> A good number of moms of babies in our NICU have PIS pumps at home.  I
> still strongly recommend that these moms use a hospital-grade pump for
> at least the first 2 weeks, to establish milk supply.  I recommend they
> record their 24-hour total milk yields closely when they switch to the
> PIS.  If milk yields decrease, or if supply takes a dip over the course
> of pumping, I recommend changing back to a hospital-grade pump, at
> least until supply increases once more.
> 
> Would greatly appreciate any information or sources regarding this
> issue!  
> 


First, let me say that I think the PIS is a terrific pump -- but not for the mom pumping round-the-clock for weeks to months. (And because we're talking PIS, I'm only referring to Medela pumps in this post.) I work with a lot of mothers of multiples, many of whom begin their BF relationship with a pump -- which one MOT in our LLL multiples group referred to as her "ugly baby (as in "I've got to go 'feed' the ugly baby so I have milk for the cute ones) -- and I've known too many report less than optimal production (for even a singleton) when depending on a PIS (and a number even with a Lactina). I think part of the reason may be that mothers frequently report to me that it tends to take them 5-15 minutes longer to get the same amount of milk vs when using a rental, esp a Classic or Symphony. Our NICU LCs say they've seen similar, so we all emphasize the use of a rental throughout the period a mother is pumping round-the-clock and depending on a pump for entire production volume. (Sure, a given mother may not have a problem, but how do we know that mother until production is in trouble?)

Our outpatient LCs, who also oversee a rental/retail station, frequently use a pressure gauge to check the vacuum on returning rentals; they also check vacuum on PISs moms bring in (on own or by LC request for outpatient visits). They say the vacuum of PISs are consistently lower vs. the rentals (mainly Classics and Symphonies). This may also explain why it takes many moms longer to pump. Longer sessions, especially once baby/babies are home and requiring care can lead to fewer pumping sessions -- there still are only 24 hours in their days -- which, obviously, will also contribute to lower production. 

I find the company's web page re: which pump to use to be a bit ambiguous -- and I'm tired of mothers who will be depending on a pump to establish and maintain milk for the next several weeks not get clear info prior to purchase. However, I give them credit for including some guidance -- most companies are even more vague.

Though already slightly out of date, this LLLI Leaven article is still helpful re: pump comparison: 
http://www.llli.org/images/LV/LVJunJul04p52.pdf 

Karen

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