Q&A: breast pumps

Woo-hoo! Back to alleged reality for most everyone today. Over the break, my cats pried seven of the keys off my laptop, I had wacky hijinx involving airline flights, and I discovered that somehow all the crap in my apartment is reproducing so the more I get rid of the more there seems to be. I hope you're well.

Today's question is from Maria, who writes:

"Do you have any advice on picking out a breast pump? I feel lost trying to pick one out!"

This is when I confess that my breast pump knowledge kind of stopped in 2005, when it became evident that my second son was never ever ever going to drink my milk out of anything but me, so I gave up on pumping, and if I was out he just ate something else or waited.

But I do think the advice I've been giving all along is basically sound: You don't really need to have a pump ahead of time.

Here's the logic: Some women don't need to pump at all for the first month or so, and, in fact, pumping can screw around with their supply and get them overengorged and just cause all kinds of wackiness that's basically unnecessary. (Those of you who suffered from undersupply may not believe it, but oversupply can cause problems, too.) Plus it's just another task added to your overstressed brain and body, and why cause more headaches for yourself if there's no reason to do it?

If you are having actual supply issues (and by "actual" I mean that it's not just the normal "am-I-making-enough-how-can-this-possibly-be-working-when-I'm-not-actually-doing-anything-and-why-does-the-baby-want-to-nurse-from-3-9-every-evening?" stuff) then you should go directly to renting a hospital grade pump for the first few weeks until all that shakes out anyway. Sometimes supply issues are a matter of management and time (if you have edema, for instance, or got a bad start or had a traumatic birth) and you'll end up needing your own pump, but you can figure out which kind once you know what kind of pumper you are. Sometimes you're going to need to keep the hospital grade pump for the duration of your nursing experience. Sometimes you have issues that mean nursing isn't going to work, and having bought a pump is just going to add to the whole ball of suck that surrounds that discovery.

So. Upshot: Unless someone else desperately wants to buy you one, and will only buy it now, or you live someplace where you need lead time to obtain a pump, hold off until the baby's a few weeks old so you know what kind you'll need.

Having said that, I'll recommend the two gold standard pumps from a few years ago. Please, commenters, if there have been any new developments in pumping, put them in the comments.

For people who only have to pump once or twice a day, the universal favorite was the Avent Isis. It's a hand pump, but women said time and time again that they get more and have an easier letdown with the Isis than with an electric pump. I know first hand that their customer service is phenomenal, so if you lose a part or are confused about something (the white star disc has to go in facing down or you won't get any suction) they will fix you up cheerfully and quickly. (I would not use any other hand pump, no matter how cheap or available, because it just isn't worth it IMO.)

For people who need to pump more often, the Medela Pump in Style (PIS) was the winner. It's portable and reasonably quiet and has great, comfortable suction. Everyone I know who had to pump on the jobsite had the PIS and loved it about as much as anyone can love a pump.

And with that, I'm going to leave you with my own opinion, which is that pumping sucks. I don't know anyone who liked it, no matter how often or for how long they did it. It's one of those things we do for our kids if we can, but just counts as a sunk cost of parenting. 

Any new pumps out there that beat the Isis or PIS? Has anyone tried the new dual electric Isis and want to give a review?

Comments

[Tamara]

Honestly and truly, the Isis was a complete waste of money for me. It never worked right, and I ended up buying a Pump In Style anyway, which worked pretty well. I suspect my son was able to get more milk out of me than the pump, but the PIS enabled me to keep breastfeeding when I went back to work.

[Lauren Ananas]

Whoa, I've been reading AskMoxie for months now, and here's an issue I can comment on! Awesome!

I had my first baby in November and I bought a pump before she was born. I got it in October because it was on sale and it's probably the most expensive non-hospital grade pump (Medela Freestyle) out there and doesn't go on sale much. I did not break the seal on the box until I was ready to use it, though, so I could resell it more easily if I needed to.

It was a godsend when I had engorgement, because my breasts were ROCK HARD and baby girl couldn't latch on. I pumped off about an ounce (not every time, just a few times a day) before nursing and we were all much happier that way. I had tried hand expression, but that didn't work and just frustrated me to tears. Thanks to the fact that it's cordless, I was able to pump easily no matter where I was.

Since then, I pump about 3-4 times a week. I pump right into playtex liners (there's a pump & store kit) which go into the fridge or freezer, and then directly into the bottle.

I LOVE the Freestyle. It was a splurge for me, but so, so worth it. If you can afford it, it rocks. I charged the pump once, the day before Thanksgiving, and it still has plenty of juice left. It weighs almost nothing and comes with all the parts to allow for hands-free pumping.

