how to choose a breast pump

How to Choose a Breast Pump: Literally Everything You Need to Know

How to Choose a Breast Pump: Literally Everything You Need to Know

In the past four months, I’ve used five models of breast pumps, from $25 manual hand pumps to $5000 hospital grade pumps.

I’ve pumped for my baby when she was in the NICU and at every stage in between.

Now, at four months old, she’s eating 6 to 8 times per day, and 3.5 oz (or 100 ml) each feed as an exclusively breastfed infant. She’s never had a drop of formula touch her digestive system…

And at least 50% of the breast milk she’s consumed has been milk that I’ve pumped, rather than nursed.

I’ve been around the block and back with breast pumps and I’m here to share my knowledge (and that of many badass pumping mothers before me) with you.

Let’s start with the why and then get into the details.

Why You Might Have to Pump

(Instead of exclusively breastfeeding)

When I was pregnant, I thought I wouldn’t have to pump.

I knew I needed to buy a pump, if only for the rare occasion I’d want a night out. But I thought that I’d nurse Poppy most of the time and pump only occasionally.

And then I gave birth.

I’ve expressed over 84 litres of breast milk over more than 1,000 pumping sessions, and I’m not slowing down anytime soon.

I think part of the reason I assumed I’d not need to pump is because I had no idea under which scenarios I might need to, but there are a ton of reasons women pump.

Here are the top reasons.

1. To Establish Your Milk Supply

When you first give birth, your baby won’t nurse right away (especially if they’re premature).

They might suckle for a few minutes and then ultimately fall asleep at the breast. But babies (just like you) go through a lot during delivery, and they’re exhausted when they get here. That’s why they tend to go through a marathon of sleep after being born.

What they do eat is a small amount of colostrum, and because breastfeeding is hard work (especially at the early stages), it can be difficult for babies to get it directly from the source.

So, to establish your supply, you’ll usually need to pump. What you can establish during the first few weeks after delivery sets the tone of your breastfeeding career.

Those early days are critical.

You’ll be directed by nurses and midwives to pump every 3 to 4 hours in the first few days after birth (or hand express, which I found to be difficult).

2. To Help Your Baby Gain Weight

My friend had her baby a month before I had Poppy, and she didn’t buy a pump while she was pregnant, assuming, as I did, that she wouldn’t need to pump much (if at all).

But when she and her husband took their son home from the hospital, he wasn’t gaining weight.

If you’re still pregnant and a first time parent, this might sound alarming, but it’s pretty common. The problem is that you don’t know how much your baby is eating when he’s very new and nursing.

Breastfeeding is hard work for newborns, and many of them fall asleep while nursing because of the sheer exhaustion of it.

So guess what they were instructed to do?

Yup. Buy a pump and feed breastmilk using a bottle.

That’s because pumping can tell you exactly how much your baby is consuming and makes it much easier for your baby to take the milk (because bottles release the milk easier and silicon nipples are ergonomic).

Pumping and feeding your baby a bottle can be the difference between your baby gaining weight and some scary talks from the doctor.

3. To Promote Equality in Your Relationship

Pumping is feminist af.

Pumping means that Ryan can do night duty and parent Poppy as an equal. It gives me freedom from being the default primary caregiver, and gives him a sense of purpose and pride with our daughter’s growth.

And feeding a baby is prime-time bonding opportunity. You notice their personalities develop right in front of your eyes.

If I didn’t pump and bottle feed Poppy breastmilk at least 50% of the time, I would not enjoy early motherhood nearly as much as I am (and neither would Ryan enjoy early fatherhood as much as he does. Granted it is more work for him compared to the alternative. But it’s worth it).

Nursing is also feminist AF, but it doesn’t exactly promote equality in your relationship.You’ll still have obstacles even if you do pump. But at least you’ll be better equipped to share the burden.

4. If You Want to Feed Your Baby Breastmilk But Have to Go Back to Work

It’s a human rights issue akin to a third world country that there’s no mandated maternity leave in the United States. But it’s the sad truth, and what employers do give… well, it sucks.

The World Health Organization recommends breastfeeding for the first two years of life and that your baby “only receives breast milk without any additional food or drink, not even water” for the first six months.

