Consumer Reports Breast Pump Article: Review and Comparison of Breast Pumps by Consumer Reports; What Type of Breast Pump is Best For You; Breastfeeding Pumps.

Breast Pumps Review and Comparison

From ConsumerReports.org - November 2005; reprinted with permission

A breast pump is indispensable in a number of scenarios: You want to continue breast-feeding but return to work; you need to formula-feed your baby temporarily for medical reasons but want to resume breast-feeding when you get the go-ahead from your doctor; you need to occasionally miss a feeding because you're traveling or otherwise away from your baby.

It also can come in handy during those first few days after you've delivered, when engorgement may be an issue. With engorgement, the breasts can become so full that a baby can have trouble latching on. "Things can be sailing along in the hospital, but when you get home, supply can outdo demand," explains Ann Darrah, director of maternal health at LaPorte Hospital in LaPorte, Ind. The solution is to express some milk with a breast pump--and to have one on hand before your baby is born, so the bottle is ready to go as soon as you return home after delivery.

A breast pump allows you to store milk (in bottles or storage bags) for later, then bottle-feed it to your baby or mix a little in cereal when he or she reaches the "solid" food stage. You can refrigerate breast milk safely for five to seven days, or freeze it for up to a year. A housekeeping note: Thaw it in warm water. Don't boil or microwave it; both of those heating methods can destroy valuable immunological components that make breast milk the liquid gold it is.

There are several types of breast pumps available--from large, hospital-grade and midweight "professional" pumps to handheld models that work one breast at a time. You'll want a pump that's appropriate to your particular situation.

A baby's natural sucking rhythm is 40 to 60 cycles per minute (one pull per second or a little less). Hospital-grade and midweight pumps typically operate at 30 to 60 cycles per minute. Other pumps are usually less efficient.

Speed is especially important if you plan to save a large quantity of milk. Mothers returning to work, for example, need to have much more breast milk on hand than those who stay home with their babies or are supplementing breast milk with formula.

Pumps also vary by the type of suction they apply. Intermittent action better imitates a baby than a constant vacuum--and is easier on mom.

Using a breast pump will take a little practice. You'll need to learn how to position it correctly and adjust the suctioning to get the best results. Don't worry--with the right pump, you'll soon get the hang of it. Pumps require some assembling and disassembling for cleaning. Wash any parts of the pump that touch your breasts or the milk containers in the dishwasher, or with hot, soapy water. Drain them dry before each use.

SHOPPING SECRETS

Never buy a used breast pump. Other than hospital-grade rental pumps, which are designed for multiple users (they have special barriers that prevent cross-contamination), all other breast pumps are made for one person only. To buy or borrow someone else's pump can put your baby's health in jeopardy because research suggests that bacteria and certain viruses can be transmittable through breast milk. And even if you buy your own tubing, bacteria and viruses can cling to a pump's internal diaphragm--the part that connects to the tubing--which can't be removed, replaced, or fully sterilized.

Consider cyber-shopping. A little research reveals that there are deals to be had in the online breast pump marketplace once you know what kind of pump you want. (Not sure where to start? Simply type in "breast pump" on a search engine like Google.)

Browse at the hospital. Many hospitals and birthing centers are now in the breast-pump business, offering competitive prices on a variety of pumps--plus advice that can help ensure breast-feeding success. It also wouldn't hurt to get a recommendation from your hospital's lactation consultant as to the right type of pump for someone in your particular situation.

WHAT'S AVAILABLE

The options in breast pumps are dizzying. The major brands are, in alphabetical order: Avent, The First Years, Hollister, Medela, Whisper Wear, and Whittlestone.

Breast pumps come in these basic types: Large, hospital-grade dual-action models, which aren't typically available for sale (you rent them from the hospital where you deliver or from a lactation center); "professional" midweight, fully automatic models that can travel with you; small electric or battery-operated units that double- or single-pump; single or double pedal-pump models; one-handed manual pumps; and even "hands-free" pumps that you wear in your bra that pump while you work, do errands, or drive. (We told you the options were dizzying!)

