Several months ago our hospital switched from Medela pump kits to Ameda.
This was done for two reasons: cheaper cost, and the mothers we had trial
the one-hand pump strongly preferred it to the Medela manual pump we were
offering. We trialed a few of the electric pump kits, but in retrospect not
nearly enough--I never expected that to be an issue. The change was made
with the understanding that the electric kits would be used primarily with
Medela Classics and Ameda SMB's--I was not interested in a change that would
affect our DME provider and all the pump rental stations in the area.
Shortly after we made the switch we started noticing what seemed like a high
number of mothers getting sore nipples, sometimes horrendously so, sometimes
from the very first pumping. I searched the Lactnet archives and found no
reference to this. On OB we have four electric pumps--two old SMB's, two
Classics. We have always used them interchangeably and never had any
problems. I checked the pressures with an in-line gauge--all within normal
limits. The Hollister (Ameda) sales rep checked them also--supposedly fine.
I then did my own test one afternoon and pumped, myself. (My youngest is 14,
so these are really dry breasts!) After 5 minutes on minimum with the Ameda
kit, I couldn't WAIT to get the pump off--pinchey and annoying. 5 minutes on
minimum with the Medela kit was no problem; I probably could have pumped a
half hour without getting sore. I tried this with both an SMB and a Classic,
and tried putting the flexishield in the Ameda, all with no appreciable
difference.
Then this week I finally got the kind of manometer you put in the nipple
tunnel of the flange, and was appalled. No wonder our moms were getting
sore! On all four of our pumps the Medela kit's pressure ranged from around
50 on minimum to around 210 on maximum. The lowest minimum pressure I got
with the Ameda kit was 120; the highest 160. On minimum! The maximums
ranged from 260-300. I also tested the Ameda kit with the one Ameda Elite
pump we had recently received, and that tested out at 0-220, so that's fine.
To share another tidbit--since our SMB's had been used for years with Medela
kits they didn't have the little hard plastic piece on the end that the
tubing plugs into. The pressures I tested were with the little plastic
piece--without it the minimum pressure was even 20-30 mm higher.
I've talked to several LC's who are very happy with the Ameda kits, but I
believe everyone I've talked to is using Elites. Is anyone else having the
problems we are? From what I've found, I think it is unconscionable that
Ameda/Hollister is marketing these kits (Hygienikit) as compatible with all
their electric pumps. They seem to be designed to work fine with the Elites,
but not the SMB's and I would bet the same problem exists with the Lact-E's.
So right now we're in the position of deciding what to do. I'd really like
to hear from anyone who has run into the same thing. Thanks, and sorry for
being so long.
Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin
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