A breast pump is a nursing mother's close companion during lactation. For some, a double electric breast pump can make all the difference between a stressful experience and a successful one, or a lackluster and robust supply, which makes it worthy of well-researched consideration.
Unfortunately, breast pumps can be confusing, which can make selecting the right one a chore. There are a plethora of manufacturers and models, and technical terms such as “2-phase expression”, “closed system,” and “massage mode” that can complicate the issue.
We recommend reading our Article titled Best Practices for Handling Breast Milk.
To help you find the perfect breast pump for you, we tested several of the most popular breast pumps from various brands to find the best. We evaluated them comparatively, side-by-side, on the following important criteria: efficiency, comfort, ease of use, portability, and hygiene.
Do You Need a Breast Pump?
Whether you are exclusively or partially feeding your baby breast milk, you will likely use a breast pump at some point. The frequency of its use depends upon your lifestyle, milk production, and your baby's appetite.
Typically, a baby's latch and sucking power during breastfeeding produce superior stimulation and volume in comparison to what a pump can accomplish. So, pumping may not produce as much milk as you might during a nursing session. Also, every mother's letdown and production varies widely. While one mom might produce 5 ounces on each side in a 15-minute pumping session, another mother may yield 2 ounces or less.
Engorgement
Some women have significant engorgement to the point where the baby can't possibly provide relief. Also, it can be difficult for newborns to latch onto an engorged breast, so a pump can help reduce volume and soften the breast before the baby.
Insufficient Supply
Pumps can also be vital in stimulating milk production when the supply is low. The physiology of breastfeeding is a demand-supply loop. Pumping for 10 to 15 minutes after the baby has already nursed will typically create a more robust milk supply over time.
Challenging Nursing
Sometimes it can be challenging to get your baby to latch and suck properly. There are many reasons for this, such as inverted nipples or a baby who is ill or developmentally delayed. If this happens, moms need to pump for their baby to have breast milk. To keep up with a full or part-time pumping schedule, you'll need powerful pumps to keep your milk supply going.
Working Away From Home
Working away from home means being separated from your baby for extended periods. You'll need a breast pump to create sufficient supply and demand to continue nursing and collecting breast milk when you are away. Breast milk is the most nutritious and healthful option for a baby, and it takes a great breast pump and maternal dedication to keep things going.
If you plan to return to work, building a stockpile of frozen breast milk is crucial. When to start and how much to store depends upon your milk production and how many hours a week you'll be away. If supply is a challenge, starting the storage process earlier is helpful. Supply is usually greater in the morning, so pumping after a morning feed is one approach. Or, if your baby only feeds from one breast, pumping the other can also help. Regardless, breastfeeding while back to work requires daily dedication and preparation to keep production going.
Staying Home
For those whose job is caring for their little one(s) full-time, a breast pump can be an integral tool for engorgement, low supply, and difficulty with latch and sucking. But if you're with your baby 24/7, having reserves to take a break from your baby is also a good reason. By having a supply of expressed milk available, you can get away for a few hours to run an errand, exercise, or have a precious date night. Dads can also help feed and bond with their baby by feeding expressed breast milk via a bottle while mom gets much-needed rest or personal time.
Health Insurance and Breast Pumps
Signed into law in 2010, the Affordable Care Act (ACA), requires commercial health insurers to include the services of “breastfeeding support, supplies, and counseling” in the comprehensive health care of women. This ACA law includes coverage of a breast pump for lactating women. The caveat here is that “coverage” may or may not pay for the entire cost of the pump, and this can vary from company to company, plan to plan, and network to network. Yikes!
Obtaining a breast pump through your health insurance can make a big difference in your pocketbook at zero to less out-of-pocket cost when compared to buying one without it. However, know that it will take some legwork and make plans in advance, if possible. For example, some insurance plans will allow filing a claim no earlier than 30 to 60 days before delivery, while some will only do so once mom has delivered and up to a year past childbirth. The 30 to 60-day policy does make sense because if you end up having a baby prematurely, you may need a particular prescription for a hospital-grade breast pump.
The basic steps to obtaining a breast pump through health insurance are the following:
- Prescription — A mother must get a prescription/prior authorization for a breast pump from her physician. If you plan on pumping frequently or have a history of low milk supply, make sure your doctor writes a prescription for a double-electric one. Though manual breast pumps do fill a particular niche, double electric pumps are much more efficient. Additionally, manual pumps are much less expensive than electric ones, so if insurance covers the bigger expenditure, take advantage of this opportunity.
- Submission — The prescription needs to be submitted to your insurance company.
- Choose a Pump — Upon submitting the prescription, you will be provided with a selection of covered pumps and one or more Durable Medical Equipment (DME) companies through which you can order. You may also find out further information about your coverage, such as whether your insurance company will only cover a set cost or if you will be responsible for a copay.
- Order Pump — Contact the contracted DME company and place an order, as well as pay any remaining costs not covered by insurance.
