Nikki writes:    I have always heard that the only pumps that are efficient at
establishing a milk supply are the hospital grade ones, because their motors are designed
to stand up to pumping 7+ times /day plus their suction/cycling is better.
    However, I work with many women that have spent big bucks to purchase the
fancy pump in the backpack or others like it. If they are pumping 7+times
day, stretching those nipples, and removing milk (in many cases 2+ ounces per
session), where is the problem?

I wish we had a better answer to this question.  There have been a couple of
company-published studies, but no research done independently to determine whether the
hospital-grade or personal pumps are equivalent in effectiveness or whether the full-size
(rotating silver piston) or mid-sized (Elite and Lactina) are equivalent.  The recent
Symphony research in JHL compares only the Symphony with the Symphony, not with any other
previously existing pumps.

What Hollister recommends--and this is consistent with what I recommended in my private
practice--is to use a hospital-grade pump to establish a milk supply if a baby is not
breastfeeding.  A personal pump is recommended for a woman who already has an established
milk supply.

All we really have to answer this question is clinical observation and experience.  My guess
is that we could come up with quite a lot of different opinions on this issue based on each
of our own observations.  But these are all in the realm of opinion.  I don't believe there
is any really definitive information on this.

Nikki, I agree that there are women who very successfully establish and maintain a milk
supply with a personal pump.  I even met a woman once who successfully maintained her milk
production for two years with an Evenflo pump (not surprisingly, she went through two or
three of them).  I don't think that knowing  one person (or even several) who have done this
is enough to recommend an Evenflo to others who are considering pumping and bottle-feeding.

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. The 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 women.  For example, the
Purely Yours, Hollister's personal pump, offers between 30-60 cycles per minute, as does the
hospital-grade Elite.  The Purely Yours, however, only offers four cycle settings:  30, 40,
50, 60, while the Elite 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 of a
range, a mother is more likely to find settings that work best for her to  help her
establish  milk production.

Even though like the hospital-grade pumps, the Purely Yours is a piston pump (which may be
why I noticed in my private practice that it seemed to be more effective at keeping up milk
supply than a Pump In Style, which is a diaphragm pump), it is not currently recommended for
establishing a milk supply.

If anyone has access to any real research or hard information on this question of
hospital-grade vs. personal pumps and full-size vs. mid-size pumps, I'd be very interested.
One of the things I noticed over the years is that different women respond differently to the
different feels of different pumps.  As others have reported, I have had some women with
faltering milk supplies do better when they switched from a personal pump to a hospital-grade
pump and from a mid-size pump to a full-size pump.  But I have also seen it happen in the
reverse.  So I think individual differences play a role here, too.

It's all food for thought.  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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