Pumps have a life span.  This is an issue when considering the purchase of a
used pump.  I no longer sell or rent equip. but during the years that I did,
I tried to read the literature on pumps (esp. contamination issues) and to
understand the warrenties.  I also tracked how long the life spans were on
various elec. pumps by asking mothers to contact me when the pumps began to
act up or fail.  The manufacturers know this info because it tends to be
relected in the warrenties and in the product descriptions.  "Occassional
use pumps" tend to burn out in 2-4 months if pushed hard -- i.e. used many
times per day by mom with non-nursing infant or in extended separation
situations.  Therefore, to buy a used small electric-motor pump might be
quite risky in terms of functionality -- completely apart from the
theoretical contamination risks

I had moms using larger pumps such as the Pump in Style  many times per day
who complained that after 5 months they had pressure problems and milk
yields that responded when switched to Lactinas.  The Lactinas that I rented
would often begin to fail after 2-3 yrs hard use in a rental situation.  I
rotated them out, normally, at 2 yrs to avoid failures.  I've visited moms
complaining about poor milk supply while pumping for compromised infants
with heart defects and clefts of the palate.  When I checked their pump
pressure, it was often equip. failure, not milk supply failure per se.
Having them replace the pump with a "fresher mount" brought supply back up.

I've taken apart small, electric-motor pumps that lack a filter between the
motor and flange and found considerable dried milk debris in the moter
casings.  How dangerous this is I don't know, but it is certainly
unappealing. Because the pump inhales and exhales air over this debris, it
could certainly re-seed freshly pumped milk with blown down bacteria,
fungus, or virus .  We don't have any idea whether this is a  problem
because no one is tracking it, and there isn't much research on taking
samples of the debris and seeing if anything is growing in it, what kind of
symptoms it would create, etc. That would certainly be an interesting
research project.

J. Blenkharn: Infection risks from electrically operated breast pumps, J
Hospt. Infect 1989, 13:27-31, suggested that: "Despite use of a sterile
collecting bottle, retrograde contamination of freshly collected milk may
occur from previously contaminated components of the pumps.  The results
suggest that a terminal in-line air filter is esential to ensure aerosols
containing potentially patogenic bacteria do not contaminate the suction
source or be emitted to the environment with the exhaust air." The Blenkharn
study used formula seeded with Staph epidermidis rather than breastmilk.  We
know that the macrophage action of human milk does some 'self-cleaning' of
bacterial in milk, so I wish Blenkharn had used human milk rather than
formula, but the contamination did occur stemming from the design of the
pumps.   He refs some other studies where episodes of infection were
recorded in which breast pumps were incriminated as vectors, so this issue
is in the literature.  I think that in discussion of contamination of milk,
the most dramatic concerns would involve cross-contamination from separate
dyads to another dyad of the incurable viral conditions such as Hep C, Hep
B, HIV, or things such as TB.

Whether this has ever happened or not no one knows because no one
necessarily tracks it.  There are reports in the infection control lit. of
small specks of dried blood on blood pressure cuffs in ER rooms being
ultimately identified as the source of contamination of outbreaks of
Hepititis.   The dental lit. is interested in cross contamination between
instruments that contact body fluids.  We do need to separate discussion of
safety from issue of economics (i.e. loss of profit on re-sales of products
intended for single-use) but we are obligated to investigate the safety
issues as well as trying to understand how the pumps function after certain
lengths of use.  Pumps are routinely used to clinically manage certain
situations, therefore we need to accept responsibility for understanding how
they work.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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