I do plan to go back to work in March- I probably would have gone with a hand pump (or much cheaper electric) if I were planning to stay home.

[Erin]

I loved the Medela pump in style and wish I would have purchased it sooner. Although it is pricey it was definitely worth it. I tried the hand held pump by avent and was so frustrated, it would take me over a half hour to get one ounce. I am a stay at home mom so I only needed milk for occasional outings but it was so nice to know that I had enough in the freezer in case something came up. If you can afford it and are thinking about having more than one child(that's how I justified the cost) I would definitely try it. You can always try the avent pump first as it wasn't that expensive and then if it doesn't work I would try the medela. Good Luck

[meggiemoo]

I love my Medela Pump in Style (backpack version). Luckily for me, we were able to convince our HR department to purchase a hospital-grade pump that will stay at work, so the pumping moms only have to bring in the tubing and flanges and such. So that's pretty awesome.

Pumping is hard. I've never met anyone who joyfully proclaims, "I love pumping!" It's a chore. But if you're committed to breastfeeding while working, it's a necessary chore. Or if you ever want to leave the baby with anyone else and go see a movie by yourself.

If it's your first child, I would say get the nursing relationship established before you try the pumping thing. Your world has been exploded enough without trying 2 new things. But don't wait too long if you're planning on WOTH. Maternity leave is an awesome time to build up a freezer supply of pumped milk. I wish I had had more there when I went back to work.

[scotti]

I used my trusty Pump in Style Advanced for a long time - and had great luck with it. I carted that thing all over our state and on many plane trips! I didn't love pumping, but it allowed me to work and still breastfeed.

Medela products are usually considered the "gold standard" in breastpumps. Their double electric pumps have the "two phase" technology that mimics let-down and the Harmony handpump also allows you to mimic the initial flutter suck. Their website has great info and a little Breastpump selector function: www.medela.com

All of the parts that touch breastmilk on Medela pumps (including their bottles) are BPA free. Here's a posting with info on other pumps and how they measure up on that issue: http://safemama.com/2008/12/09/bpa-and-phthalate-free-breast-pumps/

I also recommend this website for all sorts of info on pumping, whether or not you are going back to work: http://www.workandpump.com/

[violingirl]

I used both of the pumps you recommended Moxie. The Avent Isis was great for occasionally pumping like I did with my first and the PIS was excellent for pumping for my second who I pumped for much more often because of my work schedule.

[scotti]

A couple additional things --

Check with your insurance company, some will cover part of the cost of a pump as "durable medical equipment". And, at least in our state, moms who qualify for WIC and are going back to work can receive a Pump in Style.

[Shannon]

From what I hear, the new Medela Freestyle is lighter and can be used hands-free, which are both improvements over the PIS.

[wendy]

I rented a hospital grade pump for the first 6 months and I would recommend that to everyone.

With the first baby, I had a cheap hand pump (which I still use, in a pinch), then a couple of more expensive ones (50$-100$ range). They hurt, took a long time to pump, leaked, etc.

Renting pumps is not cheap, 50$ a month. But, I waited until the baby was born to see if I needed one. Then, once I decided I did, I rented one for 6 months. It pumped simultaneously, took 5 minutes, never hurt, and when I was done with it, I just returned it.

[Mom to Baby J]

I have the Medela PIS which I use about three times a week when I work. It's a great pump but my supply has been waning and sometimes it takes forever to get my milk to let down. After reading this post, I wonder if the Isis would work better for me since I pump in a small, cramped office in the restaurant I work for. Anywho, I can't complain about the PIS. And our insurance paid for it so that was a definite bonus. In my state Blue Cross and Blue Shield has a better beginnings program for pregnant woman which pays for, among other things, a breast pump.

[Lee]

I heartily recommend having a pump available when the baby's born (whether it's yours or you borrow one).

I just finished pumping for my second son and after I pumped for the last time, I had images of reenacting that scene from Office Space where they smash the fax machine to bits.

[Cobblestone]

I am the only person on the planet who hated the Medela PiS. H.A.T.E.D. I am so out of the norm that I sort of expect that my PiS was somehow worn out or defective or something.

Happily, there is a hopsital grade Medela at work {whoo hoo!} and the Harmony {the manual Medela} is GREAT. So, I love the brand but PiS did't work for me at all.

[Kimberly C]

I used the Pump in style and LOVED it as much as I could love a pump- pumping was soul sucking and awful and I kinda hope I never have to do it again. That said, it worked and let me feed my kid while I was at work. I even pumped on my 45 minute commute to work (and I am awfully glad that I was never pulled over)

[amy]

One decision you will have to make is whether you are going to double pump or single pump. If you are going to double pump, you must have an electric pump. If you'll be pumping exclusively, as I did with my daughter, double pumping does two things for you: it cuts the total pumping time and it triggers increased milk production (over single pumping).

