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

[Charisse]

Also a happy PIS user, and I agree with the PPs who say to introduce a bottle before 6 weeks if you know you're going to need it. I was advised to wait 6-8 weeks and, well, Mouse never took it. This ended up being OK because I didn't have to go back to work until 6 months and by then a sippy cup would work. But it caused me a vast deal of stress over the months of trying...meanwhile, friends whose babies had needed a little supplementation in the beginning got great bottle skills from 1x or 2x/week practice and never seemed to get the dreaded nipple confusion that I was warned about. That said, it may largely have been a Mouse personality issue--she does. not. like second best and to this day (coming up on 5 years old in April) will choose something completely different over a second-best version of anything she really cares about.

(So there's a side note to anybody struggling with bottles with a baby over 4 months--give sippies a try, and try the toddler ones, not just the "transitional" type. You never know what will work, and very likely something will.)

I also used the bustier and pumped in my office with the door shut, while doing work--another side note, ladies: be real sure and attach the bags before you get absorbed in work!! Extremely awkward explaining to IT what happened to the keyboard that one time.

[Kate]

ACJ and others who may want more pumping how-tos the comments to this post are fantastic (though weighted more heavily towards women who are exclusively pumping than ACJ may have been looking for):

http://www.alittlepregnant.com/alittlepregnant/2005/03/heres_to_the_la.html

[Ginevra]

ACJ, my goddess lactation consultant recommended that people pump about an hour after a feeding, to give your boobs some time to build up some milk. She said pump until the milk stops for 2 minutes, then you're done. (Double pump if you have one, otherwise do each side individually, as I did with the Isis manual, which I liked.) I sometimes found that pumping after the milk had stopped for a minute or so was enough to trigger a second letdown, so I didn't always wait a full two minutes. She also said, "Whatever you get, you get. Don't stress about the quantity, and don't look at the bottle to see each little dribble of milk come out or you'll feel like you'll never get enough." She also said that as with nursing, your body takes time to adjust to it, so if you don't get much in the beginning, don't give up, because you will produce more as time goes on.

I am a SAHM and was able to get a good supply of frozen milk for times away from the baby. I liked the Lansinoh milk bags best for storage, BTW. Good times that worked for me for pumping were during the morning nap or after my baby went to bed in the evening, like 7 PMish. Remember that your supply tends to be higher in the morning (so more *quantity* of milk) but evening milk has more fat (hence more filling), so it kind of evens out, and you should pump whenever is more convenient for you.

The only trouble is if your kiddo feeds every two hours, it is tiresome to finish pumping and then right away have to feed the baby, but you should have plenty of milk for the feeding. The LC used to say, "You're never empty. The baby is your best pump, and if you nurse you'll trigger another letdown and there will be plenty for the feeding."

Congrats on N reaching birth weight, and good luck with everything!

[Keri]

I second Moxie's suggestion to wait. If you do have a supply issue and need to pump to build supply, a rented hospital-grade pump is going to be a lot more effective anyway.

I think the last month of pregnancy is a good time to find out what kind of breastfeeding support is in your area (LCs, LLL, etc.) and make contact.

I did this at the urging of a friend, and am so glad I did. I had horrible supply problems early on, and the LC I had chatted with before delivery was able to zip out our first day home and spend hours helping me.

Later, when the time came to go back to work, she stopped by with Avent and Medela pumps to try. I was surprised to find that I really did prefer one over all the others, and that happened to be the Medela Pump in Style. I absolutely hated the PISA with its automatic letdown feature.

So that's my advice. Know where you can go for support but hold off on buying stuff until you *know* what you need.

[mida]

I own both the Avent Isis and Medela PiS - and I found that they are both good for different times.

I originally got the Avent - price, the oddness of having electric, friend's recommendation, but found I had a lot of trouble maintaining the vacuum suction with it. This was within the week of coming home from the hospital. Pumping was really hard. So we got the Medela PiS and while I felt like a cow in a dairy farm, it worked.

I switched back to the Avent when my supply was more established, around 6 weeks, and found that all the problems I had before had disappeared.

I am theorizing that the Avent didn't work well at first because my supply wasn't well established and my breasts just weren't ready. The six to eight weeks later, I found I got as much milk using the Avent without having sore breasts from the suction on the Medela, and much faster.

If you have enough gift cards, I recommend getting both.

