have to pay out of pocket for the cute carrying case) but the pump itself should be cove
You maybe able to get your pump at your local pharmacy or through a medical supplies retailer. Many of them ship directly to your home. Check with your insurance plan before purchase.
PAYING CASH FOR YOUR PUMP
Why would you pay cash for a pump if it is covered by insurance? Well, you shouldn’t but some people feel like the hassle is not worth the cost and register for a pump. Sometimes, the pump they want is not covered by their plan or the requirements to get coverage prove to be a barrier. Some people do pay cash, but you should not have too. Check with your plan before you buy a pump. Many will only reimburse you for a pump that you bought from an in network medical supplies retailer and BTW, Target does not qualify. 😉
RENTING A PUMP
Some women do not plan on a pump purchase but then need one or require a hospital grade pump and find costs prohibitive. Renting a pump is a viable option, especially if you require a hospital grade pump to help establish lactation. Costs can be covered by insurance if there is a medical indication. Check with your plan for details.
WIC CAN HELP
WIC (Women, Infant, and Children) governmental support program helps low income breastfeeding mothers cover costs associated with breastfeeding including support and medical equiptment. Because WIC recognizes breastmilk as optimal nutrition for infants and it is considered preventive care to support breastfeeding dyads, exclusive breastfeeding mothers received benefits such as:
- Greater quantity and variety of foods to support lactation
- Longer participation in the WIC program
- Trained support staff, educational materials, and counseling to support continuation of breastfeeding
- Potential coverage for breastfeeding materials such as shells, pumps, etc.
For more information about how to apply or your details about the program, check out the following links:
Pump parts: Learning the Lingo
Now lets talk about how to use your breast pump. There are three major players when it comes to breast pumps. The most commonly used brands are Medela, Ameda, and Spectra. Each brand has different models that has some variations amongst parts, but this portion of the post should give you some ground work for understanding how your pump parts fit together.
MEDELA PUMP IN STYLE
NOTE: CHECK BACK FOR SPECTRA AND AMEDA VIDEOS AND GRAPHICS.
Flange fit is an important part of pumping. If your flange is too small, it can cause pain and nipple trauma, while being too large can compromise your seal and how much milk you express. Just like Goldilocks, you need your flange to be, “Juuuuust Right.”
Your nipple should fit inside the tunnel of the flange and have very little extra space as it is drawn up with suction. If your nipple is rubbing or pinching on the sides, your flange may be too small. If there is a large amount of space between the edges of the tunnel and your nipple, you may see additional breast tissue being drawn up with the suction. This is a flange that is too big.
Many women will fit in a standard sized 24mm flange that comes included with your pump. Most companies have additional sizes that can be ordered. You may even need a different size for each breast.
Pumping Pals are an awesome product I first heard about through a mommy friend. This friend of mine was exclusively pumping for TRIPLETS, so she was a bit of boss when it came to the subject of pumping.
Pumping Pals are a unique flange that can be used with most pumps (it is compatible with all the major players like Medela and Spectra). Pumping Pals boasts to promote better flow and reduce irritation with a more comfortable fit. The graduated shape of the flange is designed to not constrict milk ducts and promoting better milk collection. The downward shape of the flange is also more comfortable for moms and ensures you do not miss a drop.
WHY IS FLANGE SIZING IMPORTANT
Why is this worth mentioning? As we know, milk output is all about supply and demand. The more you are able to empty the breast, the larger the order you are placing for the next serving of milk. A pump is naturally not as efficient at emptying the breast as a baby, which is why we use techniques like hands on pumping and the Marmet Technique to maximize our yield with each pumping session. The better job your pump does with milk removal, the more it encourages a healthy milk supply. Not to mention, if you are using your limited time and energy pumping, you want to get the most milk possible for your efforts!
Pumping Pals delivers on all fronts and I personally used Pumping Pals after my friend’s recommendation. It is much more comfortable than a traditional flange. If you are exclusively pumping or find your are getting nipple fatigue (is that thing? I think I just coined a new phase), then the Pumping Pal is a great fit for you. Honestly, if you plan on doing any amount of pumping, get this in your pump kit. They are worth every penny for the increased comfort and every additional ounce of milk they garner.
