Kidalog/Baby Love Products, Camrose, Alberta, Canada
www.kidalog.com

CHOOSING A BREASTPUMP

Do you REALLY need a breast pump? Not every nursing mother needs a breast pump--need for a pump is the exception rather than the rule.
Some mothers never need to express milk, as babies are very portable and you can usually arrange to be together at every feeding time. So, if you were thinking of getting a pump for occasional use, you likely can just arrange things to avoid those occasional separations.

Another option is manual expression. The technique is explained in most breastfeeding books and you may find it easier than pumping. No equipment is needed other than a clean cup.

Breast pumps can be helpful in allowing a mother to breastfeed, in cases where without the pump she would have to stop. They allow more "freedom" but can create problems with milk supply if used unnecessarily. "Freedom" is in quotations, because one might ask the philosophical question of whether nature designed baby's natural feeding method in order to keep baby and mother close together--more than meeting baby's nutritional requirements might have been in mind!

Some women have a quick let-down and can hand-express or hand pump large amounts of milk easily and quickly. For others, it may be necessary to pump 5-10 minutes before the first few drops of milk appear. Just because milk doesn't appear within the first few minutes doesn't necessarily mean your pump is defective. Once the first drops of milk appear, it may be a few more minutes before the let-down occurs and milk comes streaming out. Because it will take time to become accustomed to pumping, it's a good idea to start practicing with the pump at least 2 weeks before being separated from baby.

Listed below are some of the reasons you may be thinking of buying a breast pump, and the type of pump we recommend.
1. To have milk on hand for the occasional separation from baby (once or twice a week).
*Hand expression or manual pump (NEVER bicycle horn/bulb style--they can cause very sore nipples). The Kaneson and Ameda One-Hand Pump are excellent quality manual pumps.

2. Pumping at least twice a day due to mother working.
* While some mothers find hand expression quick and convenient, others prefer to use a pump. The best pump for this purpose is either battery-operated or has an A/C adapter. If you have a slow let-down and find it difficult to relax when pumping, a battery-operated or electric pump is best for you. It allows mother to relax while the motor does the pumping, which helps the let-down. Before you return to work, begin pumping about 2 weeks ahead of time, in order to become accustomed to the pump and to have some milk stockpiled in your freezer. If you are returning to work and expect to pump 3 or more times a day, a larger pump like the Ameda Purely Yours is recommended.
3. Pumping for the preemie baby. (This means pumping many times over a 24 hour period to build up and maintain milk supply.)
* Electric pump only--and this means one of the large pumps, not the hand-held and not battery-operated. These pumps must be loaned or rented from a hospital or breast pump depot. They are too expensive to buy (over $1500). Electric pumps have variable suction, most like baby, require no effort to operate, and are the most efficient at getting milk out.
4. Temporary interruption in breastfeeding due to hospitalization, medication, travel, etc.
* If pumping several times a day, electric pumps or battery-operated pumps are the best. In many cases, arrangements can be made to avoid the separation. e.g. Modern hospitals now encourage baby to be brought for nursing if mother is in hospital; if baby is in hospital, mother can stay with him or come in for nursing. If you are travelling, most young babies travel well because the motion is soothing, and the sights, sounds, and smells are distracting. If you are on medication, often a doctor can prescribe something that will not affect baby through your milk if he knows you are nursing.
5. Relieving engorgement, or oversupply of breastmilk
* Use a manual pump or hand expression. In most cases of engorgement or oversupply, pumping is NOT advisable, if it is done, it should be only enough to make any discomfort bearable. Breast milk is produced according to demand. Your body won't realize that milk that is pumped isn't going into baby's tummy; therefore, it will produce the same amount of milk (including the amount that you pumped!) the next day. Pumping may the relieve the pressure at the moment, but pumping too much milk could create a real oversupply problem. You may feel as if you have an oversupply of milk, but remember that each day your body produces the same amount that baby consumed the day before. If baby is several months old and your breasts are always uncomfortably full--in other words, if you are certain that you have an oversupply, you can decrease the milk supply by nursing at just one breast per feeding, switching to the next breast at the next feeding. (You may have to nurse a little on the other breast to relieve a bit of the pressure.) After about 2 days, return to normal nursing. If you have a problem with engorgement only because baby sleeps for long periods between feedings, you can solve it simply by nursing more frequently. If baby is really sleepy, he'll fall back asleep after nursing anyway.
6. Weaning
* Manual pump or hand expression Ideally, weaning should be done VERY gradually, for the sake of both your child and your body. If this is not possible, and you find it necessary to pump, just pump enough to relieve the pressure, not to maintain the supply. It is not necessary to have a very efficient pump for this purpose.
7. Increasing the Milk Supply
* Under normal circumstances a breast pump is NOT necessary to increase milk supply!
We have been surprised when mothers who are trained medical professionals tell us they are buying or renting a pump because their milk supply is dwindling. Our advice to these moms is to take the weekend off (no guilt here--it's for the baby!)--forget about household chores, let someone else cook, nap and sleep (bringing baby to bed with you might make nursings a lot easier), and putting your feet up for day time nursings. Most working moms are just plain tired, and nursings may be infrequent or rushed. All of this interferes with milk production, and if you take a few days to nurse on demand, your milk supply will increase again. The easiest way to increase your supply is simply to nurse more frequently. A breast pump cannot completely empty your breast as it draws the milk from the lower ductal areas under the nipple, but not the deeper ducts. .
8. Relactation; premature weaning.
* Sometimes baby is well on the way to being weaned, when it is discovered that, due to intolerance of formula, or some other reason, that it is desirable to continue breastfeeding. If the milk supply has declined to the point where there is so little that baby will not nurse, a pump can be used to increase supply until baby will nurse. We recommend the large electric pumps for this purpose. Another method is to use a supplemental nutrition system (a bottle containing formula is hung around the mother's neck; a tiny tube leads to the mother's nipple, so that when baby sucks he gets formula, while the sucking stimulates mother's breast to produce milk and the supplementation can be decreased gradually).
9. Lactation for an Adopted Baby
It is possible by using a large electric breast pump and pumping as frequently as baby would nurse, to stimulate the breasts to produce milk for an adopted baby. Ideally this should be started well in advance of baby's arrival. The SNS (see above) is another method that can be used. If you want to nurse your adopted baby, we recommend that you contact a lactation consultant or La Leche League for advice.

10. Cleft Palate In most cases, it is possible to nurse a cleft lip or cleft palate baby, but if not, the large electric pump will build up and maintain the supply so that baby can still receive the benefits of breast milk.


"For many mothers who work, storing expressed breast milk is a concern. It is known that breast milk can be kept at room temperature for at least 6 hours without bacterial growth, but how long can breast milk be kept refrigerated? Researchers in Florida cultured breast milk for bacterial growth after varying times under refrigeration. The number of cultures positive for bacterial growth decreased with time, so that after five days under refrigeration there were one third as many positive cultures as immediately after expression. This effect is a result of the antibacterial components in breast milk. Interestingly, they found fewer bacteria in hand expressed milk than in milk expressed by a sterile breast pump."
American Journal of Diseases of Children (111-112, 1987)
Please note that it is still recommended that you store pumped breast milk in the refrigerator immediately.