The newer guidelines from the Milk Banking Association of North America 
recommend a closed system where the air doesn't circulate into the 
flange/bottle part for moms pumping for NICU babies. What I understand 
is that an open tubing system like Medela's pulls air in and out of the 
tubing, down into the bottle and back up. This is why the Symphony 
tubing gets condensation in it.  While you mostly only see the 
condensation near the flange part, I wonder if enough liquid moves up, 
could it "park" itself on the pump body where the tubing attaches? And 
then go down into the next users tubing. If you  look at the tubing 
systems of the cheap drugstore brands, you can see how milk might go 
into the motors direct from the tubing. Ameda is one example of a closed 
system with a barrier between the flange and the tubing. Dr. Brown, 
Playtex, and Avent also say theirs are closed systems. (I do sell or 
rent pumps myself but I do work for a government agency that uses a 
closed system for pumps.)
Kathy Eng, BSW, IBCLC

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