When you’re pregnant for the first time, there’s a whole lot of supplies to buy - and if you’re planning to return to work after your baby is born, a breast pump is probably high on your list… after a crib and a car seat, of course. And, so it should be.
Breast milk is the perfect source of nutrition for an infant, and the World Health Organization recommends exclusive breastfeeding for the first six months if at all possible.
Why do you want a breast pump?
Besides the obvious convenience of a breast pump, there are a couple of other reasons a new mother might consider purchasing one.
Insufficient milk supply - There are many reasons women aren’t always able to produce sufficient milk, including the strength of the baby to release milk and continue sucking until satiation. Reduced demand leads to reduced supply even when a baby desperately needs more milk. Breast pumps can stimulate greater demand, making it easier for both mom and baby.
Engorgement - On the other side of the spectrum is engorgement, when so much milk is produced that it’s difficult for infants to latch and subsequently drain all of the milk. In this instance, a breast pump can reduce the volume before breastfeeding, making it easier for the baby to latch. And, as breast milk stores incredibly well (in the right conditions), it doesn’t need to go to waste.
Medical and physical demands - Premature babies may be kept in the NICU for some time, during which it may not be possible to breastfeed (some or all of the time). Pumping makes it possible to maintain milk supply for future breastfeeding. Other physical conditions (both maternal and infantile) may make it almost impossible for comfortable breastfeeding; pumping still provides optimal nutrition without the strain.
Types of breast pumps
There’s a lot more variety to breast pumps than you may initially suspect; there is one for every budget and reason, but you will need to spend some time considering what will work best for you.
Breast pumps are available with single and double cups; the latter provides the option to express more milk in a shorter time span - though they are often more expensive (and some designs are significantly less comfortable).
Additionally, you’ll find manual, electric (or battery-operated), and hospital grade pumps. The right one for you may not be the one you initially expected; it’s best to consider the pros and cons of each before investing.
Although there are other considerations, the type of breast pump you need is the first point you need to address.
Manual breast pumps
Though these are definitely the least expensive option out there, they do require a fair amount of effort as they are exactly as described: manual. That said, they are the perfect choice for women who:
- Plan to leave their child only occasionally (such as with a sitter);
- Are on a strict budget (and can’t claim a breast pump from their health insurance); or
- Just want something for emergencies.
It is possible to find both single and double manual pumps, but you’ll need to check whether they require one or two hands for both types of models.
On the plus side, these pumps are:
Conversely, manual pumps may not completely empty mom’s supply, have reduced suction control, and can be difficult to operate. And, you should steer clear of any with parts that are difficult to clean.
Electric breast pumps
Electric breast pumps are perhaps the most common - and there are definite advantages, including ease of use. But you’ll pay more for the features that go with these pumps. Women who can afford an electric breast pump should consider one if they:
- Need (or want) to express often (such as moms who work outside the home);
- Require multiple modes (including letdown); or
- Don’t have a lot of time to express.
Many electric pumps offer double pumping (though single options are available), weigh less than five pounds, and require only one hand to operate. In addition, you’ll find that there are usually a few extra features and sometimes an added battery pack - though you will definitely pay more for these options.
You should be aware that most electric pumps work with an open-system; these are only designed for one user as there are multiple areas that touch breast milk and residue may be left behind.
Hospital-grade breast pumps
First, you should note that while the FDA regulates breast pumps, they do not have a hospital-grade classification. To further complicate matters, there doesn’t seem to be an agreed definition as to what manufacturers mean by hospital-grade. Often, but not always, this is taken to mean a high-end, electric, closed-system breast pump.
For reference, closed-system pumps (which ensure milk never touches working parts) are the only suitable options for sharing or renting, though extreme care must still be taken and lactating mothers must still invest in their own accessories.
Most women do not require such systems; those that do usually receive a referral from a medical professional. However, women who are exclusively expressing and have the budget available may want to consider a breast pump labeled as hospital grade, though these are more commonly rented out by hospitals and lactation specialists.
How to pick the right breast pump for you
A recommendation from your sister, friend, or co-worker does not mean you will end up with the right breast pump. Sorry. But, as you know by now, you don’t have the same breasts as they do. You also don’t have the same child. And, you probably don’t even have the same needs or comfort levels.
By now, you’ve probably got a good idea of whether you’re interested in a manual or an electric pump, and whether double or single pumping is right for you. But there are a few more things you should consider before you look closely at specific models.
How much pumping will you really do?
If you’re almost exclusively expressing milk (or you will be at some point), you definitely want to consider the higher-end models. Sorry. Remember that the more powerful the motor is, the longer your breast pump will continue to be effective. Luckily, this means that you’re more likely to get a few extra features.
How well do you express milk?
This is such a tricky one as you really don’t know until you give it a go - and it can be different for every baby. If you’ve previously had a lot of success expressing, you’re more likely to have an easy time of it… but not necessarily. However, if you’ve experienced problems in the past, you probably want to opt for a higher-end model that features more suction-and-release cycles and stronger suction than cheaper breast pumps.
Remember, though, you should never try out your breast pump until your baby is born, as you can bring on early labor if you do!
How portable is it really?
If you’re after a manual breast pump, you have almost no need to worry about this. And, if you’ll normally express at home, you probably don’t need to spend too much time on this aspect either. Everyone else should consider how easy (or difficult) a pump will be to tote around. This is where battery packs and car adapters can be important.
Portability goes further than the pump itself, however. It’s also critical to consider the safe bottling and storage of milk once it is expressed. Some breast pumps will come with everything you need in a single pack while others will require you to buy additional pieces. Either way, it’s important to understand the ease of use for every item in your breastfeeding bag when you use it away from home.
Is it easy to clean?
