5 things to know about buying and using breast pumps

I made a mistake with my first child: I underestimated how important my breast pump would be.

Like many of my patients, I was like a deer in headlights when it came to selecting a breast pump. The choices can be overwhelming: manual, electric, single, double, hospital-grade. The list goes on. It’s tough to know what you need when you’ve never done it before.

My colleague, Denise Bulpitt, B.S.N., RN, IBCLC, is a lactation consultant at William P. Clements Jr. University Hospital. She says breast pumps are often the most-asked-about topic during prenatal classes. I asked her to answer some of the most frequent questions women have about buying and using breast pumps:

1. Will my health insurance pay for my breast pump?

Yes! The Affordable Care Act requires that health insurance companies cover breast pumps. This is still new enough that not all expecting moms know about it.

Every plan is different, so talk to your health insurance company about what it covers. Here are a few questions you should ask:

• What types and brands of breast pumps are covered?
• Do I need a prescription from my doctor?
• Can I get the pump through my insurance company before my baby is born?
• Do I need to contact a specific durable medical equipment company (DME) to receive a breast pump using my insurance (such as a pharmacy or medical supply company)?

Most insurance companies will pay for a good, basic double electric pump. If you want an upgraded version or a multiuser rental pump, you may have to pay a little bit for it. It’s similar to coverage for generic versus brand-name prescription drugs.

Texas has been great about making sure moms who want breast pumps get them. For example, the Women, Infants and Children (WIC) program has provided breast pumps to eligible moms since 1999.

2. What’s the best breast pump for me?

First of all, you don’t absolutely need a breast pump. Women have breastfed for thousands of years without pumps. So if you don’t want to use one, that’s perfectly fine.

If you do plan to use a breast pump, it’s important to understand the differences in the types of pumps and to think about how you’re going to use it.

Types of pumps

There are four main types of breast pumps.

• Manual: These pumps are hand-operated to create suction. While you should be able to obtain a comparable amount of milk as you would with an electric pump, it’s more time-consuming and labor-intensive. However, they don’t require a power source, which makes them more portable.
• Single electric: These pumps are run by a motor, which can be electric or battery-operated, and they pump one breast at a time.
• Double electric: Also operated by a motor, these can pump both breasts at the same time, cutting down on the time needed to pump.
• Hospital-grade: The true term for this type of pump is “multiuser.” They’re most often used by hospitals for moms whose babies are in the neonatal intensive care unit (NICU). These pumps usually have a bigger motor and pump more efficiently. Each mom has her own tubing and accessories, and when used and maintained properly, multiple women can safely use these pumps.

Think about how you’ll use your breast pump

You want to match the pump with how you’ll use it. If you’re going to be at home with the baby for several weeks or months and plan to pump only once or twice a week, a manual pump might be all you need. There are great manual pumps out there, so don’t count them out.

If you work outside the home, you’ll likely want to consider an electric pump to save time. As for whether you choose a single or double, it’s what you feel comfortable with.

If your baby needs time in the NICU, I recommend renting a hospital-grade pump because you’ll likely be pumping eight or more times a day to supply milk for your baby. You can switch to a personal pump later, but as you’re establishing your milk supply early on, you’ll appreciate the extra power a bigger motor brings.

Unless you’re pumping for a NICU infant or have a history of low milk supply, most women will not need a hospital-grade pump. They can be heavy and inconvenient to lug around!

It’s not one-size-fits-all

Flanges are the plastic pieces that you put over your breasts. The pump pulls the nipple into the flange to express the milk. It’s important that the flanges fit properly to avoid pain or abrasions that can lead to infection.

Many women will fit the standard-size flange, but not all will. You can get them in different sizes, either at the store or by contacting the company. If you start pumping and find it uncomfortable, you may need a different size. 

Top tips for selecting a breast pump

Here are some tips to keep in mind while shopping for a breast pump:

• Availability of replacement pumps: This is my No. 1 tip. While I don’t recommend specific brands, you may want to consider a more well-known and widely available brand because the parts are easier replace as they are carried in local stores. If you choose a newer company in which you need to contact them, and it takes days or weeks to get the part, it can wreak havoc on your pumping schedule.
• Get your hands on the pumps: You can read reviews and what’s on the boxes in the store, but it helps to actually hold the pump and examine it before you buy it. Many prenatal classes, including ours, have a variety of pumps available for you to take a look at and learn more about.
• Don’t buy used: Pumps that are not hospital-grade are considered single-user pumps. Even if they are well washed and sterilized, bacteria and viruses can still be passed on. Fortunately, with insurance now covering the cost of breast pumps, we’re seeing fewer women buying second-hand pumps.

