Breast Pumps

Manual breast pumps

For moms who only need to pump occasionally, a manual breast pump is an inexpensive option. Experts say manual pumps do an adequate job of expressing the occasional bottle of milk or of relieving engorgement. Manual pumps are small, light, portable and have no electric parts to break down, but some parents report they can be tiring and frustrating to use, especially long term. Since you need one hand to control the pump, manual pumps only express milk from one breast at a time.

The Avent Isis Manual Breast Pump (*est. $50) is the top-rated manual pump in professional reviews. It is also a favorite of About.com's Guide to Babies and Toddlers, Stephanie Brown, as well as editors at Breastfeeding Magazine. Parent reviews on Amazon.com and other sites are mixed for this model. Most say they find it easy to use and a few say it rivals the more expensive professional-grade pumps for speed and convenience. On the downside, some moms say expressing milk with the Isis Manual is slow, inefficient and the plastic cracks easily. Another consideration is that you need to use Avent bottles (using non-Avent bottles is possible but requires the purchase of adapters). The Isis comes with two bottles.

The Medela Harmony (*est. $40) is another good choice, according to reviews. About.com's Babies and Toddlers guide, Stephanie Brown, recommends it for moms who will be using standard bottles rather than the proprietary Avent bottle system, since most standard bottles will fit the Medela. Other reviewers also say it's a good alternative to the Isis. Parents on Amazon.com rate the Harmony slightly higher than the Isis, reporting that it works fine and is easier to assemble. Durability doesn't seem to be an issue, although a few user reviews do note problems with poor suction (a complaint found to some extent for most breast pumps). Like the Avent Isis, the Medela Harmony comes with two bottles but the Harmony is generally a bit less expensive, so we've included it in ConsumerSearch Fast Answers over the Avent Isis.

Electric breast pumps

Small electric pumps are recommended for occasional use or to replace one or two daily feedings. Slightly larger and heavier than manual pumps, they use batteries or AC adapters to power an automatic suction and release cycle. We found the best reviews overall for the Medela Swing single pump (*est. $130) , which receives the best reviews from parents posting to Amazon.com and Babies "R" Us. A few parents say they actually prefer the Medela Swing over bulkier professional-grade breast pumps (discussed below), reporting they find it easier to carry and just as efficient to use. One common complaint about the Swing breast pump is that the lack of a double-pumping option means each side has to be pumped separately. That might not be a problem for the occasional pumping session, but it makes the Swing a less convenient option for frequent or workplace pumping.

Although the Evenflo Comfort Select (*est. $45) is inexpensive compared to the Medela Swing breast pump (*est. $130) , experts warn that it's not a good value. Moms posting to Amazon.com complain of nipple pain, along with pumps that break down within the first few weeks of use. The First Years Deluxe Natural Comfort Breast Pump (*est. $45) receives similar ratings from users. Complaints on Babies "R" Us and Amazon.com focus on inefficiency, low suction and faulty motors. Several posts mention nipple pain and even damage to the nipples. Reviewers say moms are better off purchasing a manual breast pump or spending the money on a top-rated Medela or Ameda manual breast pump instead.

Lactation experts recommend that mothers who want to improve a low milk supply, or those whose babies have trouble latching on, need a full-size professional-grade breast pump. The same applies to moms who need to pump several times a day, especially if they're away at work or school full time. Full-size electric pumps typically allow users to collect milk from both breasts simultaneously. Besides making milk expression more efficient -- often an important consideration in the workplace -- double pumping can be helpful in stimulating the let-down reflex. These pumps plug into an electrical outlet, but most can also run on batteries. Professional-grade breast pumps are larger and heavier than manual and small electric versions, but most come with discreet carrying bags or backpacks.

The Medela Pump in Style is by far the most recommended breast pump by both parent reviewers and lactation experts. The Pump in Style Original (*est. $220) is a long-standing favorite, while the newer Pump in Style Advanced (*est. $325) has begun to take the lead in more recently written reviews. The Original breast pump comes in a black shoulder bag which folds down to make a flat surface for bottles and other pumping accessories. It includes a double pump with adjustable speed and suction control, a battery pack for pumping away from a power outlet, collection containers with lids and a cooler pouch for storing expressed milk.

