Nikki writes:

>    Dr. Jennifer asks a question that I would love an answer to as well.
>    I have understood that a hospital grade (rental) electric pump is
>necessary to bring in a milk supply as its motor can stand being used 8-10 times a
>day, whereas something such as a PNS isn't. A PNS is for a woman whose supply
>has been established already, and who will be pumping only 2-3 times a day.
>    Many women already have a PNS, and don't want to spend more money to rent
>a pump when they have a situation that requires pumping more than 6 times a
>day. I have given up trying to persuade some women and haven't noticed any
>difficulty yet; those women will make plenty of milk and their PNS hasn't died.
>    However, a mother I am working with who bought a $300 pump and has to
>pump 8 times a day did take my recommendation. And lo and behold, her sore
>nipples went away because she had the suction too high on the PNS!
>    Any input would be useful.
>
>
>
I don't believe that the current recommendations have anything to do
with pump durability.  I get a lot of calls in my job at Hollister from
parents of premies who want to save money by purchasing a Purely Yours
rather than renting a hospital-grade pump.  They want me to tell them
why they should rent a pump instead of buying.

I tell them that we recommend hospital-grade pumps in this situation
because they offer more settings and are therefore more likely to be
effective for more mothers.  For example, the Purely Yours, Hollister's
personal pump, only offers four cycle settings--30, 40, 50, 60--while
the Elite, a hospital-grade pump, also offers everything in between:
30, 31, 32, 33, 34, 35, etc. up to 60.  With the vacuum settings, the
Purely Yours offers eight, while the Elite offers an almost infinite
number of variations.  Because the hospital-grade pump offers more
choices, a mother is more likely to find settings that work best for her
to help her establish milk production.

I wish we knew more, but as far as I know, no independent research has
been done to determine whether the hospital-grade or personal pumps are
equivalent in effectivenss or whether the full-size (rotating silver
piston pumps) and mid-sized (Elite and Lactina) are equivalent.  The
recent Symphony research in JHL compares only Symphony with Symphony,
not with any previously existing pumps.  (BTW, I just found out that the
current Symphony offers the same number of total possible settings as
the Purely Yours--32).

Other LCs I know recommend the rotating silver piston pumps over others
because they believe the suction curve of these pumps is more effective
than other types of pumps. Unfortunately, the only information we have
to go on in making these decisions is clinical observation, and I'm sure
if we took a poll on Lactnet we could come up with many different
opinions! Here's hoping for more definitive research in the years to come.

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

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