What happens if you prefer a pump different from what your insurance allows? This can feel like a great roadblock, one where many may choose to quit the coverage process. However, many DME companies may offer “upgrades” for a determined out-of-pocket cost. We encourage you to take this opportunity to shop around for the best price and package with reputable retailers to ensure you are getting the best deal.
If you prefer to have an advocate do the behind-the-scenes work for you, contact your health insurer to find out which Durable Medical Equipment company they contract with, as some, like Aeroflow will do just this. Their services include contacting your insurance to determine its coverage policies for reimbursement, requesting a prescription from your doctor, filing a claim with your insurance, and mailing a pump directly to your door.
Types of Breast Pumps
There are so many brands and styles of breast pumps that it can be tough to decide which one is right for you. Each pump has its strengths, weaknesses, and price points.
The two main categories of breast pumps are manual and electric. Each has pros and cons, and there are reasons why one may work better for you.
Manual Pumps
Manual pumps are hand-operated and pump one breast at a time via a flange and manual lever that creates suction. They are less expensive than electric pumps and light and small, so they easily fit into a purse or carry-on. A good manual pump should express a decent amount of milk, comparable to an electric pump. However, this process is more time-consuming and labor-intensive. They are best suited for the sporadic pumper. Even if a mom has an electric pump, manual pumps are a nice companion.
Electric Pumps
Electric pumps have a motor and run via an outlet or battery power. Most breast pumps now have the following options: an AC adapter, a car adapter, a rechargeable battery, or a battery pack. They are available in single and double versions. Single Electrics pump one breast at a time. Double Electrics can pump both breasts simultaneously, which can be a huge time saver. Typically, doubles can also be easily configured to pump just one breast if desired. A double electric pump is a worthwhile investment if you pump more than 3x/week. Working moms, moms with low supply, or moms who exclusively feed their babies pumped breast milk all fit into this picture.
What is a Hospital Grade Pump?
The FDA regulates breast pumps as medical devices. However, the term “hospital grade” is not recognized by the FDA and does not equal safety or hygiene. Do not let the term “hospital grade” influence your purchase, as manufacturers can make this marketing claim without a consistent definition.
The FDA advises paying closer attention to the terms multiple-user and single-user. Understanding the differences between each and when to buy a single-user versus when to rent or invest in a multi-user can make a big difference in the beginning and sometimes even in the long haul for some moms.
Multiple-User
Multiple-user breast pumps are typically used by hospitals, lactation consultants, and for home rental. If used and maintained correctly, multiple moms can safely use them. Each user must have their personal tubing and collection containers attached to the pump. This might be how the term “hospital grade” originated, referring to multiple-users and increased strength. Multiple-user pumps are commonplace in NICUs where mothers with preemies who can't nurse yet can initiate lactation and save milk for their newborn to drink later. As these mothers are lactating without the suction power of a newborn, the increased power of multi-user pumps is essential to long-term breastfeeding success.
Single-User
All of the pumps in our review are single-user models. Single-user breast pumps tend to be less expensive than multiple-user pumps. Single-user electric pumps have either open or closed systems.
An open system does not have a barrier between the milk collection kit and the pump, which can potentially cause issues. Because air is drawn through the pump to create suction, without a barrier, pumped milk is technically exposed to matter in the air, like dust particles, dander, pollution, bacteria, and viruses.
In addition, in an open system, contamination can stem from the opposite direction as well. If milk gets into the tubing, the tubing must be cleaned and thoroughly dried before using the pump again. If milk is left inside the tubing, mold can grow and ultimately transfer to the motor, which can not be cleaned. To painfully illustrate this point, we came across a lactation consultant's Facebook post where she took off the faceplate of several used open system pumps and comparatively photographed them to create a visual for her clients of why re-using, selling, or giving them away is out of the question. All we can say is that a picture is worth a thousand words. If you purchase a breast pump with an open system, paying close attention to the manufacturer's manual, outlining the operation, cleaning, and maintenance instructions, is particularly important.
Open-system breast pumps have been successfully used for years. Most have a clear assembly video that covers how to remove the pump's faceplate to clean the diaphragm and inner area regularly, as well as how to clean and air dry tubing if milk or condensation should enter it. Though regular cleaning and maintenance significantly help, it is still perplexing why open-system breast pumps are still in production. However, in today's age, you'd be hard-pressed to find an open system currently being produced, and we recommend avoiding used pumps in general.
A closed system has a barrier between the milk collection kit and the motor; fluid cannot enter the suction tubing or the motor. The barrier also prevents air impurities from being introduced into pumped breast milk. If cared for appropriately, closed systems are more hygienic. However, this doesn't mean they should be handed down or sold for other moms' use (more on this below).
Do Not Buy or Borrow a Used Single-User Breast Pump
We know that even single-user electric pumps can feel like an exorbitant cost, and borrowing or buying a used one might be tempting. However, it is not worth the risk. Simply put, don't do it. Single-user breast pump manufacturers do not recommend this practice.