So unless you live in a country with a leave policy or have a super generous maternity leave of 6 months or more, if you want to avoid stay-at-home-momhood and still feed your baby breastmilk, you’re going to need to pump.

Pumping at work deserves a 10,000 word article to itself (if you’re planning on doing this, I highly recommend reading Work, Pump, Repeat by Jessica Shortall), but suffice to say most people can’t bring their baby to work with them, so pumping it is.

5. To Have a Life After Motherhood

We have to give a hat-tip to this reason of why you might find yourself pumping, because that’s what Adventure Baby is all about—not losing yourself in the throes of parenthood.

Having a baby can feel all-consuming at times, but it doesn’t have to be all-consuming.

Pumping will allow you to leave your baby with your partner (or a babysitter) while you go do something for yourself. It will allow you to get some much-needed rest when it doesn’t jive with your baby’s feeding schedule.

And it will allow you to date your partner after your baby arrives, which is really damn important.

6. If Your Baby is Premature

What I said up there about breastfeeding being a lot of work? Yeah, it’s super taxing on premies.

Poppy was 6.5 weeks premature and her suck/swallow/breathe reflex wasn’t fully developed. But she still needed the food she was no longer getting from the placenta. And breastmilk is crucial for premies, so I pumped and fed her my breastmilk (almost) exclusively (we opted to feed her donor milk instead of formula when my milk production was still coming in).

Eating from a bottle is a lot less work than fighting for every drop from the boob, so for the first few weeks Poppy was exclusively bottle fed (or fed my breastmilk via a nasogastric tube).

Almost every single premature baby will require pumped breastmilk.

7. If You or Your Baby Can’t Breastfeed

Some babies can’t hack the whole breastfeeding thing.

Some bodies don’t support it.

Sometimes, your baby has a tongue tie or difficulty latching. Or sometimes, your nipples are cracked, bruised, or bleeding. Or you might have really low milk supply as a result of postpartum depression. Yup, research suggests that the two—mood and lactation—might be controlled by some of the same hormonal pathways.

Whatever the reason you're having a hard time feeding from the boob, it’s not your fault.

Not their fault either. But you might want to feed them breast milk anyway. And you’ll have to do so via the good ol’ breast pump.

Your Breast Pump Buyer’s Guide: What You Need to Know

So you’ll probably need to pump.

Check.

So in this section I answer the age-old question: what pump should you buy?

There are two types of breast pumps:

1. Manual Breast Pumps

Manual pumps (like the Medela Harmony) are also called hand pumps. All you do is squeeze the handle to manually activate the pump to to extract breastmilk. image2

There’s no such thing as a double manual pump (er…unless you worked two pumps using both hands, on both boobs at the same time. Not practical).

The pros of using a manual pump is you don’t need a power source or a charger, and they’re lightweight. They’re also relatively cheap. The Medela Harmony is only about $25. Compare that with electric breastpumps that start at around $100, and you’re saving a ton of money.

The biggest downside is that they’re really tiring to use. I didn’t put much stock in how tiring until I had to use one full time for two days because my pump died and the charger was elsewhere. Needless to say, my wrist was sore for a week and I ended up renting one for the interim.

The second drawback to manual pumps is that they are slower. Not intrinsically. But because they’re human powered the pump frequency tends to be slower than electric pumps.

Manual pumps are best for if you plan on predominantly nursing your baby, and just want to pump here and there (maybe once every few weeks) for a night out. But beware, if you don't release milk easily, this things are hard work, even to get out one feeds worth.

2. Electric Breast Pumps

image1

Okay, so if you’re one of those people who decides to just pump a bit here and there and otherwise nurses her baby 98% of the time, a manual pump would probably do the trick.

But for the rest of us (read: vast majority), you need an electric pump.

Electric pumps are more expensive (they start at about $100 for a weaker pump and increase from there), but are much more efficient.

I have an electric pump (the Medela Freestyle) but have a manual pump (the Avent Manual) as a backup just in case.

So, this next section is based on electric pumps because there’s not much more to say about manual.

How to Choose a Breast Pump: The Two Biggest Considerations

Breast pumps are like electronics in that the price you pay is strongly correlated with the quality of the pump.

