Laurie Wheeler asked about the Symphony Preemie Card's unique pattern. I have just had personal experience helping my daughter-in-law pump for her 33 week preemie.

 The Symphony preemie card is incredible. The card alternates between a stimulation phase which is fast and light to start the milk flowing and an expression phase, which is slower with more vacuum and has pause times during the cycle too, to mimic what a baby would do at the breast. When you watch a cycle  with the pressure gauge attached, you see a huge variation in the vacuum  pressure. This seems to be the secret.

 In the research on the pump it allowed mothers on average to pump 124 fewer minutes during the first 14 days. When you have a tiny preemie baby and are pumping 2 hrly that is a substantial reduction in time!

We were using the medela lactina and on day 13 she was getting around 400 mls a day. We switched to the Symphony with the preemie card on day 13. I was concerned that we may have missed the opportunity of the increased supply the research showed mothers obtained during the first 14 days. But from the time she started using the symphony her supply increased daily until by 3-4 weeks she was getting 1000 mls a day! 

For these tiny preemie babies, breastmilk is medication not just food and we felt the pump was worth every cent we spent on it!

I also found Nancy Wight's book "Human Milk in the NICU" an invaluable source of information especially as she delivered in a foreign country and we needed to convince neonatologists of best practice.

Penny Reimers RN RM IBCLC
South Africa

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