What to Look for in a Breastpump
Tim Johnson, BS, CLE

1. Physiological Action - Does the pump automatically provide the proper breast stimulation for sustaining lactation while collecting milk?
A breastpump is more than a collection device for breastmilk. To be completely effective, it also must act as a surrogate baby in breastmilk production. Although no two babies' nursing actions are the same, all do follow a similar cycle of suction and suction relaxation.

2. Vacuum - Is the pump's vacuum always within safe, natural limits? Can it be regulated?
To create proper stimulation, a breastpump uses suction to duplicate baby's suck-and-release action. To be most effective, this suction should be neither stronger nor longer than a baby's suck. Many pumps can allow the mother to build high levels of suction, thereby decreasing the number of pumping cycles per minute and prolonging negative vacuum pressure on the breast. This pattern provides breast stimulation which is insufficient for maintaining the mother's milk supply, and can also damage sensitive tissues.
In order to create suction at the breast, breastpumps have to suck air out of the airspace between the breast, milk container and suction source. This suction begins when the breast is inserted into the breastshield and a seal is formed. The shape of the breast, as well as the breastshield design determines the effectiveness of the pump in creating vacuum.

3. Biomechanics - If it is a manual pump, does it properly use the appropriate muscle groups to avoid stress, fatigue and possible injury?
A well-designed manual breastpump works with the muscles in the shoulder, arm, forearm and hand to minimize user fatigue and the chance of injury.

4. Hygiene- Does the pump have safeguards against cross contamination? Is it easy to clean thoroughly? Are the parts autoclavable?
Hygiene is a vital consideration when evaluating any breastpump, whether for hospital or home use. The hygienic flow of breastmilk in the breastpumping system is always a critical safety consideration. A pump's design should minimize any "traps" through which breastmilk can flow into the suction source, thus creating potential contamination. This consideration is especially important for hospital-grade electric pumps that are typically used by a number of mothers.

5. Ease of UseTo ensure comfort, breastshields should be designed with a flange and nipple tunnel that accommodates different nipple shapes and areola tissue, since these soft tissues undergo extensive changes during pumping. The nipple tunnel is designed to allow comfortable elongation of the mother's nipple, even if the breast is engorged.

6. Initiating and Sustaining Milk Supply - Does the pump not only help sustain lactation, but help initiate it as well?
Breastpumps have been used to initiate, as well as sustain milk supplies, a critical benefit for mothers of premature or sick infants who cannot breastfeed at birth. Some brands, especially manual or handheld battery models, may not be effective in sustaining lactation once it has begun.

7. Availability - Are parts and accessories readily available?
A breastpump that is used in hospitals should also be available for at-home use through rental stations, pharmacies, medical supply stores, baby stores, the WIC Program, corporate lactation programs and breastfeeding specialists.

8. System Integration - Is the breastpump part of a system that allows a variety of types of pumping?
Some hospital breastpumps are designed as integrated systems with interchangeable components.

There is no substitute for a baby, who is the best breastpump available. However, if breastfeeding is not always possible, effective use of a breastpump can make sure that the infant will get his or her mother's breastmilk, and all of the benefits breastmilk provides!