For the year I exclusively pumped (traumatic birth + NICU + other problems), I started with a hospital grade pump for a month and then bought the Pump in Style. It lasted but aged considerably. I had the pump's suction checked by my lactation consultant (handy gadget that was!), and it is good enough for single pumping now, but if I needed to double pump, I'd need a new one.

Before my son was born last October, I bought the handheld Medela pump and I love it. I really only need to single pump now to make the occasional bottle and to relieve the pressure during times he decides he's more sleepy than hungry. I have heard from my lactation consultant and from one of her other clients that the new Medela electric single pump is great. I think it's called the Swing.

Best of luck! And remember - no matter if you're able to breastfeed or you have to pump exclusively or you're somewhere in between, you're doing great! Feed the baby, enjoy the baby. :)

[Moxie]

Lee, damn it feels good to be a gangster...

[a non]

if you are looking to save $ long term: I bought a medela "hospital" type pump on ebay and was able to sell it for the same price after (since those are multi-user pumps).

So all I spent really was on the 'kit'

[heather]

Depending on your circumstances you may want to look into renting a pump. Ask your doctor or midwife or just phone around. If you're in Canada, a big Shoppers Drug Mart store is where I rented mine after my daughter was born. Many of the Lactation Consultants in my area also rent pumps.

When my daughter was about 2 months old I stopped the marathon pumping sessions (as others have said, it's tedious) and I returned the pump. I ended up buying a simple, single hand-pump (Medela?) that served me well for the next few months.

[Margot]

If you do go for the Pump In Style (I got the backpack version which made my morning commute on crowded trains and buses easier), then shop around online for the best price. I found mine through some weird medical supply company in, like, Indiana or somewhere. But it was about $30 cheaper than any of my local baby stores! Also, you could check Craigslist or your local baby re-sale places, buy the pump itself for cheaper, and then just buy yourself new tubing, etc (i.e. all of the parts that touch you or touch milk). The pump part is the expensive part, and in hindsight, I would have no qualms about borrowing or buying someone else's. I've had 2 friends ask to borrow and use my pump (they were buying their own tubing). I bought mine and started pumping about one month post-partum, once breastfeeding was established. My doula said there was a window in which pumping and bottle-feeding the breastmilk would be optimal - about 4-6 weeks after birth. Breastfeeding from you has been established and now the babe needs to learn to drink your milk from a bottle (this is if you are returning to work and the babe DOES need to learn this skill!). So, my girl had her first bottle of breastmilk (fed by Dad) at about 6 weeks old. And she had no trouble moving back and forth between nursing vs. bottle feeding (we were lucky!)

[amy]

I just remembered something my LC told me. If you're having a hard time getting milk while pumping or if your production at the pump goes down over time, consider getting a bigger breast shield. (That's the thing that looks like the end of a trumpet.) If the shield is too small, it actually pinches off the milk and that can cause damage to your breast. They're fairly cheap (like $5) and that is worth the experiment if you're struggling to get milk out.

@Cobblestone -
I can't say that I loved the Pump in Style, but I didn't totally hate it, except for the fact that I hated having to pump. It was not anywhere near as nice as the Medela Symphony (hospital grade), but the Symphony cost me $80 a month, and I couldn't justify it for the long run.

[meggiemoo]

Also, finding a way to pump hands-free is essential, in my opinion. My favorite product was the hands-free bustier (http://www.easyexpressionproducts.com/). I used this, would take my laptop to our pumping room at work and would actually work while I pumped, which made me feel less weird about taking 15-minute segments out of my day.

[meggiemoo]

Oops...shouldn't have put the URL in parentheses...

http://www.easyexpressionproducts.com/

[Joceline]

I have the PIS and really liked it, until my son was about 8 weeks old and stopped taking a bottle. I gave up on pumping a few weeks later and was basically tied to him for a year. I'm hoping to be able to get more use out of it any day now if my baby will ever decide to make an appearance!

I pumped a decent amount for those first 8 weeks, and I found the PIS to be very portable and comfortable. It was also very efficient and simple to use and clean. All of that being said, as a SAHM, it NEVER would have been worth it for me to buy it myself, but my sister was no longer using it and gave it to me (love her!). I definitely agree with Moxie that it would be worth waiting a couple of weeks and renting a pump in the meantime if necessary, unless you have someone else who desperately wants to buy it for you!

I know "they" say not to buy/borrow used breast pumps, but I don't really get it. The stuff I've read said that milk can get in the machine and be bad for the baby, but if it happens with my own milk, isn't that just as bad once it is all rotten and gross in there?

