RE:; Lactina PUmp Query: Joy asked if anyone had had trouble with the Lactina struggling with a double kit on maximum. It is a relief to me that someone else has seen this. My Medela rep says she has never seen anyone have this problem. I have a large pump station (for 8 years) and I check every pump with a vacuum gauge when it is returned to me. I use the same piston each time and on occasion, I will install the piston on a pump on max. and the piston will balk. If I turn it to medium it works well but go back to max and it will struggle to complete the stroke. I have seen this happen twice at client's homes when I have followed a pump delivery with a home visit a few days later. It doesn't seem to matter how old the pump is. So far I have seen it only with Lactina Plus, not Select. If it were a problem with the piston, all my pumps would balk because I test each one with the same piston. I have seen a situation where it WAS the piston and all I did in that situation was to manually work the new piston 15 or 20 times and then reinstall it on the motor. All was well. But I do think that on occasion, a Lactina will eventually malfunction. I have returned these to Medela and eventually they are supposed to tell me what is causing the problem. Judy Eastburn, BS, IBCLC Private Practice, Dallas, Tx.