Choosing the Right Breast Pump

For Your Needs and Preferences

Are you pregnant and trying to decide which breast pump to get? Or recently had a baby and wondering if you should buy another breast pump? Did you know that under the Affordable Care Act, most insurance companies will provide you with a breast pump with each pregnancy? The insurance companies decide what they will provide: some provide only a hand pump while others may have options for large motor double electric breast pumps. But then you may also have the option to upgrade! Meaning, you can choose whatever breast pump you want, but you may have to pay the difference in cost versus what insurance will pay for. The options are endless and, honestly, a little overwhelming. Let’s dive in to how to choose the right breast pump for your needs.

Types of breast pumps and their pros and cons:

Hand expression: Using your hands to compress the breasts for milk expression is surprisingly easy and efficient with trial and error and practice. Hand expression can be utilized any place and any time and it’s free! You can catch your milk in a glass, a mason jar, or commercially available milk catchers. Hand expression can be used both in the early days of breastfeeding and multiple months or years in! Did you know that hand expression is the most efficient way to remove colostrum during the first 3 days or so before your milk volumes increase? Most people can learn how to effectively drain the breast with practice and this is a very useful skill for navigating engorgement and if you’ll only need to be away from your little one for a few hours at a time like for errands or some mom time alone. If you’re at risk for a NICU admission, low milk supply, or will be returning to work, you may also want other expression options.

Hand pumps: These little wonders are very light weight, portable, and cheap at around $20-30 each. They don’t require any batteries or electricity and are very useful for very occasional use or if you’ll only need to be away from your little one for a few hours at a time like for errands or some mom time alone. They are super lightweight and handy to keep in a diaper bag. They are not great for people who have problems with their hands (like that pesky pregnancy carpal tunnel). You can also only pump one breast at a time prolonging the time necessary to adequately drain both breasts. There are not appropriate as an only pump if mom and baby will be separated for a significant amount of time like due to NICU admission or return to work.

Passive silicone pumps: These are also very light weight, portable, and cheap at around $10-20 each. They also don’t require any batteries or electricity. These are handy for people who want to pump on one side while nursing on the other side. Also, you don’t need to do anything - just put it on and wait. These have three different levels of suction depending on how you apply them. They are useful for pumping for comfort due to engorgement and catching milk during hand expression. They are not very efficient at removing milk, will rarely drain the breast unless you’re also using hand expression, and there’s no option for changing the flange size and the flanges on these are quite a bit larger than the vast majority of people’s nipples. The overly large flange may cause discomfort for some. In addition, anecdotally IBCLCs all over have noticed they may contribute to oversupply if used at most or every feeding. There are not appropriate as an only pump if mom and baby will be separated for a significant amount of time like due to NICU admission or return to work.

Wearable in-bra pumps: Now we’re moving into pumping both breasts at the same time which is more manageable time-wise. People who use these pumps can move around and do tasks while pumping and they can also be worn under clothes and in public which is very appealing. The flanges can be made smaller to fit using flange inserts. These are very useful for very occasional use or if you’ll only need to be away from your little one for a few hours at a time like for errands or some mom time alone. However, these pumps can be VERY expensive ranging from $140-550 dollars. They are also not all created equally and some brands or updated models may be more efficient than others. Wearable in-bra pumps vary in how well they will drain the breast and it also depends on your anatomy as to whether or not they will be able to adequately drain the breast. Some models are prone to leaking and will only hold a certain amount of ounces of milk. They are not appropriate as an only pump if mom and baby will be separated for a significant amount of time like due to NICU admission or return to work. These are generally not appropriate for multiple users or re-sale due to possible contamination of milk into the motor, so I don’t recommend purchasing a used one. In addition, anecdotally IBCLCs all over have noticed they may contribute to clogged ducts and mastitis. Now this could be due to them not adequately draining the breasts in specific breast types or shapes OR could be due to bras being too tight during use pressing on ducts and resulting in inadequate breast drainage and/or breast inflammation. One of my clients had 4 or 5 bouts of recurrent mastitis that suddenly stopped recurring after she stopped using her wearable in-bra pump at work and began using a different pump instead. We’re not entirely sure yet, so I usually recommend these only be utilized a couple of times per day if they work well for you. Examples of these pumps are the Elvie Pump, Willow Go, and Momcozy S12.