[amy]

I would be wary of buying a used personal use pump (i.e., not a hospital grade pump) unless you could see it in person and have the pump's suction tested. My old PIS looks great on the outside, but once you switch it on, you can hear that the motor is loud and if you tried it (and knew the difference), you'd feel that the motor is weak. It would not be a good pump for anyone looking to double pump or pump long-term, but because it looks nice, it wouldn't be hard to sell it on eBay.

Besides, I think the PIS is an open-system pump, which might mean bacteria that cannot be cleaned out. I'm not sure about that, but it's worth looking into if buying used is on your mind.

[Stefanie]

My son will be 1 year-old next week and I've been pumping since he was born. At first, we had latch issues and I was using a hospital pump. After the first week though, I bought the Medela pump in style. It is great! I also got the Easy Expression bustier to go with it so I can pump hands free. It's awesome! I pump twice a day at work and bring my laptop into our pumping room. Then I can work or surf the internet while I pump. The time just flies! I hated pumping before I got the bustier. I'm the only nursing mom at work right now, so I just leave my pump there.

Anyway, I also have the Medela Harmony breast pump that I keep at home in case of engorgement. I've actually used it quite a bit in the past few weeks to fix any mistakes I made after my son has gone down for the night about which side to feed on. It's just as comfortable as the PIS and I like it very much for this sort of thing. My lactation consultant had recommended that every breastfeeding mom should get a hand pump for use those first few weeks in case you are engorged and your nipple is too hard for the baby to latch onto.

[Kate]

I'll add to Moxie's advice not to buy a pump before the baby arrives: my daughter wouldn't latch while we were in the hospital, so they sent me home with an Ameda Purely Yours (dual electric pump) that was entirely covered by my insurance.

I highly recommend the Ameda Purely Yours, which is nearly identical to the Pump In Style but less expensive and easier to clean. My pump came with a backpack but was not built-in, so I could carry it in any bag I wanted.

Once I returned to work, I bought the Avent Isis to keep at home. I got good let down with it and found it easy to use once I removed the "petal"/cushion silicone liner to the cone. I have small breasts and found that the cushion just provided another place for hard won milk to get trapped.

[Ann]

I just put away my Medela Pump In Style, now that my 16-month-old is too busy to nurse. It worked great for me, and I definitely recommend it!

I also recommend -- if you can afford it -- getting a hand pump, too. When my son was maybe 8 months old, I won a Lansinoh Manual Breast Pump (this one: http://refs05.securesites.net/snap038/index.php?src=directory&view=Products&submenu=Products&category=Breast%20Pumps&query=category.eq.Breast%20Pumps&refno=10407&srctype=Products_detail) and I loved that thing. It works with the Medela bottles, which is great since I had a ton of them. My son only nursed on one side per session, so once I got the hand pump, I could pump a little on the other side while he nursed (taking advantage of the natural let-down), and just build up a full bottle's worth over the course of a day. It really took the pressure off of pumping while I was at work, which meant that I was actually more likely to get a good yield while at work!

I especially recommend this if you won't have to pump daily -- I work full-time, but only a couple of those days are in the office, so I don't think my body ever got used to pumping the way it might have if I'd done it 5 days/week. (ta

[TFV]

My kid had massive feeding problems, so I started with a hospital-grade pump, which was my constant companion for the first two months of his life. (There's nothing to choose between the various hospital grades, as far as I can tell. They all are huge and unwieldy and loud and heavy.)

Then I graduated to a Medela Freestyle, and although I still hate pumping, I really love the Freestyle. The hands-free stuff works better than any of the other hands-free products I tried (like the bustier), the unit is tiny and rechargeable and light and portable, and it works as well as any other near-hospital-grade pump.

Caveats:

The hands-free stuff with the Freestyle is designed to attach to your nursing bra, and the bra it's designed to go onto is Medela's, which I couldn't wear because they don't make J cups, which is what nursing has made me. The pump also comes with attachments for Bravado bras, hook-and-eye bras, and some other kind of bra I have never seen. But the Freestyle will not work with snap bras or Velcro ones or any other weird hook.

The hands-free stuff...sort of works. Because my breasts are so big right now, I can't, say, walk around while I'm pumping, the way you're supposed to be able to. I still have to sit still, and I still have to adjust things occasionally. But I can type or mouse or read or whatever. That's worth a lot.

The Freestyle, at least when I bought it back in August, isn't as readily available as the other Medela pumps, and I suspect that might mean the parts aren't, either; you likely would have to order replacements if you needed them.