[Cecily T]

I have to second MLB here, at least in regards to NOT waiting until the baby is born to get a pump. I had the cheapo Medela Harmony, an unmedicated vaginal birth, and all that, and I had massive amounts of milk. I ended up with mastitis and clogged ducts. If I hadn't had the pump to relieve me, there's no way that my daughter could have latched on.

Moxie - I know it can be true that the pumps can mess with your supply, but I just wanted to add that I had the opposite problem. I had heard so often *not* to pump if you had extra milk b/c it would only increase your supply that I was miserable with clogged ducts nearly every day. What I learned from KellyMom is that for the first few weeks post-partum, the milk supply is also driven by your PP hormones, and not just supply and demand. Next time I know that I'll just need to pump like crazy and I'll still have enough to feed my little one. I just wanted to put that out there b/c I feel like it doesn't get said enough; I certainly had a hard time finding it out when I was a newbie learning to BF.

[Keri]

Oh, and PSA to Mom to Baby J and anyone else using Medela: Don't forget to change out your pump membranes if you notice your supply dropping or pump suction weakening. (I found I needed to change out about every three months.) It really can have a big impact on pumping output.

Also, Kellymom has a great (cheap!) hack for pumping handsfree. I used this and a nursing cover to pump at my desk:
http://www.kellymom.com/bf/pumping/hands-free-pumping.html

[Keri]

Cecily, that's a good point. The hospital where I delivered gave me a pump to use for my stay and my husband picked up a rental one on our last day in the hospital. But if you don't have those resources within easy reach, purchasing a pump beforehand makes sense.

[amy]

Keri makes a good point that the last month is a good time to wrestle up breastfeeding support. I'm in the Ann Arbor, MI, area, and I LOVE my lactation consultant. She helped save my nursing relationship with my son and she figured out a key component of my 4.5 year old daughter's feeding ongoing issues. (Can you say "tongue tie?")

If anyone out there needs an awesome LC in Southeast Michigan, email me at amy at thetextureofthings dot com.

[Elizabeth]

I had the Medela hand pump before the baby was born, and I'm so glad I did. I had issues with engorgement, and sometimes the baby couldn't latch. I would pump off just a little bit of milk (I could seriously get an ounce in two minutes) to soften up (and I think it helped draw out my nipple), so that she could latch on. I guess I could have hand expressed, but it was easier to just pump. It was good for pumping occasional bottles, but I stopped when I realized that she was never going to take milk from anything but me. I guess I could have pushed the issue, but since I stay at home, I didn't see the point.

[lwh]

Haven't had time to read the comments, so sorry if I'm just reiterating what everyone else has said.

I was given my electric pump (Ameda, which I liked but I believe might have BPA issues) as a gift. It wasn't something I would have gone out and bought ahead of time, but looking back I would have been a mess without it. I suffered from such painful engorgement in the first week that pumping a little off before a feeding/between feedings was the only way I could get comfortable and help DD latch.

Unless you think you'd be comfortable hand-expressing (which I couldn't seem to figure out to do effectively), I would definitely recommend having some kind of pump to help alleviate any discomfort you might have once your milk comes in.

[Cloud]

@ACJ, I went back through my old blog posts, because I was sure I had written up my tips for pumping. Turns out, I hadn't. I wrote tips for going back to work (http://wandsci.blogspot.com/2008/01/working-mum-going-back-to-work.html, if anyone is interested).

What is relevant to you from that post that you may not hear elsewhere is to be sure you increase your water intake. No one mentioned this to me, and I kept getting killer headaches. Eventually, I figured out it was dehydration.

I had a baby who only nursed one side per feeding for her first 9 months or so, so I pumped the side she didn't nurse after the first two feedings of the day. You have the most milk early in the day. Well, actually, in the middle of the night, but there was no way I was waking up to pump.

[Susannah]

No time to read the comments, but FWIW in my experience (and later confirmed by the lactation consultants I worked with for low supply), a rented "hospital-grade" pump in NOT necessarily better than the PIS. In fact, i suffered with my super-duper hospital-grade rental, ignoring the insurance-supplied PIS, for two months before I decided to give the PIS a whirl.

WAY WAY better. Who knew? One friend who exclusively pumped three children's milk for a year each said each style of Medela was different for her and if one doesn't work, try another.

FYI Insurance will pay for a pump ad the hospital with go out and get it for you if you need it for any medical reason right away.

