My personal experience with the Gomco pump is that it is essentially a vaccuum sucker whose power can be easily increased to damage breast tissue. It hurt to use it, I had to be careful to release suction regularly, and for me, the small battery/plug-in pumps worked better, collected a lot more milk and were more comfortable. Does the FDA or someone else regulate the purposes for which medical equipment can be used? (For example- the nipplette?) Has this pump been approved for collecting breastmilk? I also have some serious questions about kits being adapted for use with this machine, lack of filters or overflow containers and ultimately bacterial safety. Perhaps another pump company could provide the information needed by the HMO. Cathy Liles