Still. I am really, really happy I bought a Freestyle - it's worth the extra money to have something so light and portable, and to have the hands-free attachments.

[Michelle]

My son was extremely tongue-tied (resolved by snipping at 10 weeks) and delivered at 36.5 weeks so he would.not.latch.

Anyway, I ended up exclusively pumping for several months and had the Medela PIS. Loved it! Worked great and I took it to work with no problems.

[ksmaybe]

Two things to add...buy your pump from a medical supply company (Hackley Medical has great prices and extraordinary shipping-so fast!). You'll spend about 1/3 less, at least on the PIS. I used a PIS for my workhorse pumping, early on dealing with NICU and later on for work-took me through to 12 months old. I have used the manual piston that came with it when traveling and that was fine, I also came into an Ameda manual pump (http://www.amedaonline.com/amonehabrpuw.html) during a stint in the hospital (baby, not me) and it was fantastic! It became my go to travel set-up fast.

[Laura]

I had good luck with the Ameda Purely Yours. Ameda has been making hospital-grade pumps for a long time and the Purely Yours is their portable electric pump. You can often find them at a lower cost than the Medela PIS.

[Diane]

I'm a huge fan of the Ameda Purely Yours. What I love about it (vs. the PIS) is that it is a completely closed system. All the parts can be sterilized. You could actually buy one used, get yourself a fresh hygienikit, and you wouldn't have to worry about cooties or anything like that from the other person.

What it does not have going for it is in-store access to replacement parts. They have to be ordered over the internets. It can be a pain, but I'm still glad I have this pump. I EBFed for my first daughter's first 4 months, then had to switch to pumping exclusively. I kept that up until she was 1. I had no problems getting enough milk for her each day, even with only 3 pumping sessions. Obviously, YMMV.

(As an aside and threadjack [sorry!] -- does anyone have a good cloth diaper overnight solution for a 28-month-old HEAVY wetter? Two large inserts in a BumGenius 3.0 is forcing me to wash sheets several times a week. You can email me at dashoff at hotmail if you have any advice! Don't want to clog this up. I just have been all over the internet and can't seem to find a good answer. I'll be forever in your debt if you can help me out here ... I trust my fellow Moxie moms!)

[Lawprofmom]

I *loved* the PIS. It did a great job, was relatively fast, didn't hurt, and was portable and discreet. I used it at home and took it to work daily. I then used the Avent and Dr. Brown bottles-- both of which worked well.

I echo the suggestion that you rent from the hospital. You can decide how you feel about various brands before making a (very significant) investment in your own pump. You can also see how nursing is working out for you before you make the investment.

I'm also going to raise a somewhat controversial topic: with breastfeeding you never know what is going to happen. It may not work exactly the way you imagine it will.

When I was pregnant with my first child I was under the impression that breast-feeding was "natural" and therefore easy and something everyone could do. It seems like everyone I knew breastfeed easily and with no problems. Turns out I was wrong.

With my first child, I tried to breastfeed for about 3 weeks. My daughter's latch was HORRIBLE-- I spent every day of those three weeks at the lactation consultants', and even they couldn't fix it. She was miserable and not gaining weight. I was miserable with my bleeding nipples and my marathon nursing sessions. I finally started pumping all the breast milk for every feeding and giving it in a bottle. I did that for 6 months and then went to formula. So the PIS was a god-send.

With my second child, I planned to nurse but was unable due to some medication that I take. The doctors forgot to mention that the medication would be dangerous to my child until after she was born (and giving up the medication wasn't an option).

I think we all know that breastmilk is best. I would never argue with the physical and psychological benefits of nursing-- for mom and baby. However, breastfeeding is a skill that takes a while to learn. You'll have a learning curve and so will your baby. Most breastfeeding advocates never mention that it can be *really* difficult in the beginning. You may need to work with a lactation consultant, who may suggest pumping, pumping with a specific pump, or not pumping at all. You may also find that breastfeeding doesn't work for you for any number of reasons, and may decide to pump a lot or give the whole thing up and go to formula. You might do some breastmilk and some formula. There's no one answer that works for everyone. Don't let anyone tell you differently or guilt you into something that is not working for you.

With I guess the moral of the story is that, despite your best intentions, you never know how breastfeeding will shake out. Don't drop a lot of money on how you think it is going to go.

[ivymae]

For work or exclusive pumping, a PIS is a godsend, But if you just need to take the edge off engorgement, or pump for an occasional night out, The Medela Harmony is a great little hand pump. I used the PIS for my older daughter, but am able to stay home full time with my second, and pull out (and washing) all the attachments for the PIS got to be a pain. It's worth having around, and then if you realize you need something more substantial, it was only $30.