Cleaning your breast pump and all its accessories is critical for the health and safety of both baby and mom. If you’re only pumping on the odd occasion, you can spend a little more time cleaning than women who plan to express several times a day. So, pay close attention to the number of parts you need to clean as well as the cleaning method.
Can you adjust the suction and the settings?
This isn’t a deal-breaker for all women. But, everyone has an optimal suction strength (which may be different for every baby) and having some control over this is one way to ensure a breast pump works for you. In addition, babies drink at their own pace and variable cycle lengths can make or break the pumping experience for some moms. It’s not usually critical, but it’s worth taking the options if they’re affordable.
Can you afford it?
Babies are expensive as any parent will tell you. And, while you may be tempted to skimp a little on your breast pump, it’s better to purchase the best model you can afford that ticks all of the right boxes for you. Otherwise, you may just need to go through the whole process again and shell out for a second pump.
If you are covered by health insurance, Medicaid, or WIC, you can be reimbursed in full or in part by your provider. But, this may not always be the case.
Does your health insurance cover the cost of a breast pump?
In the US, the Affordable Care Act includes specific provisions for insurers to cover breast pumps in their policies. However, it is uncertain when and if this requirement will be dropped. It is, however, likely. And, it is also possible that legally-mandated workplace spaces for breastfeeding will fall away, as well as coverage for breastfeeding support from qualified lactation specialists.
Despite a mandate, employers and insurers may continue to offer these services. However, upon the complete repeal and (or) replacement of Obamacare, you will need to check with your health insurance provider rather than assuming a breast pump will be covered.
You may also want to check out Aeroflow Breastpumps, a company that assists women with the process, investigating whether their insurance covers the cost of a breast pump (or to what amount they will pay) as well as obtaining the necessary prescription from your doctor and completing required paperwork. This company can take a lot of work off your plate and it’s always worth the look.
What else do you need?
A breast pump isn’t the end of the road; it’s the beginning. You will need some extra pieces to make the most of your new pump. And, some aren’t as obvious as you may think.
- Additional shields (flanges) - Unless you’re renting a closed-system pump from a professional, you will definitely receive the cones that attach the pump to your breasts. These are commonly known as shields or flanges, but that’s where the commonalities end. The shields that come standard with a machine may be too big or too small, they may suck too much of your areola in or just feel uncomfortable. Double check that your breast pump has options (even if they’re sold separately) and that they’re easy to get. They’re usually affordable, costing somewhere between $10 and $20.
- Battery adapters and car connection kits - These are a nice to have... until that one emergency and then you’ll be happy you have one or both.
- Cleaning products - You’ll be able to get by with the cleaning stuff you use at home… until you leave the house. A portable cleaning kit is essential if you’re planning to pump outside your home.
- Insulated tote bag - Unless you’re planning to express and dump your breast milk, you’ll need to be able to store it safely until you return home. That typically requires an insulated cooler of some type and an ice pack. As you’ll definitely need this to express while you’re out, it’s worth looking at breast pumps that come with fitted carrying accessories. Make sure the capacity of the bag matches your intended expressing plans.
- Bottles and milk storage bags - It’s much, much easier when you can express into the bottle you will use to feed your baby. It’s worth buying a machine that allows for this and offers several bottle sizes and options. Remember that milk bags may also offer better long-term storage solutions. As always, look for a system that offers a complete solution, even if you need to buy a few extra pieces.
Breast pump safety
When it comes to breast pumps, you absolutely need to be safe about it - even if you’re pumping and dumping. We seriously recommend reading through all the instructions and warnings included with your pump. But, there are a few things you really should pay attention to.
It is possible to purchase a second-hand pump or to rent one, but only if it is an FDA-recognized multi-user pump. And, even then, you need your own accessory kit and bottles. Single-user, open-system pumps can easily harbor bacteria and viruses from previous users - including HIV and cytomegalovirus which are really not the start you want to give your baby.
Unless your healthcare provider has recommended such a pump to you, it’s always advisable to buy a new one rather than save a few bucks this way.
Clean after every use
We know you’re not going to do a full sterilization in the office after expressing during your break. But, you should wash parts with dish soap and rinse with hot water for at least 10 seconds. It’s preferable to air dry pump parts (even if you give them a once over with a paper towel), but you may not have the option to do so when you’re away from home. When you do return, it’s worth the extra washing, drying, and sterilizing according to the manufacturer’s instructions.
But, don’t clean tubes
These only need to be cleaned if milk gets into them. But, you will need to refer to the manual as to the best way to clean and dry the tubes according to your specific model. Keep in mind that some breast pump models advise replacing certain tubes if they become foggy and it’s better to do so than to provide a convenient breeding ground for bacteria.
Shields and single pumping (with a double pump)
Always turn off an electric breast pump before removing the shields. While this is a mistake you’ll only make once, you want to avoid it altogether if you can. Need we say more? Even after switching off, it’s best to use a finger to break the seal before removing the flanges.
If you have a double pump, but only plan to empty one breast, seal the other side, otherwise you’ll have an issue with the suction. While this isn’t a matter of safety, per se, you’ll appreciate the reminder if you don’t want to sit with your pump for the next three hours.
How to use your breast pump
This is where things get personal. And, as every breast pump is different (as are the women using them), we can’t advise you how to use yours. You really do need to read the instruction manual and contact the manufacturer if you have additional questions.
If you’re really struggling, your first port of call should be your doctor or a licensed lactation specialist. Not every pump is for every woman, but some issues go beyond pumping itself. But, one thing we can tell you before you head off to find the right machine for you is that pumping can take time - the first couple sessions are likely to be trial and error as you find the right settings and the most comfortable positions. And, at the beginning of every session, you’ll need to exercise plenty of patience (it’s not as if you’re a faucet that can be turned on and off at will). But for your sweet little baby, it's all totally worth it.