[hedra]

I'm also on the PIS and Avent Isis bandwagon, though I have a friend who swore by the Ameda Purely Yours because it was way more comfortable for her. Her supply also dropped severely and she quit pumping at 8 months, BUT, I suspect that had more to do with her rather random pumping schedule than the pump (I just put it out there because I can't verify the cause). For me, the Isis was my travel buddy (mainly during the toddler years) and my backup plan for whatever (just be absolutely sure you put the valve in the right side - DH put it in the top instead of the bottom, once, and I could not for the life of me figure out why I was getting no suction, until I disassembled the whole thing and reassembled it). The PIS was my friend through 11 months, 14 months, and 15 months (twins) of pumping, and I loved that thing. Not a huge fan of pumping, but since I'm a pumping cow, it wasn't too bad an experience for me. If anyone cares, here's my pumping tips article:

http://www.storknet.com/cubbies/breast/pumping.htm

Rather than going with the 'don't get one before the baby' advice (which works for some and not others, clearly), I HIGHLY HIGHLY HIGHLY encourage moms to ask an expert instead of just going to the pump on assumption for whatever seems to be the problem. Knowing one before the baby is born is ideal. If you're having multiples, extra double (or triple) the encouragement to meet with them before the babies arrive - local Mothers of Multiples groups often have pre-selected lists of those that are good with multiples (or even have multiples themselves).

IME, we don't like to ask for help, in general (moms are supposed to know how to be moms, RIGHT? I can't need HELP. ARGH), and it's worse in the postpartum period - we are already feeling out of whack, and asking for help is tantamount to admitting failure entirely, or so it always felt to me. Calling in a PROFESSIONAL? Never! I can do it or my mom can help me or my aunt or my best friend, but never someone with a lot of experience and some outside perspective.

Anyway, that was my approach, and it resulted in misery. Dumb dumb dumb. Not a good model. Anyway, don't just start using your pump without a diagnosis of the problem by a Lactation professional (or at the very least an LLL leader, but I'd go for IBCLC first). And if that doesn't help, keep trying different LCs until one helps.

Seriously. I know many people who had trouble in the first few weeks.

1) baby had okay latch but super-suction and mom should have been encouraged to pump exclusively and try to get baby to latch after things had settled, but she waited because you're not supposed to pump and by the time she started she was so torn up she was pumping blood. That was a 'way too late' scenario, that she only later found out could have been helped if she'd called in an LC ASAP.

2) Another quit after an LLL leader misdiagnosed a bad latch as a bad maternal attitude and treated the mom to a load of guilt instead of support and guidance. Hint: if it feels disturbingly, er, *good* but in waaaaay the wrong way, look for a latch problem.

3) Another struggling, miserable, in pain, and baby was not growing well (no weight gain, but gaining length), and first LC said nothing wrong (just keep going, you're doing fine), I told the mom to try another LC, the next LC said nothing was wrong just sometimes it hurts at the start, and THIRD LC (after I routed the dad toward someone I knew) diagnosed a) tongue sucking in the baby resulting in bad latch, b) milk-protien intolerance, and c) MASSIVE oversupply (she could have nursed triplets without trouble). Sheilds + latch retraining + diet change (temporary) + block feeds = success! She also ended up pumping, but pumping would have been the wrong answer at the start. (And yay for a doc who says, 'you're working with an IBCLC? Go with what she says and come in again next week - we'll get this baby nursing yet!' instead of 'baby not back to birth weight at 2 weeks? FORMULA!')

So, that's my advice - get the pump if you can and you want to, or hold off if you want BUT always be prepared to get help ASAP - not after you're miserable, but as soon as you're fretting - especially if the help (IBCLC) can help you get a pump on short notice, if it turns out you need it.

Rental pumps rock, though, for figuring stuff out, and are often covered by insurance at least partly. If you're going to end up pumping 24/7 sor some reason, and bought a PIS, you may wear it out and still need a hospital-grade rental - it's fine to just start there if you can, and determine your exact need as you go.

Oh, and ditto the not waiting to 6 weeks to introduce bottles if you're going to. With the twins, I just lost track and was late starting, and it was absolute hell - they DID take bottles, eventually, but it was after 3 days of tear-stained effort by our DCP (who ran the range of cup/spoon/dropper/nipple-varieties-times-20 and warm/cool/cold and so forth, until it clicked). My stonach still knots up remembering that time period.

[Diane]

Cloud -- Is that where these headaches are coming from? I couldn't figure it out! I thought I'd been drinking enough water, but maybe not.

Gals, I learn something new here every day. Thank you so much for that.

[the milliner]

@Amy - Thanks for the tip on getting bigger breast guards. I had no problems pumping 2-4 oz. per side in the beginning, but now (DS is 6.5 mos) I seem to be barely able to pump 1 oz. per side.