[lucy]

If you are simply dealing with morning engorged boobs, then a a hand pump can do the job while your baby is very new.
If you are pumping to store milk for work, then are contemplating pumping at work (big applause for you if you do) then buy the best you can afford. The Medela Pump in Style is excellent and you get a hand pump with that. All the parts are safe and can all be replaced. Medela doesn't recommend using a second hand pump; but I did and bought new tubes bottles membranes etc. It was excellent and I've put it away for number two.

When I was pumping to store milk I would give my son one boob in the morning and then pump the other, then it was out of the way and I had a good 4 ounces to freeze. Good luck!

[Lawprofmom]

Lee, Yeah, I'm going to need those TPS reports.

Diane, I tried to respond to your cloth diaper question (LOVE the bum genius diapers!) Let me know if the email didn't come through.

[hush]

If you've had breast reduction surgery, the Medela Symphony (a wonderful, quiet, hospital-grade rental breast pump) is definitely the breast pump to consider.

I rented a Symphony for 6 mos. postpartum, and it was a godsend! But if I had waited until DS was actually born before I had arranged for the rental (in the fall of 2007), it would not have been available to me anywhere on the Northside of Chicago - as that's what happened to a friend of mine who had her baby a month after us. Rental Medela Symphonies may be hard to come by, apparently, so don't wait! For Chicagoans, Symphonies are available by request in the postpartum rooms at Prentice, so you can try it out in the hospital, and be sure to keep the free "kit" they give you with the pumps & tubing.

I had breast reduction surgery 9 years before DS was born. Having suffered debilitating back & shoulder pain for years prior, my insurance co. paid for the surgery, which dramatically improved my overall health. It's one of the best decisions I ever made (now I can run! and sleep at night!) though I knew it might eventually hinder my ability to breastfeed.

For anyone else in this boat, I highly recommend Diana West's book "Defining Your Own Success: Breastfeeding After Breast Reduction Surgery." Because the truth is, your dr/midwife probably doesn't *really* know how to properly advise gals like us. LLL and a lactation consultant MIGHT know... so you'll need West's book to better educate yourself in order to fill in the gaps in the professionals' knowledge. Case in point, I was told 3 different things by 3 different doctors: 1) My breast surgeon said I could breastfeed in the future, but might have low supply which would improve with each subsequent birth (he was correct!); My OB said I can't (she was 100% WRONG!), and even the Pediatrician chimed in unsolicited and said I'd have a perfect supply (He was 100% wrong & WTF?!).

About the Medela Symphony -- it costs several thousand dollars to purchase, so most folks rent them. Insurance may chip in for some of that expense, and it is usually a Flex Spending Acct-eligible expense. Mine cost $60/month. For gals with surgically-altered breasts, where some of our milk ducts may have been severed and haven't yet recanalized, lining up a hospital grade rental pump is absolutely critical during those first few weeks when we are establishing supply. A baby's sucking is the most effective way to remove milk from the breasts, and a hospital-grade pump is the second best way. Essentially, we need to pump after every feeding in order to trick our bodies into thinking we have 2 babies to feed, so that we can hopefully produce enough milk for one.

I also have large breasts (though no longer ginormous) and flat nipples. So I had latch issues in addition to being one of those "actual" low supply folks, which I learned was "actually" the case when DS was diagnosed with failure to thrive. Formula supplementation was necessary for him. At most, I could produce only a few ounces a day. I decided not to use galactologues (fenugreek + blessed thistle, and prescription domperidone not available in the US) - so I may have had better supply had I used the drugs.

[Awesome Mom]

I pumped exclusively for my first son and I used a PIS for the majority of period of time I was pumping for him. There really was not a huge difference between the hospital grade version and the ones you could buy. I just think the motors were built better so they could be used longer. I also used the Isis but I would not recommend it for more than the occasional pumping, for that it is super awesome.

I used the Bravado hands free thingamajig for pump hands free with my PIS. It was great because I could check my email and surf the web while I was pumping.

