What’s The Best Breast Pump? A Birthsmarter Pumping Guide

Wednesday, August 2, 2023

There are three ways lactating people can remove milk from their breast/chest: through the act of suckling, hand expressing, or “pumping.”

There’s a lot of confusion out there about how and when pumping should fit into someone’s lactation journey.

Physiologically, there’s no inherent need to pump milk. Once a baby is born, if they’re able to latch and remove milk effectively and efficiently, they could, theoretically drink from the tap until they began eating enough solid food to get the nutrients they needed. In our current society, though, it’s incredibly rare to feed for any substantial length of time without expressing milk somehow. Whether you’re trying to increase your supply, heal from damage, or store milk for your baby to take in a bottle, expressing and collecting milk is now a part of most people’s journey.

Pumping Considerations

If you do decide to start pumping, there’s, unfortunately, no one size fits all advice on which pump is best and how often to use it. Your individual needs for pumping will be dictated by many factors and we like using the Birthsmarter Framework to find “your right way.” To find it, we look toward the intersection of the physiological process of lactation, the societal context around pumping, and your own personal circumstance.

You might break it down like this:

Physiologically: When and for how long might you be separated from your baby or what other reasons may arise where you’ll need to express and feed with bottles or alternative methods?

Societally: Do you feel any pressure to pump and bottle feed at some point?

Personally: Might you be primarily pumping (at home, in an office, or on-the-go), pumping occasionally if you’re going out for the night, or somewhere in between. Something like having a baby in the NICU or Return-to-Working would influence these options.

Depending on your overall pumping needs and expectations you can explore different pumping options. Most people consider “pumping” to be with a “tabletop” or double electric pump which is likely to be covered in full or almost in full by insurance. There are, however, so many alternatives to the classic “breast pump” option and dozens of accessories (like hands free cups) or purchase wearable electric pumps down your nursing road.

Please know that it can be challenging to choose a pump based on friends’ reviews, as most people don’t have experience comparing/contrasting multiple pumps. Additionally, each person will have slightly different experiences using pumps.

This article has one person’s experience testing different wearable and portable pumps and is reasonably up to date. Some IBCLCs carry multiple pumps in-office and allow you to “sample” and see what feels most comfortable and which pump stimulates the most milk.

To start, we would suggest looking at pump mechanics and features to get a sense of if and how the pump would suit your needs. For example, ask yourself:

Types of Pumps and Pumping Accessories 

Catch Cups

Catch cups are inexpensive, non-motorized, simple devices that will catch leaking milk in-between nursing sessions and the letdown on the non-nursing side during a feed. Leaking milk can really add up over the course of a day so catch cups are a great option for someone who is primarily nursing and is interested in collecting milk for occasional bottles. Catch cups need to be washed regularly and are safe to buy used. As an example, check out:

Passive pumps

As compared to the entirely passive catch up, passive pumps use gentle suction to draw milk. While not nearly as powerful as an electric pump, they are still using stimulation and should therefore be used with caution by folks who tend toward oversupply or hyperlactation. Under the counsel of an IBCLC, they may be useful in encouraging a slow letdown as well. As an example, check out:

Manual Pumps

Manual pumps are a little “old school.” With no motor, you simply pop the pump on and squeeze away. Sometimes considered an “in case of emergency” option if power goes out, a manual pump can also be a great option if you need something lightweight to carry or will be pumping somewhere without electricity and do not want to spring for the wearable electric pumps. Typically easy to find in most drugstores if you’re in a pickle. Check out:

Electric Pumps 

“Tabletop” Electric Pumps are most people’s primary pump. Typically these are the most powerful and longest lasting, though they are also often the heaviest/largest/loudest. Check out:

Portable Electric Pumps

Sort of the step between a tabletop and a wearable. Smaller than the tabletop (but also typically a little lighter on the suction). Handy for folks who need to pump while traveling or commuting and need something smaller. Check out:

Wearable Electric Pumps

Convenient for folks who are on the go A LOT or who may not have as much time to be seated at work/while needing to pump. Obviously portable. These tend to have more charging/power/motor challenges than the bigger, standard “tabletop” pumps. Lots of little, finicky parts to clean (though they are almost all dishwasher safe). Check out:

Pumping Cups

Pumping cups are a new-ish accessory to hit the market and can turn tabletop or portable pumps into more of a wearable option. As opposed to bottles that need to be held or hang out of a pumping bra, pumping cups fit entirely inside of your bra and connect to the pump mechanics via a tube. Folks tend to like them both for the privacy aspect and also for working at a computer - it’s easier to type without bonking into the bottles. Check out:

A few notes:

Flange Fitting: The flange is the cone shaped funnel that sits over the nipple. Most pumps come with 24mm or 27mm flanges or “standard sizes” however most people don’t fit the standard sizes and will need to find a size between 21mm and 36mm that’s a better fit. It’s worth finding an IBCLC to help you - virtually or in person - find the correct fit. Flanges and inserts for popular pump flanges are fairly inexpensive and easy to find, sometimes from the pump brand or similar from Maymom on Amazon or Lactation Hub.

“Hospital Grade” is a non-regulated marketing term. If you need a true hospital grade pump you would rent that directly from a hospital, medical device provider, or certain IBCLCs, or International Board Certified Lactation Consultants.

Buying Used or Sharing Pumps: We love buying used or accepting hand-me down baby gear. When it comes to pumps it’s safe to share a “closed circuit” pump. Closed circuit means there is a barrier that prevents the milk from leaking into the pumping mechanism. Open circuit pumps are technically not safe to share.

Pump Parts. It’s important to notice that pump parts need to be replaced! How often and which parts will depend on how frequently they’re used, but one of your considerations may be choosing a pump with parts that can easily and quickly be replaced. Some of the bigger brands are carried in big box stores and can be replaced day-of or next day; some are a little harder to come by.

Pumping Bras

While we have you, we thought we’d share a bit about pumping bras too.

A _hands free_ pumping bra (like Simple Wishes) is a tube-top option which is great if you’re only pumping once a day (or generally on occasionally). Simple Wish is the most common because there are two widely adjustable sizes and it fits most flange types.

_Convertible nursing + pumping bra is _great if you’re going to be both pumping and nursing throughout the day and don’t want to have to change frequently. On some brands, sometimes the cutout for the pumping parts can chafe or irritate around the areola.

Is a current favorite of ours! There are no clips and no nipple/flange cutouts and it’s incredibly comfortable! Size up to wear all day, size down if you’re planning to do high impact exercise.

If you have more thoughts or questions about pumping or pumping products, please comment below or reach out! We’re so happy to help if and when we can.

Last thought: the first step of understanding if, when, and how you’ll need to pump, is understanding the physiology of milk production. We highly recommend taking our prenatal lactation class that goes into more depth around milk production, supply, demand, latching, pumping and more to set you up for success.

Find live, virtual & on-demand classes and support groups near you:

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