When I was pregnant with DS, I never got around to getting my pump before birth (he was a little early & I was having a hard time deciding which to get), and I ended up regretting not having something. 2nd day back from the hospital, and I was soooo engorged. Tried to express manually, which worked, but was very slow going. Also, so much else to deal with after the birth that it added a bit extra stress.

DH went out and got me the Medela Harmony, and it was fantastic. Relieved the pressure right away. I had lots of milk in the beginning, so having the hand pump really helped take the pressure off when needed. As someone else mentioned, just an oz. or so when needed.

Moxie, when you mention that you ended up just feeding your son something else or waiting, what age were you able to start having that flexibility? So far, haven't had too much luck in bottle feeding the little guy, but I would really start to like having some time out alone (longer than 1 or 2 hours) or with DH. The spa is beckoning us & I got a gift certificate for Xmas!

[Christiana]

In my experience - a super fast 2 hours where all my milk came in suddenly and I couldn't get my baby to eat because my breasts were so full and hard that she couldn't latch and I ended up freaking out in the middle of the night when she was crazy hungry and crying through the 1 oz of formula I had to give her because it was 2am and I had no choice....
Have a hand pump on hand. And know how to use it. I had the Isis given to me after my friend who ended up not nursing at all gave it to me but quickly upgraded to the PIS, because it just wasn't enough and I was planning to go back to work. For the first few months, I LOVED my PIS. It meant an extra couple of hours of sleep for me (DH would give her a bottle of pumped milk) and some freedom to occasionally leave her for more than half an hour.

Once she was sleeping through the night (I got lucky, it was an early thing for her), and it was determined that I wasn't in fact going back to work, I used it much less, but it was still one of the best purchases I ever made.

[amy]

@ACJ, regarding what pumping looks like for other moms.

Here's what worked for me. (For context, I never nursed my daughter. I exclusively pumped for a year. Also, once I got my milk supply established, I would pump 4-6 times per day and I would get an obscene amount of milk each time, fairly quickly.)

In the early days, I pumped 10-15 minutes at a go and I was pumping 8 or 9 times a day. That was to establish my milk supply. Recently, I heard my lactation consultant tell another mom in a similar situation to mine to pump at least 15 minutes at a time to stimulate the breast to make more milk. I'm sure it's different for each woman, and it would definitely be different for a mom who is nursing and pumping.

When I wanted to pump to increase supply early on, I pumped until the milk stopped and then pumped 2-5 minutes past that. The milk letdowns would start and stop. When one would start up again, the clock reset to zero, I waited for the milk to end, and I continued to pump for the 2-5 minutes. During those days, that pumping session was about 20 minutes or so.

When I wanted to pump to make bottles or bags for later use, I pumped the quantities I wanted and then stopped at the end of that letdown, keeping in mind that the sugary milk comes out first and the fatty milk comes out later.

I'm not pumping exclusively with my son (3 months) now, but sometimes I need to take the pressure off, so I will pump until the letdown stops and just accept whatever that quantity is. Often that takes 10-15 minutes, but then again, when my breast is full, I can often take 20-25 minutes to empty it (and the yield is 8 ounces or so).

Obviously, every woman is different, and for some dumb reason I have a large milk storage and respond very well to a pump, so this is a gigantic Your Mileage May Vary. Still, I hope this helps give a data point for how pumping might look.

P.S. Dr Brown's 8-ounce bottles fit the Medela pumps.

[Cloud]

@Diane- when I was still breastfeeding and pumping a lot, I had to drink pretty much constantly through the day to not get headaches at work. I also found that sports drinks helped- I developed a serious Propel addiction. I'm not sure if I needed the electrolytes or just something to make me drink more fluids, though.

The standard test is that if your pee is coming out quite yellow, you're not drinking enough water.

Now that Pumpkin only nurses a few times a day (she's 21 months) and I don't pump, I drink less water, but it is still more than I did pre-baby.

[hedra]

Oh, and I know at least one IBCLC who lets moms try different pumps before they buy, to help identify comfort at least. It's worth asking, anyway, if you can't figure out which one you want.

[amy]

@the milliner:
any time! it made a huge difference for me. the smaller shield was tearing up my nipple.