[MLB]

Have not read the comments yet, but I held off with my first and completely regretted it. Here's my story in a nutshell: milk comes in about four days after uneventful vaginal birth. And REALLY comes in. It's fast and I become so engorged so quickly that my daughter (who had been nursing fine) can't latch on. She's frustrated, I'm a basket case and of course it's 10pm and this is before 24 hour targets sold breast pumps. I did everything I could to relieve the engorgement w/o pumping since I didn't have one but was really happy once I got the PIS the next day. And the exact same thing happened to my SIL, although she already had her pump but unopened for the reasons that she didn't know how nursing would go. So my advice is get a Medela PIS but leave it unopened until you need it, so you can return it if that becomes necessary. I have also heard great things about the new hands free Medela pump, but it came out six months after my third was born so I never tried it out. And the Avent hand pump was a complete waste for me. I personally too have strong objections to the way Avent (the corporation) handled the BPA issue so my gut reaction is not to patronize them if possible, but others may obviously feel differently. HTH

[iris]

I pumped at work 2 days per week (worked from home the other days and did not pump), and the Medela Swing was an excellent pump. It is the single-side electric pump. It worked well for me because it was very easy to transport (about the size of a donut!) to and from the office but was powerful enough to work quickly. I was also able to do email or other tasks while pumping because I only needed one hand to hold it in place. If I were pumping daily, a double-sided pump might have been better, but I was really happy with this for the year that I pumped regularly but not daily. A co-worker used the Swing daily for a year and she also liked it.

[Blythe]

I pumped about once a day so I could share feeding duties with my husband. Didn't need a hospital-grade pump. I used the Isis at first but my hand got tired! So I bought a Medela Single Deluxe:
http://www.medelabreastfeedingus.com/products/breast-pumps/173/single-deluxe-breastpump

It's a very compact battery/electric pump. I loved it because it was portable but I didn't get carpal tunnel trying to use it. A nice compromise between the big hospital-grade pumps and the hand pump.

[Cloud]

Another happy PIS user here. I pumped at work until Pumpkin was 17 months old. Also, meggiemoo is right that you definitely need the hands free bustier if you're going to be doing a lot of pumping.

I remember agonizing of whether to buy the Medela or the Ameda, and couldn't find any objective reason to go with one over the other. In the end, I bought the Medela because I liked the bag better, I think.

I will also second the PP who mentioned that if you are going back to work, you should introduce the bottle well before you head back. The lactation folks at my hospital recommended at about 3-4 weeks, which is what we did, and had no problem with Pumpkin switching back and forth. I had friends that waited until their baby was >2 months old, and they had a heck of a time introducing the bottle. I'm sure that even with the "optimal timing", some babies aren't going to like the bottle, but really, the last thing you need when you're already freaking out about going back to work is to be freaking out about your baby not taking a bottle- so definitely, try the bottle earlier. And you have to keep giving the bottle at least a few times a week so that the baby doesn't forget. We ended up doing 1 bottle/day. Hubby gave her the first middle of the night feeding, which helped me get a little more sleep. That extra couple of hours of sleep was well worth the annoyance of having to pump after her first two feedings during the day (she only nursed one side at the time, so I'd pump the other side).

I agree that pumping is hard. I didn't have serious supply issues or pain while pumping like some people I know, and it was still no fun. For the first 6 months or so that I was back at work, I had my own office, which made it a lot easier. I just closed my door and continued to work on my computer. Then I switched jobs and had to use a lactation room (yeah for CA requiring employers to provide such a room). I missed having my computer, so I had one put in the room. I'm the head of IT at this company, so that was easy to do. But I strongly recommend asking IT/HR to do this. You can argue that it will allow you to answer emails, etc while you pump.

[Jen L.]

LOVED the Medela PIS. I really liked the backpack that it came in, which made for easy and discreet travelling. (except for that pesky security guy at the Memphis airport who took EVERY PART of it out. Can you say "Double Sterilize?" GAH.) I found this pump to be quite comfortable and fairly quiet. Before I got it, I was using a hospital grade one which HURT. I also had a Medela Harmony manual pump that I used from time to time. It wasn't as comfortable as the PIS, but it was easy to just throw in the diaper bag if I needed it for a short outing.

[meggiemoo]

Oops...shouldn't have put the URL in parentheses...

http://www.easyexpressionproducts.com/

[ACJ]

Sorry to maybe hijack here, but can someone review the how-tos of pumping? With T. I pumped with a rental to increase supply which involved pumping after feedings to get about half and ounce a few times a day and then pumping before bed instead of waking her for that damned dreamfeed that never actually was dreamy at all.

N. is now 20 days old and nursing is much improved - he's well-past his birth weight already which seems miraculous to me after last time. So how (when? for how long? help please!) does one pump under "normal" circumstances when you don't want to increase your supply necessarily, don't want to replace a feeding during the day... just want some on hand for 'emergencies'?

And for what it's worth, I ended up using the Isis exclusively after 2 months with the rental because they were equally effective for me.

[ikate]

I had a Pump in Style which I purchased from Ebay (factory sealed) for about 40% less then retail - it was "last years" version, but I didn't care. My LC recommended going this route and I bought it right after she was born. The pump worked great and with a hands-free bra-like thing it was easy to use while I knit or watched TV. I tried the Isis and hated it.

