Making It Work
From: NEW BEGINNINGS, Vol. 12 No. 6, November-December 1995, pp. 176-78
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
"Making It Work" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.
I plan to return to work soon and need a pump. I've looked at the various kinds available and I am confused. They're too expensive to buy just to "try out," though I'm thinking of borrowing a friend's for just that reason. What should I be looking for in a pump? Are they really all that different?
Three-and-a-half years ago when my oldest child was born, I didn't have a clue about what I needed in a pump. When my husband brought home a pump he had purchased for $120 I didn't think twice about it. I was working full-time but was determined that my daughter would receive only breast milk while I was away. Three months and many problems later, I wondered if I would be able to continue pumping. Fortunately, a friend loaned me her hospital grade electric pump. I tried it and could not believe the difference! Not only did I collect more milk, it was comfortable and easy to use. Currently, I own a pump rental station and carry a full line of pumps including manual, electric/battery operated, and hospital grade (rental). I have used almost every kind of pump on the market. As a breast pump expert of sorts, I know what a difference the right pump can make.
There are two criteria for choosing a pump: the number of cycles in a minute, and the strength of the suction. These two factors will affect the amount of milk you collect, how long it will take, and how comfortable you will be in collecting it.
A baby sucks between 40 and 60 times each minute. Each suck can be compared to a pump cycle. Hospital grade (rental) pumps cycle automatically about 50 times per minute. Rental pumps cycle automatically to imitate a baby's sucking pattern: suck, release, relax. Non-automatic pumps have only a finger regulated valve or button to release the suction, thereby completing one cycle. However, most of these pumps have motors that are much smaller than rental pumps, and many can take so long to build suction that the pump can only cycle 6 to 8 times per minute (you can test this with a balloon). This holds the nipple out for a longer period of time than it would be if the baby were actually suckling. These pumps often create soreness which makes it difficult for a breastfeeding mother to relax. When this happens, she may have trouble getting her milk to let down and hence not much is collected. I believe that many mothers may have thought that their milk supply was decreasing and subsequently stopped breastfeeding when all they needed was a different pump.
The second criterion is the amount of suction. A normal, full-term baby applies suction of up to 220 millimeters of mercury at the breast. Hospital grade pumps have between 200 and 220 mm. Other lighter weight pumps (or even small rental pumps) do not have as much suction. This means it will take longer to collect the milk.
If I were planning on pumping two or three times a day, I would rent a hospital grade pump (Ameda Egnell SMB, Ameda Egnell Lact-e, or Medela Classic). Double pumping (pumping both breasts at once) with any of these means that I would be finished in 8-10 minutes. If I planned to pump only once a day, I would probably buy a Medela MiniElectric (cycles-35 times/minute, suction-175 mm). This would take about 15 minutes on each side. For occasional pumping, I would buy either a Medela SpringExpress manual pump or an Ameda Egnell one-hand manual pump. If you have a pump that doesn't work for you, try another type or brand.
Orem UT USA
Four weeks after my daughter's birth in August 1992, I began my search for a good breast pump in anticipation of returning to work. I purchased a manual, cylinder-type breast pump and found it to be both uncomfortable and difficult to use. Because I was committed to breastfeeding, I knew I had to find an acceptable alternative.
I read everything I could find about breast pumps. I spoke with lactation consultants, La Leche League Leaders, and the mothers who attended my LLL Group. Finally a nurse affiliated with a local hospital's home care division recommended that I try the Ameda Egnell one-hand breast pump.
I ordered the pump and began using it immediately. My initial results weren't spectacular, but I was determined to succeed. I eventually purchased three of the one-hand pumps from Ameda Egnell, plus spare parts in order to be prepared for emergencies. This pump was right for me for several reasons:
- At work, I do not have a private office. My pumping sessions were held in the restroom during my breaks. Although there was electricity available, I considered a manual pump preferable to using extension cords and batteries.
- Because one of my breasts let down more easily than the other, I would first get the milk flowing by pumping on that side, then use two one-hand pumps simultaneously to maximize my pumping sessions.
- If I needed to increase my milk supply or pump extra milk because I would be away for a longer period of time than usual, I pumped one breast as my daughter nursed from the other.
- The pump was easy to use, wash, assemble and disassemble, the components were well-made, replacements parts were readily available, and the pumps lasted through my daughter's first birthday, when I discontinued pumping.
My daughter weaned herself last month, shortly before her third birthday. Looking back, pumping my milk definitely helped me feel more connected to her while I was at work.
Bonita CA USA
If possible, try out any pump(s) that you can without making a purchase. I rented a Medela Lactina hospital grade pump beginning six weeks postpartum to get accustomed to the pump and to start my son on bottled breast milk before I returned to work. Since cost will be a factor, discuss it with a rental station; the price usually drops the longer you rent.
The Lactina was comfortable, easy to use, and allowed for pumping both breasts at once. Since you will be expressing anywhere from one to three times at work, double pumping will help decrease the time spent collecting milk. I was able to express enough breast milk at work for my son to drink the next day, as well as freeze an ample supply.
After a couple of months, I decided to purchase a Medela mini electric for use at home, because I was getting tired of transporting the pump back and forth between work and home. Then I purchased a Nurture II to use at work so that I wouldn't have to continue renting the Lactina. I had no trouble with the mini electric, since it worked with an automatic cycle like the Lactina (although it wasn't as quiet), but I pumped only one side at a time. I could never get used to the rhythm of the Nurture II, because you have to create the suck-release by using your thumb or finger over an opening in the cap that fits on the bottle, and a pre-existing condition in my thumbs interfered with this. However, I do know people who have found it to be a good, reliable pump, so try one if you can.
When my son was ten-and-a-half months old, I returned the rented Lactina but still use my mini electric about once a day to express a small amount of milk for snacks or freezing. My son will be one year old soon and still enjoys nursing. He also enjoys expressed milk in a sip cup.
Mansfield OH USA
(Editor's Note: The Nurture II pump by Bailey has been replaced by the Nurture III.)
Your choice of a pump should be guided by your work situation. Having the wrong kind of pump can foil the best intentions of providing breast milk for your baby. When I went back to work after my first child was born, all I had was a manual pump. I didn't have the time I needed to use it and before long, my daughter was getting formula during the day. That made it easier for me to stop breastfeeding completely when she was five months old.
I was better prepared with my second child and am thrilled to say we're still nursing after ten months. I had to go back to work when he was only two months old, but this time I have not needed any formula at all. I believe our success is due to the small double electric pump (Nurture III by Bailey) I bought; it allows me to express enough milk for a feeding in ten minutes.
I, too, thought pumps were expensive—until I calculated the cost of a month's worth of formula! Because my pump is a smaller model, it costs about the same as three months worth of renting a larger model.
Glendale, Arizona, USA
When I went back to teaching part-time (three full days each week), I no longer needed the large Medela Lactina I had rented earlier. Since my baby was eating and drinking other foods, she only needed two bottles a day. I then purchased a Medela battery-powered motor kit to attach to the pump shields that I had used with the larger model. This enabled me to pump with one hand. It took longer to get a full 4-ounce bottle since I had to switch back and forth, but since I only needed one each day, it was okay.
I really liked the flexibility of this system, and the way it met my changing needs. Successful pumping, I'm convinced, depends on matching your pumping system to your individual needs.
Rogers, Arkansas, USA