[Shelley]

See, I didn't have a pump when my daughter was born, and it was kind of a disaster because she was born on a Friday and needed about a week of NICU time, and I wasn't allowed to even hold her for a couple days much less try to feed her. The medical supply company was closed on Saturday, and although the hospital let me use their pump I was discharged on Sunday.... and this was one of many factors that led to a really, really crappy, stressful start to what wound up being an EP-w/-lots-of-formula feeding situation.

If I were to do it again, I'd have a pump on-hand, particularly as I knew I'd be going back to work... and I'd surely have a pre-chosen lactation consultant at the ready, as the hospital support was LOUSY. There are a million things I'd do differently but at the time I was so overwhelmed with dealing with the unexpected NICU situation, and just becoming a mother, that I was totally unprepared to advocate for myself on the BF problems.

[hedra]

@the milliner, there's a 'pumping slump' around 6 months and around 10-11 months. That's normal. Speculation is that these are points of change in your hormonal process as well as being low-sleep periods for mom (and baby) which tends to reduce supply. The combo is killer.

I ended up going through the 6-month slump with the aid of Kathleen Higgins (the author). She said to pump an extra time in the morning, and try supplements (I had success with oatmeal and fenugreek, YMMV), and stick it for two weeks and see how it was at that point. At that point, it has been better - each time. And it has happened for each kid/s, too. Both slumps, like clockwork. Both times supplementing with Mother's Milk Tea or Fenugreek, watching diet (more whole grains to counteract the stress-related vitamin B loss with the sleep loss, perhaps?), pumping more often, having nursing vacations on the weekends (all day in bed nursing) to boost supply, making sure I don't get dehydrated, taking every possible care of myself (yeah, but at least trying), etc. - and then I'd get through and carry on.

Plus, after 6 months or so, solids began to hold a little sway (table foods ground up at that point), and that helped a lot for the total amount needed daily.

Granted, three out of four of my kids were 'wait till mommy gets home' kids - Mr G would down 20-22 ounces a day while I was at work, but Mr B took max 15 ounces and rapidly went down to 10 oz, and Miss M and Miss R started at 12 oz and went to 10 oz each. I think I still have milk in the freezer... should toss that, really, since it is 3-plus years old... and like I'm going to use it for something? So, your kid may change their intake with the change of diet, too.

Good luck! I highly recommend one of the items in my linked article - a professional full-body massage. Mmm, yeah, good for the supply/letdown. Especially for mommies with kids going through fussy stages. I'm totally serious.

[Eva]

I exclusively pumped for nine months. I rented a hospital-grade pump (Lactina). I am glad I didn't buy one ahead of time--for one thing I was very happy to see that thing walk out the door. I did borrow an Avent Isis once and couldn't get anything with it. If I ever have another kid I'll wait and see on the pump. There are lots of ways to make pumping more effective so I recommend if you do that to make sure you seek out good info from an IBCLC or whatever to make sure you maek the most of it.

I didn't enjoy pumping and I wish I hadn't had to do it but I'm very glad I was able to breastfeed even if my kid couldn't nurse. Great technology.

[hedra]

Uh, Huggins. Yeah, I need more coffee. (The Nursing Mother's Companion author) She's just insanely nice. And she emailed a few months later to make sure I was still doing okay, which just about made me cry. Serious mommy crush, there. Heh.

[donnab]

This one worked well for me (back in '06):
Ameda Purely Yours Breast Pump

After the fact, I may have just gotten a hand-held because she stopped taking milk from the bottle around 6 months when I didn't use one for a few weeks. But it was very fast and handy. A really good choice if you'll need to use it a lot.

[Charisse]

oh also, on shields, there are softer, more pliable ones as well as bigger ones. The softer ones (they have a name but I'm at work in an open office so I'm not googling it right now) made things much more comfortable for me.

[Mogget]

I had the PIS and I rarely used it. I had better let-down (and more milk) just hand expressing. I couldn't work while I was pumping, obviously, but I spent less time if I hand expressed than if I use a pump. It was a great machine, I think I just couldn't get my mind past the thought that it was a machine (why my hand was better, I don't know...). If I used it while my DD was nursing, I had fantastic results.

I second Moxie's suggestion to wait to buy a pump unless you have some reason why you can't wait. You never know how things will be after. The pump-in-style has my vote, though, if we're taking votes!

Sort of on-topic, I used the Gerber storage bags, and I really liked them--not many that sprang leaks on me, which was a great relief. I would cry whenever that "liquid gold" was wasted!

[caramama]

I used the Advanced PIS (lovely black bag), but I have to admit that it didn't agree with my nipples. I tried larger and larger shields with little to no luck. However, I discovered flexible shields for the PIS and was able to use that on the lowest setting to get milk without having bleeding nips. So just remember that there are options out there that can help with your comfort.

