Hi Anne,
    I've worked with this pump; demonstration only, but it seems to work well.  The mechanism performs in the same manner as do their other pumps, the set-up fits in in a similar fashion to the electric, but it is all done with foot power.  At first it looks a little silly, but when sitting in the proper breastfeeding position (back straight, shoulders thrown back) it's very comfortable.  This is not as hands free as the electric pumps and I don't have enough coordination to keep the foot rhythm going and do something else, but it is definitely a viable option to the electric pump when available power is not an option.  It's above a manual because it allows for double pumping and I guess as long as the foot action is maintained it will provide a good pumping session.  Everything else is the same exact stuff that you would use with the Medela electrics, only the power source is different.  I hope this helps.
    Mary Hansen
    LLLL, Amherst, VA

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