Here's the lowdown on each:

Hospital-grade breast pumps

These powerhouses are about the size of a car battery and can weigh 5 to 11 pounds. Manufactured for users in hospitals and for those who choose to rent, they have sensitive controls that allow you to regulate suction rhythm, intensity, and pressure. Some have a pumping action that's almost identical to a baby's natural sucking. Accessories permit dual pumping so you can empty both breasts at once. These are quite expensive to buy, but you can rent them from hospitals, medical-supply stores, lactation consultants, and some drug stores.
Pros: They're fast and efficient.
Cons: Some women may find these pumps noisy--they produce a rhythmic swishing sound. And even though some come with a rechargeable battery and an adapter for use in a vehicle, you wouldn't exactly want to lug one to and from work every day because they can be awkward and heavy.
To rent monthly, expect to pay $30 to $50.

"Professional," midweight breast pumps

Usually no bigger than a briefcase, these breast pumps are slightly less efficient than the hospital-grade models, although you may notice little difference.
Most "professional" pumps offer intermittent suction, which mimics baby's natural sucking, although some use a constant vacuum. Many models include dual pumps for emptying both breasts at once. Many come in a black microfiber case to resemble a tote bag, which is ideal for working moms and those on the go. Some are also available in a backpack style, which leaves your hands free for your baby, when commuting, traveling, or shopping. They're often equipped with an adapter for your car's cigarette lighter or a battery pack, for times when you're not near an electrical outlet.
Pros: A quick and easy way to double-pump and fill up a bottle in minutes when you're on the go.
Cons: May be more breast pump than you need if you plan to pump only occasionally.
Price range: $160 to $300.

Small electric or battery-operated units

These can be useful if you're away from your baby now and then--for a night out or a couple of hours during the day. Using widely available AA or C batteries or household current, these lightweight, compact devices can fit discreetly in a purse or briefcase. They're relatively quiet and can be used just about anywhere. But the suction can be slow and tedious, achieving only five cycles per minute. Some also have a constant vacuum that can cause nipple discomfort.
Pros: Portable and inexpensive.
Cons: If you use it more than occasionally, you may find that pumping takes too long. Consider one of these for occasional use only.
Price range: $40 to $80.

Manual breast pumps

With these small pumps, you produce the suction yourself by squeezing a bulb or lever or by manipulating a syringe-style cylinder. There are many different designs of manual pumps on the market. Cylinder, or piston-style, pumps usually allow you to control pressure and minimize discomfort. Some manual models let you operate them with one hand. They're easier to use than those requiring one hand to hold, one to pump.
Pros: These pumps are less expensive than electric models and don't need an electrical source or batteries.
Cons: Any small pump could tire your hand and arm and cause repetitive strain injuries if you use it frequently. Manual pumps are often markedly slower than other pumps. We recommend these only for occasional use.
Price range: $30 to $45.
Note: Some electric breast pumps, such as Medela's Pump In Style pumps (the Advanced and the Traveler) come with a manual breast pump, so you get two for the price of one.

Pedal pump

These innovative breast pumps are powered by pushing a pedal with your foot and allow you to single- or double-pump.
Pros: Because your legs do the work, you won't have to worry about the wrist and hand discomfort that can occur with other manual, do-it-yourself pumps.
Cons: Some women find this type of pump too bulky and not easy to carry around. The pumping action also can be weak. After you've been nursing a while and expressing milk becomes more of a challenge (which tends to happen), this model may not be up to the job.
Price range: $35 to $55.