Why?
Health and Hygiene
Humans can harbor infectious diseases without knowing it. Sharing personal care products, including breast pumps, is not recommended, even with a good friend. Breast milk is a biological substance that can harbor HIV and CMV, which can be unknowingly transmitted. Also, if a mother with cracked, bleeding nipples pumps, blood can come into contact with external pump parts. Despite diligent cleaning, bacteria and viruses can still be transmitted. It is also important to always use personal milk collection kits.
Single-user pumps are not meant to be passed along. Over time, an open-system pump is more likely than not to have breast milk and mold inside the motor, which can not be adequately disinfected. Closed-system pumps do not have these issues if a new collection kit is used. However, they are manufactured as single-use pumps, as motor life can only last so long.
If multi-user pumps are cleaned and cared for properly, they can be used by more than one person. If someone chooses to make the costly investment of buying one, it can be passed along if it is well cared for.
Motor Lifespan
Most single-user electric breast pumps are designed for use for about one year with one child. However, manufacturers' and models' warranties differ. Also, manufacturers typically void a single-use breast pump's warranty if it is used by more than one person.
In a nutshell, if you are pumping three times a day for a year, the motor will eventually lose strength. Hand-me-downs aren't likely to have as much strength as they did when new. We firmly discourage a new mom from relying on a used electric breast pump, not only for the health and hygiene concerns, but also because it is likely to have lost significant power. If you are concerned about your pump's performance, you can take it to a rental location where they have a vacuum tester and can measure its suction capacity for appropriate levels.
What to Do with a Used Single-User Pump When Use is Over
There are two ecologically sound options since it is not kosher to pass pumps on. The first is to check with the pump manufacturer to see if they have a pump recycling program. If not, check to see if your county has an electronics recycling facility.
Important Breast Pump Features
We recommend the following key features in any pump you purchase.
Well fitting flange(s)
Flanges are the plastic/silicone pieces that you put over your breast when pumping. The pump's suction pulls the nipple into the flange, so flanges must fit properly. Most breast pumps have different-sized flanges available. You do not want the nipple to constantly be rubbing against the plastic, as it may cause abrasions and lead to bleeding, pain, and infection. If you have questions or concerns about fit, seek the help of a lactation consultant.
Dual-Phase Expression
Having a pump with 2 phases is important as each attempts to mirror a nursing baby's sucking patterns. The first step is stimulation, where the baby takes short, shallow, frequent sucks to produce the letdown. The second phase is the expression where the milk comes in, and the baby's sucks become longer and deeper.
Helpful Related Accessories
For pumping moms, pumping, transport, and storage accessories are necessary for smooth pumping sessions, easy transport of the goods, and efficient, safe storage of milk. With some pumps, you will need to purchase items separately. However, some pumps include items like a tote bag, bottles, lids, breast milk storage bags, and a small insulated cooler with ice pack for storing breast milk until you find a refrigerator or freezer.
Breast Pump Bag
For moms who need to pump outside of the home, having a good breast pump bag that fits the essentials plus extras like water, snacks, keys, wallet, and cell phone can be a huge perk. One that looks like a purse instead of the iconic pump totes is a real treat. Not all tote bags included with the pumps are big enough for these tasks. Take a look at our breast pump bag review to find other options.
Breast Milk Storage System
Whether you are pumping on the go or at home, you'll need to purchase a breast milk storage system, such as bags or glass containers. For more on this topic, read our article Best Practices for Handling Breast Milk.
Insulated Cooler & Freezing Pack: Size and Quality Matters
Insulated cooler bags are typically not a one-size-fits-all solution. They come in varying shapes and sizes, holding 3-8 bottles per bag. Total milk production will need to be considered to find the right capacity. You must also consider how long the cooler can maintain the breast milk at a healthy temperature. You are golden if you have a refrigerator at work for pumped milk and use freezer packs to and from work! Otherwise, the longer you are gone and the more milk you have, the bigger the insulated bag and more robust cooling packs need to be.
Bottles, Lids, and Milk Storage Bags
Before returning to work or pumping away from home, it is essential to consider your options and process. Basically, the longer you are gone, the more accessories you will need. Transferring milk into storage bags like Lansinoh Breast Milk Storage Bags can save space in the insulated cooler, but everything must be well-sealed and packaged to prevent mishaps.
Power Supply
Having the right accessories is essential if you depend on an electric pump away from home. Most electric pumps come with an AC adapter to plug into an outlet. A car adapter or battery pack will be necessary if you are pumping in the car or on the plane. A rechargeable battery pack is necessary if you need battery power for a long time without access to an outlet. Not all pumps offer these features.
Conclusion
When you're ready to buy your pump, our favorite breast pump review includes all the details you need to make an informed decision based on testing and your pumping needs. We feel confident there is a top-ranked option in our review for any goal or budget; whether you want to capture passive letdown or go bike riding while pumping, there's a pump for that, and we can tell you all about it.