The more expensive the pump, the better it is, and the more effective it will be for expressing your breastmilk.

That last part is key because the last thing you want is low breastmilk supply (it’s super stressful worrying about breastmilk supply. So my advice is buy the highest end pump that you can afford. And for all the dads out there, trust me. Removing that stress is worth it for you too).

Breastmilk production is a supply and demand system. And the better (read: more expensive, unfortunately) pumps demand more milk from your breasts.

When I used the hospital-grade pump, I have a more productive session then when I used utility-grade. And the effectiveness of all the pumps I’ve used has a direct impact on how many ounces I extract.

If you want to feed your little one breast milk but for whatever reason you can’t nurse him or her, you need a super efficient breast pump.

Two things that really help establish your milk supply is the oxytocin that is released when you’re nursing your baby and the efficiency at which babies extract milk (except preemies as we discussed earlier).

So each time you nurse, your breast gets emptied fully and you get a surge of hormones to promote milk production (supply and demand, remember?). So if you can’t nurse your baby, you need a powerful pump to make up the difference.

There are two things you must think about when you’re buying a pump:

  1. Closed system vs. Open system
  2. Single vs. Double

Closed System Vs. Open System

Closed system breast pump: Extracted breastmilk has no chance of interacting with the internal parts or motor.

Open system breast pump: The pump’s internal parts and motor could get exposed to breast milk.

A closed system is definitely better because breastmilk is completely separated from the pumping mechanism using a silicone gasket. Whereas an open system draws milk out of your breast using air suction flowing through the same network of tubes that directs the milk. Breast milk is redirected into the bottle (rather than getting sucked into the pump). But accidents do happen and milk could get drawn into the pump if you say, fall asleep at the wheel and tip over a bottle of milk while the machine is running.

Ok. Sounds complicated right? But it’s really not. Here’s a simple scenario to illustrate my point.

Say you’re pumping and bend over to pick something up. But you bend over too far (which you will inevitably do) and milk to gets sucked into the tubes. So far no foul. So long as you catch it right away, stop pumping, and thoroughly clean the milk from the tubing.

If you don’t, really bad things will happen.

Milk will travel all the way to the pump mechanism and contaminate the entire inside of the pump. If that happens, you’ve probably ruined the pump because mold will eventually develop on the inside and contaminate every drop of milk you pump thereafter.

On the other hand, if you were using a closed system pump, the only consequence would be…well, spilled milk.

That’s because the closed system completely separates the vacuum created to extract milk, and the actual milk itself (using that silicone gasket I mentioned). And that means there’s no chance that milk can ruin the pump mechanism. And here's another great explanation of closed vs open systems.

Our top rated breast pump the Medela Freestyle, is a closed system.

Closed systems are usually more expensive than an open system, but usually require a less maintenance and last much longer (because the pump doesn’t continuously suck dust and things into itself (over time that stuff blocks up the pump and makes it much less effective).

Closed systems mean that you don’t ever need to disassemble the pump to clean it, you run no risk of the pump molding an contaminating your milk, and you can buy second-hand with peace of mind.

Open systems also are the riskier purchase because you have no way of knowing if it’s been contaminated or how much life  it has left (because suction is slowly reduced over time as dust inevitably collects on the inside).

All hospital grade pumps are closed systems because of the hygienic benefits.

TLDR: If you can, buy a closed system pump. They’re more expensive, but more effective, easier to manage, and last longer.

Single vs. Double

A single pump means you have to pump each breast separately.

A double pump saves you a metric crapton of time, which you’ll use to maybe have a half a shower or something.

But seriously, ain’t no new mama got time for pumping each breast separately.

Want proof?

To effectively maintain supply and empty the breast you need to pump each breast for 10 – 20 minutes every 2 – 3 hours. That’s every 2 – 3 hours from the start time of the last pumping session, by the way.

Most women are on the high side of that, meaning they need to pump for 20 minutes before they stop expressing.

Can you imagine having to pump for 40 minutes (20 on the left, 20 on the right) every hour and 20 minutes? You’d literally get nothing done.

I don’t even know why single breast pumps are still sold these days, but they’re wildly inconvenient.

TLDR: Buy a double pump or risk wasting a ton of time.