Small motor double electric pumps: These little pumps have traditional tubing, but are generally smaller, more lightweight, and more portable. They can pump both breasts at the same time, but some may not have an option for only pumping one side at a time if that is something you may need to do. Many are made with hooks to attach them to bras or belts so that the person can move around and do tasks while pumping. Flange size can be adjusted by purchasing new flanges or flange inserts. These are moderately inexpensive and easily affordable for most. These are very useful for routine, daily use, and for moms who will be returning for work for typical 8 hour shifts who also do not have any risk factors for low milk supply. These are not generally appropriate for increasing milk supply or solely establishing milk supply. Some of these are not appropriate for multiple users or re-sale due to possible contamination of milk into the motor, so I don’t recommend purchasing a used one. Examples of these pumps are the Spectra S9, BabyBuddha, Medela Freestyle, Medela Pump In Style with Maxflow, Pumpables Genie, and the Elvie Stride.

Large motor double electric pump: These larger pumps are the most versatile as far being useful to you no matter what lactation surprises come up. This could be the only pump you purchase and you’d still be fine no matter what happens after birth, whereas if you chose any of the previous pumps we discussed, there are certain situations in which you may need to acquire a second pump to meet your goals. There are lots of flange size and flange insert options for these pumps. You can pump both breasts at the same time or choose to only pump one breast at a time. These have tons of cycle and suction level options to choose from for optimal comfort and milk removal. These are the gold standard pump for returning to work and may be more suitable for those who have longer shifts away from baby such as hospital workers pulling 12, 16, and 24 hour shifts. These are also effective pumps for those who need to use a pump to establish or increase milk supply such as those at risk for low milk supply, at risk for NICU admission, or who choose to exclusively pump. Some of these described as a “closed system” may be suitable for multiple users, resale, or purchasing a used pump. These are larger and moderately heavy, but it is still possible to transport them. Some have battery option, but some may need to stay plugged into the wall for use. It is unlikely that you would be able to move around or do tasks while pumping using these pumps. Examples of these pumps are the Spectra S1, Spectra S2, Spectra Synergy Gold, Motif Luna, Hygeia, and Ameda.

Hospital grade pump: These gargantuan pumps are the big kahunas when it comes to breast pumps. They can pump both breasts at the same time or only one at a time. They are the MOST EFFICIENT at milk removal and have settings which mimic an infant nursing at the breast. They are suitable for multiple users. They are the ideal pump for those who need to establish or increase their milk supply or whose baby is in the NICU. However, they cost literally thousands of dollars. For this reason, they may be available to rent from your local pharmacy or lactation clinic for around $60-80 per month. You usually also have to purchase a new pump kit for it which runs around $50. You can change the flange sizes or use flange inserts for optimal fit. If you feel strongly about purchasing something other than a large motor double electric pump and you end up needing to pump exclusively or needing to increase your milk supply, a hospital grade pump rental can be your back up plan. They are very large and heavy, must be plugged into a wall outlet for use, and I wouldn’t want to lug one to and from work. If you end up needing one of these, you can likely go back to using whatever other pump you have after your milk supply is well established and/or your baby is nursing at the breast again. These are usually available to you as part of your room when you are in the hospital.

Now that you know the ins and outs of all the different pumps, which one are you going to get? Every one is a little different and they all have pros and cons and fit different needs! If you’re still not sure, reach out to an International Board Certified Lactation Consultant (IBCLC) for suggestions that are individual to you and your situation.