Hands-free pump

Placed inside your bra, this battery-operated pump mimics the feel and sucking pattern of a baby. Milk travels through a flexible stem and collects in a self-sealing, spill-proof bag. Whisper Wear is the only brand of hands-free pump we know of on the market.
Pros: You don't have to drop everything you're doing to pump; it's the ultimate in multitasking.
Cons: Some women report that for this pump to work, you need a super-tight bra and must position the pump exactly (otherwise, milk won't collect properly). Also, since you're placing the pump inside your bra, your chest size will expand considerably, so you may need to wear a large sweater or blazer to camouflage the fact that you're pumping, if you do so in public. And we also hear that it's not exactly "whisper" quiet.
Price range: $119 (for a single pump) to $219 (double pump).

FEATURES TO CONSIDER

Adapter/batteries. If you're pumping on the road, you'll need a pump that has the option of running on batteries or that includes an adapter that can attach to your car's cigarette lighter. However, for models that aren't "hands-free," we don't recommend pumping while driving.
Carrying case. If you'll be commuting or traveling, a professional-looking pump "briefcase" or sporty backpack is the way to go. Most models other than the hospital-grade ones come in a chic, black case with a shoulder strap so you can travel incognito.
Double-pumping. If you'll be pumping at work or pumping often, get a double hospital-grade or midweight "professional" pump. By expressing both breasts at once, you can complete a pumping session in 10 to 15 minutes. Besides being fast, double pumps are superior because they're better for milk production. Double-pumping increases levels of prolactin, the hormone responsible for milk production. Smaller pumps or a single pump may not be able to maintain your milk supply long term.
Insulated storage compartments. Look for compartments in the pump's carrying case if you'll be pumping on the go and need to store your milk for later. But be sure to keep your breast milk in the storage compartment with an ice pack or two.
Suction settings. The best pumps mimic baby's natural nursing rhythm by pumping in two distinct modes: rapid, to simulate baby's rapid sucking to begin fast milk flow, and slower, to simulate baby's deeper sucking to maximize milk flow. Together, the two phases offer a more authentic breast-feeding experience with greater comfort, increased milk flow, and quicker nursing time. Brands/models on the market that purport to pump "more like baby" include Medela's Harmony Manual Breast Pump, its Pump In Style Advanced, and its hospital-grade Symphony. A less well-known competitor on the market, but one worth a look, especially if you're uncomfortable (cracked, blistered, or bleeding nipples can come with the territory), is Whittlestone Breast Expresser. One online reader writes: "I was in terrible pain before I even left the hospital. At my follow-up appointment, they recommended the Whittlestone Breast Expresser. I was skeptical but willing to try it. It didn't hurt, and I got as much milk as with the Pump In Style."

RECOMMENDATIONS

Consider renting a hospital-grade breast pump if you're not sure how long you'll need to use a pump or if you know you'll only need to pump for a short time. Still, since hospital-grade pumps aren't very portable, renting one is a realistic option only if you plan to be home with your baby. When you rent, you're given the pump, the bottles, and the suction cups. All you'll need to buy is the tubing that the milk flows through, which costs only a few dollars.

For information on breast pump rentals in your area and referrals to lactation consultants, contact the International Lactation Consultant Association (www.ilca.org) or La Leche League (www.lalecheleague.org). The hospital where you delivered your baby may have a lactation consultant on staff.

If you expect to use a breast pump regularly, especially if you plan to return to work, buy a midweight "professional" model. A professional pump will be your ally in getting a significant volume of milk in a given time and will also be your best bet for maintaining your milk supply. Otherwise, if you plan to use a breast pump only occasionally, a manual pump or a small electric or battery-operated one will probably be all you need. They're appropriate for occasional use. Since using a breast pump can be tricky, most manufacturers now supply informational brochures with their units. You can also call manufacturers' customer-service lines if you encounter problems with a specific pump. Many offer a 90-day warranty and will repair or replace a product without charge. But keep your receipt or the printout from your baby registry as proof of purchase.

There's also a host of information on the Internet about breast-feeding in general and specific guidance for issues such as continuing breast-feeding after returning to work. The La Leche League, at the Web address mentioned earlier, is a good place to start.