Okay, So Which Breast Pump is Best?

I’ve told you that you need an electric, closed-system, double breast pump.

Here are the top two picks that meet that criteria that aren’t hospital grade pumps (because those are damn expensive).

Want more info before you buy, then read our full review on the best electric breast pumps.

Pump #1: The Medela Freestyle

After hours of research while Poppy was in the NICU (and trying a few other pumps), I went with the Medela Freestyle.

I tried the Medela In-Style and it definitely wasn’t strong enough. I produced at least 10% less on the In-Style than with the Freestyle.

I love the portability of the Freestyle, and the closed system and double pump capability.

✓ Closed system

✓ Electric (lithium ion battery)

✓ Double pump

✓ Super portable (it’s small and quiet)

✓ High efficiency (very strong suction)

✓ Digital interface and programmable

Pump #2: The Spectra S2

The closest alternative to the Freestyle if you don’t like Medela or it’s a bit too pricey is the Spectra S2.

Like the Freestyle, it’s a closed system double electric pump.

It’s in second place because it’s not as efficient as the Freestyle at extracting milk, and it’s also not very portable (it comes in at over 3 pounds).

✓ Closed system

✓ Electric (lithium ion battery)

✓ Double pump

✓ Digital interface and programmable

X Super portable

X High efficiency (very strong suction)

If you want to use a hospital grade pump, they’re going to be pricey.

I’m talking in the thousands of dollars range. Like five.

Before you shell out thousands of dollars for a hospital-grade pump here’s a sweet protip: you can rent hospital grade pumps.

So if you’re really worried about milk supply or had lots of trouble getting going with your first child, then maybe you want to rent a hospital-grade pump initially, and then once your milk is flowing, switch to something else.

That will save you money but give you a jump start on milk production.

Where to Rent Breast Pumps

If you’re pumping regularly (which you likely will be), you’ll save a lot of money by buying a pump. But if you plan to pump initially and see how it goes, you can rent one.

Here’s where you rent them:

  • Your local pharmacy
  • Drug stores
  • Big box baby/kid stores (Toys R’ Us, etc)
  • Your local public health unit
  • The hospital
  • Many pediatricians

The cost to rent a hospital grade pump is usually somewhere around $5/day, but you also have to buy a hygiene kit, which includes breast pump parts, for $80 –$100.

Sometimes, your public health unit will lend them out for free (you just have to put down a deposit). If you Google “public health [your town/city name]”, you can phone and ask them.

We found this out when simultaneously I forgot my charger  at my brother’s house while on a road trip to Vancouver and the pump died. In the days we were trying to find a charger and then getting a warranty replacement, I thought I could just breastfeed our daughter…

Well that didn’t work out and Ryan sourced a free rental from the public health unit. We got a Medela Symphony (the Cadillac of all breast pumps) for a week while we waited for our freestyle to be replaced..

Medela’s website lists rental locations for the Symphony here.

Are Breast Pumps Covered by Insurance?

In an odd plot twist, Canadian universal health care doesn’t cover breast pumps. But take a look at your work benefits (or your partners) because sometimes (though not always) they will.

American insurance, however, must cover the cost of a pump.

Insurance plans and benefits plans almost always have specific models and brands they’ll cover (and others they won’t). So if you’re eligible, make sure to check your plan so you buy the one thinking it will be covered, but isn’t..

Do You Really Need a Breast Pump?

The vast majority of new moms will need a breast pump.

You can rent one or use a manual pump if you nurse your baby 95% of the time. But life means that most moms will need a double electric pump (especially if you want to share the feeding responsibility with your partner).

If you get a double electric closed-system pump, you’ll set yourself up for pumping success.

Coming Soon: FAQ

  • Can I pump while I’m working?
  • Can I travel and pump?
  • How long do I have to pump for?
  • Hands free breast pump
  • Are they returnable
  • Are they tax deductible
  • Can I buy extra batteries for travel?
  • How long does breastmilk last in the fridge? Freezer?
  • What are the benefits of donating my extra milk?
  • What can I do (other than pumping more often) to increase supply?
    • Fenugreek
    • Blessed thistle
  • Should I also hand express?
  • My boobs produce different amounts—is that normal?

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