Breast pumps have a dial that controls suction strength and Moms are often unsure where to start. The key is to have suction high enough to collect your milk without being painful. The best way to find that setting is to increase suction until you think “YIKES a bit too much,” and then lower it a notch. By the end of your lactation cycle you will be cranking that thing to the max murmuring, “Is that all you got?” But in the beginning, we want to be careful to not abuse our nipples and cause trauma.
It is also important to remember that having your suction too high can actually impede milk collection. During breastfeeding, your baby stimulates milk letdown through a variety of stimuli. There can be as many as 4 letdowns during a nursing session.
Stress or pain can impede milk letdown. So while it seems intuitive that higher suction will equal more milk, this is not always the case. Some mothers struggle with milk letdown for a pump. Cranking the suction is not the solution. Milk letdown is part of a hormonal cascade tied to mom’s emotions and the stimuli surrounding breastfeeding and finding the key to induce letdown may not be related to suction. Suggestions to help with letdown are listed below under Creating a Routine.
Most new style pumps have different cycle settings to better mimic a newborn’s nursing pattern. The “letdown cycle” is short quick bursts of sucking (styled after a newborn when first latching). When letdown occurs, pressing the cycle button will change the pattern to slower longer drawing suction bursts. If milk flow slows again, changing the cycle back to the quicker pattern will help illicit multiple letdowns.
Cleaning my pump
Breast pumps all come with manufacturer cleaning recommendations. First always refer to the directions included with your pump.
A common misconception is that all the pump parts need to be sterilized every time. Most manufacturers actually discourage this practice as it compromises the pump collection equipment and can affect pump performance. The recommendation is to sterilize before first use and to wash the collection equipment after each use with soap and water. It is important to rinse thoroughly so there is no soap residue left behind. It is equally important that the pieces dry completely to prevent mold and bacterial contamination.
Many sets are also dishwasher safe. Hallelujah. My personal pump hack was to rinse my pump parts quickly and throw them in the dishwasher after each use. Done.
If your interested, here are the OFFICIAL pump cleaning recommendation from the CDC (Center for Disease Control).
The pump tubing should not be wash. Moisture in the tubing will cause mold growth. If you see condensation in your tubing, whirl it around to try and get as much of the water out as possible and let air dry. You can also remove the pumping collection headset while still keeping the tubing connected to the pump. Run the pump until tubing is dry. If you see milk or mold in the tubing, it should be discarded and replaced immediately.
WHAT IF I AM PUMPING FOR A PREMIE
Premies are different. They are more susceptible to bacterial contamination and we need to be more vigilant in our cleaning practices to minimize exposure. The CDC recommends daily sterilization of pump parts for premature infants. This can accomplished with a dishwasher sanitization cycle, boiling water, or sanitizing steam cleaning (see microwave sterilization bags).
TIME SAVING HACKS
I HIGHLY recommend buying multiple seats of our pumping head equipment. If you are pumping multiple times a day, it is really nice to be able to quickly rinse your pump parts after each session and save washing for the end of the day. It stinks to wash 3-4x a day. Washing all your gear once at the end of the day (or throwing everyone in the dishwasher) saves time.
If you are pumping multiple times a day at work (or home), another option is taking your pump head equipment and putting it in a ziplock back in your fridge. The milk on your equipment should have minimal bacterial growth if stored in the fridge. All pump parts should be washed at the end of the day. Do not store and use for multiple days.
I would also urge caution if you have a premature baby or even a baby that is less than 3 months old. While this hack is deemed generally safe, it is not considered best practice.
Create a routine
Pumping is not natural. Some women really struggle with relaxing for an electric breast pump. And who can blame them? The problem is that we need to relax to experience letdown. Creating a routine can be a powerful trigger. Like Pavlov’s dog, your body will respond to the familiar stimuli of a pump routine in much the same way it responds to your baby. Here are some tactics that can be helpful in eliciting letdown and can be a meaningful part of your pump routine.
- Use your sense of smell. Burn a candle, use essential oils, or use a lavender infused hot pack like Lil’ Buds when you breastfeed. Then use it when you pump. Your body will remember the smell stimuli from breastfeeding.
- Watch videos of your baby while you pump. Visual stimuli can be helpful.
