Does anyone know if the little piece called the "angle piece" is necessary
for the Medela Classic pump to work properly?   The angle piece (sometimes
called a "cobra head") is the little "hat-like" plastic piece that is at the
*end* of the thick, white tube that comes out of the actual pump itself,
right in the area between where you would set the bottles.

I had an experience about 2 weeks ago where I did a visit for a woman who was
pumping every 3 hours around the clock and yielding about a quarter to a half
ounce total each pumping.   She was on day 7 and--for reasons I can't
remember right now--had never had the baby on the breast.   So, when I went
to her house I was expecting to see insufficient glandular tissue or
something else, but she had these big, full firm breasts which poured out
milk upon hand expression.    Her pump was missing that little angle piece
and it seemed to me that air was leaking out from around it because the seal
wasn't great.   Anhow, long story short, she got onto Reglan and got another
Classic and within a week was making 3.5 ounces a pumping.   She also
remarked that with the first pump, she moved it to "normal" right away, but
that with this new pump, she was having trouble inching it up even to the
halfway point.

I know that many hospital pumps do not have this piece, and I have
conflicting answers to the question about its necessity (two different
answers from two different reps).   One RN I know hooked two pumps up, one
with the piece and one without, and the pressure was exactly the same.   I
would imagine that that could be the case, but I wonder if just putting the
rubber hose directly onto the barrier filter would wear at the hose, so that
it loosens over time, making a not-so-complete seal.   One other thing is
that the air leak around the woman's pump seemed to be affecting the speed of
the pendulum's swing, not necessarily the force of the pumping (although I
didn't test the force of the pumping in any quantitative way, but she herself
did make that comment listed above about feeling pressure difference).

I forget all the rules about mentioning brands on Lactnet, but I just really
want an answer to my question.   I have no stock in any of the breast pump
companies, or---most likely---I would be retired by now ;-)

Heather Kelly, IBCLC
New York City

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