I actually got the idea to look for flexible shields from a friend who completely RAVES about the PJs Comfort Jr. by Limerick, Inc. I really wish I had gotten that one, and if my PIS isn't doing it for me this time, I might just buy it.

I also highly recommend the bustier or some other way to stay hands free. If your hands are free, you can be on the computer checking Ask Moxie, like I did!

[Jen]

I have an Ameda Purely Yours, which is the same as the Lansinoh. Technically, it is the same as the PIS (same suction, etc.) but costs less. It's a little more noisy, but, like I said, costs less. Like $150 less. I have both the isis hand pump and the Medela Harmony. I like the Harmony more. Fewer pieces to clean, same suction.

I have heard online that the isis duo is great, but you can't get parts for it, so if the pump flange (the part you put up against your boob) cracks or break, you have to buy a new pump. Not cool.

[caramama]

Also, I'm loving the Office Space references and will now how the Damn, it feels good to be a ganster song stuck in my head the rest of the day! :-)

[Jen]

Oh, Ameda used to have BPA issues, but now the flanges are polypropelyne (Sp?), so no worries.

[Marie]

Sorry I haven't had time to read all the comments. I'd advise to buy the pump before the baby comes, or at least have a borrowed one on hand. I was induced at 38 weeks and it took 5 days for my milk to come in. (I suspect that the drugs I was given as part of the induction somehow messed with my milk production, but I don't have any proof of that.) Under my midwife's supervision I pumped to bring in my milk and also get some colostrum for my baby.

I returned to work at 12 weeks and baby continued to receive only breastmilk until she was a year (when she finally started eating solid foods!) I didn't buy a pump because two friends loaned me theirs - I kept one and work and one at home! Lucky me! I think they were both Medela Pump in Style.

[Liz]

Another vote for the Freestyle. I just got it when my old PIS started to fizzle and love it. I was really on the fence about buying it, but am so glad I did. A little research led me to the cheapest place I found to buy it online; you can't list prices if you sell it for less than the Medela suggested price, but it was $280 a few months back at Addalittlelove.com (is that ok to share a retail site?). I pump full bottles for work and pump 1-2 oz. for engorgement relief whenever my baby goes back to skipping 4 am nursing (back and forth, back and forth).

[Snarky Mommy]

I am going to have to go against Moxie on this one and say a breastpump is a great thing to have in the first month. With my son, I figured out too late that the best time to pump to build up a freezer stash is during the first three months. That is when your body is making the most milk because it hasn't regulated itself yet. So with my daughter, I started pumping extra the day I came home from the hospital. Within the first three months, I had 200 ounces of milk in the freezer -- and I am a SAHM with a baby who rarely got bottles.

For me, that freezer stash allowed me to spend a weekend away from the two kids with my husband. And since I had the pump, I took it with me and pumped and kept the milk in a fridge and brought it all home and replenished what she had consumed. Win-win all around.

For what it's worth, I have the Pump In Style and it's lasted me through two separate years of nursing. I thought it was important to have a good pump, even as a SAHM, just because you never know.

[Karen]

I induced lactation for an adopted baby (meds had side effects, though, so I stopped...) but I have lots of pumping experience from that. My 2 cents is:

*don't buy a hospital grade pump from ebay without asking for the serial # and checking it with the mfr. first. I bought one that way and found out later it had been stolen from a rental facility before it was put up for auction on ebay. Medela paid me $200 finders fee but I still lost money.

*If your nipples are getting irritated by rubbing up against the cones (yes, I know about getting bigger ones but my nipples still got irritated with the right size cones) use olive oil to lubricate; worked great for me

* leaning forward is the thing that stinks the most about pumping, so get angled shields (Pumpin' Pals) so that you can sit back and not give yourself a hunchback. I actually still have my Pumpin' Pals so if anyone reads this and wants one, come over to my blog and shoot me an e-mail and I'll send them to you no charge :) (You can steam sterilize them)

[Karen]

oops, adding to what I just posted, I meant "if anyone wants them" not "if anyone wants one" sorry

[Perfectly Disgraceful]

I bought a Medela PIS in 1998, how's that for old school? I had to go back to work, three days a week, when my first was only six weeks old. I went back five days a week when she was about six months old. She did well with a bottle so I must have pumped twice a day until she was nine months old and then probably once a day until she was maybe 14 months.

