I've been using the PNS since it's been out (1 yr now). I have to say that I was very skeptical at first. I gave the first one I got as a gift to my cousin after she had a baby. (I experimented on her !) We used it to relieve some engorgement and I was thrilled with it's performance. I have sold 56 PNS in the course of the year and only have had one client who had purchased the PNS and was not happy(she had rented a L----first) She ended up buying the L---. But overall, when I've gone in on consults where the mom already has a PNS, we have used it to aid in decreasing engorgement and have also used it to increase supply with satisfactory results. Like the rest of you, I do not and would not use it for a preemie situation or any situation where someone is pumping 24hrs/day 7 days week for an extended period of time. I basically explain to a mom in a "normal" situation that if she is going to rent for longer than 3 months (including the purchase of a DP kit) it may be more cost effective to buy the PNS. I think it performs well but will never replace the rental pumps. Also, even though the PNS is single-user pump, we all know that moms share them or lend them to each other. I have no idea but can only speculate that they may not hold up well after multiple users. I must also have to add that I am not pleased with the incredible price increases since it has been out ! Maria Parlapiano RN IBCLC The Lactation Resource Center, inc. in NJ