Lenore writes:

>"As the co-author of the protocols for induced lactation I thought I might be able to shed some light on your question. Most of the women Dr. Jack Newman and I have worked with have used the Medela Pump in Style without a problem. Although it is necessary for a pump to have a certain level of suction, the Pump in Style is adequate to do the job. Most of the moms end up pumping for about 4-6 weeks before their babies arrive and continue for a time afterwards as their milk supply builds. To date we've worked with over 1000 mothers.
>
>My understanding from Medela is that the motor on the Pump in Style is quite strong. What makes the "Classic" hospital grade has more to do with it's 3 pronged plug than the actual motor. The Pump in Style has a 2 pronged plug but the section that houses the plug is completely made of plastic so no "ground" or third prong is necessary. But hospitals don't see it that way. Most require a 3 pronged plug, expecially in delivery rooms where oxygen is often employed."
>
>
There is another much more significant difference between the Pump In
Style and Classic than the plug--the pump mechanism itself.  Both the
Pump In Style and the Symphony are diaphragm pumps, whereas the
hospital-grade pumps (and the Ameda Purely Yours) are piston pumps.
Piston pumps are generally regarded as being more effective than
diaphragm pumps.  The Human Milk Banking Association of North America's
guidelines, for example, specifically recommend that mothers with
hospitalized babies use a piston pump to establish and maintain their
milk production.
Unfortunately, we don't yet have the research to back up these
recommendations, and as I said in my previous post, I'm sure if we took
a poll, we would find many differing opinions.  I am hoping that Lenore
is documenting the experiences of the women she works with, so that we
can all benefit from this information (i.e, what percentage do well with
the Pump In Style and what percentage do not).  Many of our field's
founders spoke out quite strongly on the virtues of the pumps with
rotating silver pistons, but we all need to stay open-minded to new
information.

Research does contradict Lenore's comment about strong suction being
important.  According to the Hartmann team's research, higher vacuum
levels appear to be unrelated to amount of milk expressed.  In fact at
the last ABM conference, Peter Hartmann showed a slide in which mothers'
optimal vacuum levels were all over the map.  He spoke specifically
about one woman who got the most milk at around 75 mmHg (the minimum
setting on many hospital-grade pumps) and when she increased the vacuum,
she got less milk.

I spend a lot of time in my new position explaining to the mothers who
call that they should be on the highest *comfortable* setting and that
there is no advantage to turning the suction up higher than that. I find
myself repeating over and over:  "Expressing milk from the breast is not
like sucking liquid from a straw.  With a straw, the stronger you suck,
the more you get.  But when you express your milk, it's all about the
let-down."  Mothers need a lot of convincing on this point.  From my
experience, this seems to be counterintuitive.

Best regards,
Nancy Mohrbacher, IBCLC
Lactation Education Specialist, Hollister, Inc.
Chicago suburbs, Illinois

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