I used that same PIS when my second was born in 2005. I was lucky enough to stay home for three months and then only work three days a week until she was two. She wasn't as good on a bottle, so I didn't pump as often or as long for her, probably only until nine months.

I loved my PIS, I credit it with allowing me to nurse both my kids until they were two-and-a-half. If my work pumping hadn't gone so well, I would have had to stop nursing and that would have been devasting to me.

For the data points, I am small-breasted and never had supply issues, in fact, just the opposite, I considered donating all the extra breastmilk to a hospital with my first. The PIS fit me well and never caused any problems. I was also able to pump handsfree by wearing a bralet that looked like a sports bra but wasn't as tight. I just tucked the cones into the bra and voila! I could goof off behind a locked office door. Although the pumping noise is a bit off-putting for phone calls.

If I have a third, I will be tempted to get one of those new-fangled chargeable things, even though my ancient workhorse PIS is still perfectly fine, it is rather bulky.

[Julie]

Lots of good opinions about the pumps, so I think that's covered. I haven't read everything yet, but want to chime in to remind moms out there who are exlusively pumping that at a certain point - for me it was 10 months - it will look like your supply is dropping when you pump. I would consistently get 10-12 ounces (both sides combined) in about 15 minutes of pumping....but at the 10 month mark my supply dropped drastically to about 4-6 ounces combined. I was alarmed and called my pediatrician who thought I should make the switch to formula. It wasn't until a year or so later that I read here on Moxie that it is very typical for it to look like a dip in your supply around that time frame if you are exclusively pumping and that (if you want to) you should stick with it and things will shake out and go back to normal. I wish I had, and know this next time what to expect. Who knew the boobs could be so tricky?

[theresa]

"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."

Indeed. I blew over $300 that I didn't have on a PIS (knowing that i had to go back to work in 6 weeks and so would need to start pumping pretty quickly), and lo and behold, I wasn't able to nurse. I used it to coax a few ounces a day for the 6 weeks, then had to give it up for my sanity (7 hours of pumping for 2 oz of milk, ack). My nursing issues were becoming clear before I left the hospital and I should have rented a pump and put the $300 towards a post partum doula or more time with a lactation consultant!

[amy]

I think Julie should win a prize for this line:
"Who knew the boobs could be so tricky?" :)

[Ajs mom]

Avent isis best by far. I actually did need one when I got home from the hospital and didn't have one; the postpartum nurse who visited me at home the day after my discharge leant me one. I was engorged and baby couldn't latch so for the first week or so I had to pump a small amount before every feeding. I always advise that moms have one when coming home in case they are engorged, even if it's the $20 medela hand pump.

[andrea]

Avent's customer service is good in the US? It's SHOCKING here in Australia.

I started off with an Avent Isis, which I really only used in the early days to reduce a bit of engorgement before my twins fed, or on the very rare occasions I was away from the girls.

But then the part that screws the horn to the bottle cracked. Through Avent Australia's website, I sent a query asking how I'd go about getting a replacement part, because there was nothing in their FAQ about replacement parts. Three weeks later, no response, so I forwarded my original query. Nothing. A month later, same thing again, nothing. NB. I had PPD at the time and phone calls were too much for me to handle. Finally I said "stuff bloody Avent", went out and bought a Medela Swing electric pump, and have never looked back.

Avent also never answered my letter of complaint. What sort of company would ignore an initial desperate complaint from a mother of three-month-old twins, let alone the follow-up queries? I'd never touch Avent products here on Oz again. I realise they're just another corporation, but you'd think a company that supplied mother/baby products would at least try to APPEAR to care.

Phew! That vent felt good.

[abigail]

I liked pumping but maybe I'm weird.
I had an Avent Isis and I used to pump one side whilst feeding the baby on the other side first thing in the morning, and then pump both sides at work either once or twice depending on engorgement and age of baby. I kept the milk in the fridge at work and took it home in the evening for my husband to feed her the next day. I went back to work when she was 3 months old or thereabouts, and had this routine until she was 9 months old.
I didn't find it that much of a chore. It didn't hurt at all, and I had a really vigourous let-down, so I would basically just have to prime the breast for about a minute, and then - whoosh! - I just had to pump fast enough to keep up with the flow. I always loved that bit.
I guess you can tell I wasn't dealing with any under-supply issues. A towel is a useful accessory for gushy ladies.