I pumped in earnest 3-4 times a day for the first 3 months, collecting a nice supply in the freezer for when I returned to work. During this time my daughter fed right from the source, so I was being "milked" all the time! We started trying the bottle at 2 weeks and although she rejected it we kept trying...and trying and trying. Fast forward to her at 16 weeks, me still pumping and feeding her, her still refusing a bottle when we quit trying the bottle and I quite pumping. I had to throw out 37 nice, neat little 4 oz. bags of frozen liquid gold. How I sobbed to see all that work going down the drain. Here it is 22 months later and I can still remember exactly how many bags I tossed!

In the end I think it was a good investment and I hope to use it with a second baby sometime soon. It worked very well for me and was easy to use. *Not fun* but easy. I was lucky enough to have her at a daycare literally next door and an employer who was very understanding about my need for 4 BF breaks during the day (I basically used these instead of a lunch hour) for a few months.

[nutmeg]

I agree in general with no pump until baby arrives.

I figured out ahead of time which pump I was going to buy and where the best deal was. I knew I would be able to get it in less than a week so I was prepared. I also had the Avent Isis for relief of engorgement, etc. I actually usually took the isis to work with me as it was less unwieldy (as a grad student it wasn't like I had a place to plant myself and I often had to pump out in the field without access to electricity) and I did find I got a decent let down with it, though I found it more painful than my electric pump. Also, the little starshaped discs frequently pulled through the hole at the bottom of the suction area and I had to take it all apart, put it backtogether, etc. That was irritating, but not enough to call or to get a different pump.

I used a double electric Ameda Purely yours so that I could keep up with the ravenous baby on the days he was at school. Just to make enough milk for him, I added a "feeding" each night where I pumped every night before bed, even though he wasn't up. So I could get an extra couple feeding's worth of milk by pumping every night.

I liked the Ameda, and agree it is nice because you can purchase an entire kit of parts that actually contact milk so you can resell, but I think the motor probably is the worse for the wear. For a little more than half the price of a pump in style, the Ameda was a pretty good bargain.

And when you flinch at the price of a good electric pump, just go to the formula aisle and price out how much a week's worth of formula costs.

[Kristen]

I currently use the Ameda Purely Yours to pump three times a day at work and once at night at home. Here is what I really like about it:

1) It's a lot cheaper than the PIS.
2) It can be thoroughly sterilized.
3) It's BPA free. (I think most pumps are now, but it bears mentioning.)

I actually bought one new PY and then got a second slightly used one extremely cheap on eBay. Now I keep one unit at home and one at work. I also bought tons of new spare parts off the internet. They're not very expensive.

I have no experience with the PIS, so I can't really tell you if it's better or worse than the PY, but I can say that I do get very good results with the pump I have and from a purely economic standpoint, I'm very happy.

[Cynthia]

God I hated pumping. My god. Hated it. Bane of my existence for six months. I'm one of the unlucky folks who suffers from true undersupply, and the stress of trying to squeeze out a certain number of ounces every day made the already-stressful process of going back to work at 14 weeks pp that much more stressful.

FWIW, I could not squeeze out a single drop with the hand pump. And I mean not one.

The PIS, on the other hand, worked ok for me, but it took a long time to extract 6 - 8 ounces per pump (on a good day). I ended up renting a hospital grade pump for the office and it was truly spectacular - not just for the strength (which probably wasn't much more than the PIS turned up to the highest level) - but because it was whisper quiet, so I didn't have to think about my (male) co-worker on the other side of the paper-thin wall hearing that "thunk-thunk!, thunk-thunk!" sound three times a day.

If and when I have a second child, I'm going to take 6 months off work and then just nurse in the mornings and evenings. No pumping. And no guilt about it.

[Nutmeg]

@ACJ I usually pumped about one hour after I nursed, which was usually about one hour before he would eat again. Other options include small amounts right before the baby nurses or right after (if you respond well to a pump) This is also what I did in the beginning so I could, over the course of a day accumulate enough milk for a single feeding. And here is the key to my survival through the newborn/severe colic days:

Pump some time during the day to accumulate a few ounces for use later. Roughly four hours before you partner wants to go to bed, nurse the baby and go STRAIGHT TO SLEEP. Your partner does a feeding and you get to sleep (if your boobs let you) for almost 4 hours straight! Next time baby is hungry, partner brings baby to sleeping mommy and you nurse. It was key for me and if you think you might die because you are so tired, you might think about it!

[Boble]

My favorite hands free product was a couple of rubber-bands. I slipped them over the horns of the breastpump and hooked them onto my nursing bra. Example here: http://www.kellymom.com/bf/pumping/hands-free-pumping.html