3. When should I start pumping?

New moms often tell us they’ve heard they shouldn’t pump right after delivery. Not true. You can start pumping anytime.

We warn women that at first, they likely won’t get a lot of milk. Colostrum, which is the milk you produce for the first several days after birth, is thicker than the milk you produce later and is more difficult to pump. We don’t want women to become frustrated because they aren’t pumping much milk. If your newborn is latching, they are the most efficient pump! After those first few days, your milk will become more abundant and easier to pump.

If you’re breastfeeding eight to 12 times a day and your baby is latching well, you don’t need to pump at all. After two to three weeks, your milk supply should be well-established. At this time, many women like to start pumping to put milk away for later use.

If your baby is in the NICU and you can’t breastfeed, that’s a whole new ballgame. In those cases, we encourage moms to start pumping within six hours after birth and to pump at least eight to 12 times a day to establish a milk supply for their NICU infant. Breast milk does some of its very best work in the NICU. If you’re unable or struggling to pump right away, donor breast milk may be an option.

Pumping takes most women 15 to 20 minutes per session. As your milk comes in, it may take a little less time. If you’re exclusively pumping, you should pump eight times a day, about every three hours.

4. Do I have to wash my breast pump after every use?

Properly washing your breast pump is important for the health of you and your baby. But it can be difficult when you’re at work or traveling.

The most frequent tip we give women is if you have space to store your milk in a refrigerator at work, put the pump kit in with the milk. That way, you don’t have to wash it in between every single use. Take it home at night and wash it there. Doing this will save you a lot of time during the workday.

You don’t need fancy cleaning supplies for your pump kit. Soap and water will work just fine. You can even put it in the dishwasher. If your dishwasher has a sterilize cycle, even better. You also can buy microwave bags that allow you to sterilize your pump. Many of these bags can be reused a certain number of times. Be sure to follow the instructions.

When buying products to store breast milk, invest in ones designed for breast milk and not formula. The seams in some formula storage bags aren’t as good, so when you freeze and thaw the milk, you might lose it. You’ve never cried over spilled milk until you’ve spilled breast milk!

5. What’s the future of breast pumps?

Breast pumps haven’t evolved much since modern pumps came on the market in the mid-1900s. That’s beginning to change thanks to an increase in demand – partly because more women are breastfeeding and health insurance companies are covering the cost. We’re seeing more efficient, discreet, and technologically sophisticated breast pumps come onto the market.

Whenever we hear about a new product, whether on an online mommy board or from a patient, we write the company to ask for a demonstration product to show our classes.

We’re also excited about new pumps that fit closely on the breast under the bra. Tubing runs under the shirt to the pump and storage container, which you can sit next to you or put in a purse. No one would even know you’re pumping!

Not all new pumps are electric. A patient recently brought in a cool little hand pump we hadn’t seen before. She said she could easily use it on one breast while she breastfed her baby on the other. She called it “free milk”! 

Support for breastfeeding and pumping moms

Both Denise and I know firsthand that breastfeeding and pumping can be difficult at times. Moms, you’re not alone. There are people and resources available to help.

Don’t hesitate to see a lactation consultant. Insurance often covers these visits. We also have the Lactation Care Center here in Dallas, which offers visits with lactation consultants free of charge to women eligible for the WIC program.

And don’t underestimate the importance of peer-to-peer support. There are numerous groups for new moms in Dallas. We also periodically offer breastfeeding information on this blog, including these tips for successful breastfeeding.

Even if you’re not having trouble breastfeeding or pumping, it might be worth it to call a lactation consultant a few weeks before you return to work for back-to-work lactation coaching. The lactation consultant can help develop a plan and pumping schedule that works for you, which can ease some of the stress of returning to work.

If you would like to talk with a lactation consultant, you can request an appointment online or call 214-645-8300.