[Mary]

I have two Pump In Styles, both passed on from friends which is supposed to be a nono but whatever. I keep the newer one at work and the older one at home and it makes a huge difference to have a pump at home (I take the bus and having one more thing to carry is just too much). I also have a small Medela hand pump, which was handy before i had the second PIS for home use, and I now carry on trips when the baby is along, just in case of emergency. It was a godsend on a long car trip -- I just pumped and then gave her a bottle and we didn't have to stop to nurse or have me leaning over her car seat at a weird angle. (I was not the driver.)

I also highly recommend the Lansinoh milk bags. My day care provider asked for these over the Gerber ones which she said leak often.

What do others do for cleaning pump parts at work? We all have different work situations in terms of access to washing, etc, but I'm always interested in how people manage. I use the Medela steam clean bags so I don't have to bring home the shield and bottle every night, but I have a microwave I can use easily.

[Ashley]

DUAL ELECTRIC ISIS REVIEW:

I really love my Advent Isis Dual Electric Pump. My son was born at 33 weeks, so I have lots of exclusive pumping experience and have used both the Medela and the Isis. Without question, my Isis Electric is the main reason I can say I've never needed to give my 10-month-old a bottle of formula despite his NICU stay and my random WOHM schedule.

The Isis is a powerful pump with completely customizable suction, and it's very easy to set-up and operate. The silicone cone inserts make it more comfortable than the Medela, and works perfectly with the large Advent line of storage containers/bottles/etc. A major advantage is that it's hugely discounted on Amazon and often on sale, so it's at least $100 less than the Medela pump-in-style. Best of all, the Isis Dual Electric contains the excellent Isis hand pump, which you'll need in addition to the pump-in-style anyway if you pump much. The Isis hand pump fits into a small purse, and I've run to the restroom and quietly pumped during work events, dinners, even at a spa, during halftime at a football game, and while stuck in a traffic jam!

The disadvantages (which don't matter much if you will be pumping from home and not going back and forth to work), are that the electric Isis bag is huge compared to Medela's and there are more parts to clean and more risk of losing/forgetting a crucial piece. And Isis shields come in one size only, while Medela also has an XL size.

Major pumping hint: the worst thing about pumping is scrubbing the pump parts again and again. Treat your "used" pump parts like you would freshly expressed breast milk, i.e. they are okay to use again after 4 hours at room temperature or 2-4 days of refrigeration without washing. And take advantage of the Medela Quick-Clean pump wipes and the Micro-Steam bags.

[chaser]

Hands-free all the way! I second the Easy Expression Bustier rec -- worked wonders for my pumping satisfaction. What a difference to be able to get in a little laptop time instead of just sitting there bored. Esp at work, where I was fortunate enough to have a private office, so I could just plug in to the pump and go back to what I was doing.

Manual pump drove me bonkers. Boobs kept shifting around, my hand cramped, and even after what seemed like forever it was just the one side.

stats: pumped while WOTH full-time for one year each with 2 kids. One Medela PIS saw me through and was still going strong - I resold it with gladness.

[Diane]

Rent, Rent, Rent! I wish someone, like maybe the nurses at the hospital where I delivered via C-section, had informed me about the rental options at most hospitals. I was sent home w/ poor breast feeding instructions and no info on engorgement, a fairly common side effect after a c-section.

I needlessly spent $350.00 on a Medala Pump in Style. It was just the ticket to help me with my milk production and an excellent machine, but expensive.
The Advent ISIS was a huge disappointment for me, maybe becasue my breats were huge and engorged but I got nothin' from that pump but tears and frustration. Pumping sucks, but it was kinda neat to see all that milk coming out of me after 5 years of infertility and then finally making a baby.

[Schwa de Vivre]

I loathe the Avent Isis. Whenever I got up enough suction to get any milk out, the stupid asymmetrical star would pop through. MAJOR design flaw, that *&^^% star, and it hurt like an SOB.

Then again, I never pumped well at all, though I nursed just fine once things got established. Half an hour minimum would get me an ounce or two. I don't know what I'll do if I have another and don't have the luxury of this extra long maternity leave -- probably seek out an LC right after I pee on a stick.

The Medela Swing was much better than the Isis, though I still had supply issues. I also used the Dr. Brown's pump, but I got mine used and I'm not sure if it ever worked right. It was very strange, but worked about as well as anything else. The Swing wins for ease amongst these three, though -- hands down.

[Schwa de Vivre]

Also: Everything I've read talks about larger breastshields; few of the things I've read talk about the smaller ones, but they make smaller breastshields too, and it does make a difference ff you have smaller nipples. And note that small nipples can come on large breasts.