- Relax! Meditate, watch tv, read, scan your phone… just chill. Don’t work, don’t stress, don’t catch up on bills… relax. Make pumping your “me time.”
Heat it up
Heat has been shown to increase the efficacy of milk removal from the breast. An Australian study showed that by using warmed breast shields, mothers could expect to remove more milk in a shorter time. Ultrasound supports these findings by demonstrating the effects of heat to the nipple and areola. Warming dilates the milk ducts allowing for quicker and more efficient removal of milk. Mothers who use warmed breast shields report feeling more relaxed and comfortable during pumping sessions. Comfort and relaxation have effects on milk ejection and further support the benefits of using heat while pumping.
One can warm their flanges by heating them in a hot water bath before pumping or you can use warming packs. My favorite brand is Lil’ Buds.
Lil Buds are all natural breast comfort packs that can be heated or cooled for treatment of engorgement, clogged ducts or mastitis. They are also super handy to wear while breastfeeding and pumping because they fit snuggly in your nursing bra. There is a lavender infused option that smells divine and can be part of your relaxation routine. They are handmade and covered in a super soft flannel adorn in simply adorable prints. They are kinda hard to resist.
For heating purposes, they are made to be stuck in the microwave for 5-10 seconds, which simplifies the heating process immensely. They also keep their heat a lot longer than many of the of heat pads on the market. The half moon shape fits nicely in a nursing bra so that it can be worn while nursing without fear of pressing against the infants face. While pumping, two half moons can be combined to make a full circle for ultimate heating power.
Pain with pumping
Pain can also inhibit letdown. Learn how to care for your nipples as they adjust to the rigors of breastfeeding a baby. By giving your nips some TLC, you can speed up recovery and maintain a healthy milk supply. CLICK HERE for a FREE PRINTABLE full of Tips for your Nips.
If you are experiencing consenting pinching or pain with pumping, you may need to look at your breast flange size (see above). A flange that is too big or too small can make a big difference. If your fit is good, try using a lubricant while pumping. Olive oil or coconut oil are two great natural options. There are branded pump lubes but there is really no added benefit over olive oil.
Also take a look at your suction level. You may have your suction higher than necessary. It should be a nice strong tug… not painful.
Lastly, you can look at different flange options. Many moms report Ameda being an uncomfortable flange. Medela tends to be a better fit for more moms. If not of these flanges are comfortable, I strongly recommend taking a look at pumping pals (see above).
Don’t miss a drop
Some babies only feed on one side during a feed leaving the other breast feeling full or engorged. For many women, the other side will leak when the babe stimulates letdown on the nursing side. Wouldn’t it be awesome if you could collect that milk instead of soiling your shirt? You can! The Haakaa is a silicon hand pump that is applied by squeezing the base and applying it to the breast. The suction generated holds the Haakaa in place while also collecting milk.
I absolutely LOVE this product for a couple of reasons. It is so easy to use and it is way less burdensome than setting up your double electric pump. The ease of use to collect when you maybe wouldn’t normally go through the trouble enables you to collect some bonus milk. By using the Haakaa a couple times a day while breastfeeding, you quickly build a freezer stash without much extra effort.
I also love that it is one piece making it easy to wash. It is small and compact which is handy for sticking in a diaper bag or your purse. There are times when you need to pump that you may not have your double electric pump with you, but a Haakaa can make it possible to let off some milk and relieve heaviness. I can think of several weddings I went to while breastfeeding my kids that I wish I had a Haakaa in my handbag.
Full Disclosure: This is an Amazon affiliate link. Buying product with this code supports this blog at not extra cost to you. Thank you!
WHY I LOVE SILICONE HAND PUMPS
As a lactation consultant I love this product because it is great for stimulating a healthy milk supply. Many moms respond really well to the Haakaa and because it is so easy to use, they are more inclined to use it multiple times in a day if they need a supply boost. If you have sensitive nipples, silicone hand pumps can be irritating. Some moms find the suction created by this type of pump to be “pinchy.” Most moms don’t seem bothered and really love the product.
The Haakaa is a great tool to be used in conjunction with a double electric pump to maximize milk collection and output.
Now that you know everything about how to use your breast pump, go check out the other posts in my Pumping Series so you can learn how to prepare to go back to work, how to pump more milk, and which breast pump bag is best for you!
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