The Medela Pump in Style Advanced is similar to the Original breast pump with the addition of what Medela calls its "2-phase expression pumping" to simulate a baby's natural nursing pattern. In the first phase, called "let-down mode," the pump mimics a baby's initial rapid suckling pattern to stimulate milk flow. After two minutes, the pump switches to the second phase, called "expression mode." This slower, stronger setting is supposed to promote more efficient milk collection. Parent reviews of the Pump in Style Advanced have been very positive, with dozens of mothers posting that the two-phase feature speeds up pumping time by several minutes. On the other hand, some mothers with multiple or delayed let-downs comment that they much prefer the customizable settings of the Pump in Style Original breast pump.

The Pump in Style Advanced is available in several versions, all of which are the same basic system but with different carrying cases. Besides the basic black shoulder bag (*est. $320), you can opt for the Medela in a backpack (*est. $320), a reversible metro bag (*est. $350) or an Limited Edition designer model (*est. $325). Several mothers posting to Amazon.com and Epinions say the backpack is too small to fit all of the pumping accessories and too heavy to carry around comfortably. The small number of reviews for the Pump in Style Limited Edition all mention that they like the bag's extra roominess. So even though it costs a bit more than the other bag styles, we've included the Limited Edition version in ConsumerSearch Fast Answers.

The Ameda Purely Yours (*est. $160 without carrying bag) is another top-rated professional grade double breast pump. The Ameda breast pump gets good reviews from mothers posting to Amazon.com and Epinions. One advantage of the Purely Yours is that it can be purchased separately without the bag for less (*est. $150 to $200), making it a good value for a professional-grade pump. It is also available with a shoulder bag (*est. $225) or backpack (*est. $260) . There are fewer parent reviews for the Ameda Purely Yours than for the Medela Pump in Style, but ratings are overwhelmingly positive. Several parents posting to Epinions and Amazon.com complain that the Purely Yours breast pump is noisy and too heavy; the motor alone weighs two pounds. Others mention the difficulty in finding replacement parts, which are less commonly available than Medela's accessories. Two posters to Amazon.com complain that the Purely Yours causes sore nipples, but most say it's comfortable and efficient. To be fair, individual comfort can vary with any breast pump.

One feature that sets the Ameda Purely Yours breast pump apart is its contamination-free collection system. Other personal use electric breast pumps, including the Medela Pump in Style, have open collection systems, meaning a small amount of milk can get inside the pumping mechanism itself. Normally, that's not a problem, but there is a small possibility that disease-causing organisms like bacteria or fungi could grow inside the mechanism itself. Since the pump, unlike the tubing and other removable parts, can't be sterilized, these organisms could possibly contaminate later batches of breast milk.

The FDA cautions women never to buy a used breast pump because of this potential risk, but contamination isn't usually considered a problem for a single user. There is a theoretical risk of self-contamination, however, and mothers who feel strongly about eliminating that possibility might want to consider the Purely Yours breast pump. The other advantage of Ameda's closed collection system -- basically a silicone diaphragm that acts as a barrier between the pump tubing and the breast flange -- is that the tubing never needs to be cleaned.

Hospital-grade breast pumps

Professional-grade breast pumps like the Medela Pump in Style and the Ameda Purely Yours work well for mothers who need to replace two or three feedings daily or who want to pump as a supplement to regular breastfeeding. However, experts say moms who need to pump full-time – those with premature babies who are unable to nurse, for instance – should use a hospital-grade pump instead.

Hospital-grade pumps, also called piston electric pumps, are rugged, multi-use devices designed to withstand several years of continuous heavy use. These pumps are normally rented through hospitals, pharmacies, medical suppliers or lactation consultants rather than purchased outright. Rental rates range from $20 to $80 per month. Each mother also buys a pumping kit (*est. $30 to $50 depending on the model) to prevent cross-contamination.

The Cerean Breastfeeding website calls the hospital-grade Medela Symphony (*est. $1,650) their "true favorite home pump." The Symphony uses the same two-phase pumping process as the Pump in Style Advanced, but also includes an updatable program card, an LCD screen and a choice between manual and automatic pump setting control. Like all hospital-grade pumps, it incorporates a protective membrane to prevent cross-contamination through the pump mechanism, meaning it can be used by more than one mother as long as each uses a separate pumping kit. Alternatives to the Symphony include the Medela Lactina Select (*est. $850) and the Ameda Elite (*est. $900) . Neither breast pump has the Symphony's two-phase pumping system, but both are hospital-grade pumps designed for frequent, long-term use.

One thing to keep in mind when considering a hospital-grade pump for daily use is that they are heavier and far less portable than professional-grade pumps. They also don't come with discreet shoulder bags or backpacks, so they're not ideal for carrying to and from the office. Also, unless you think you'll need to pump exclusively for many months, buying a hospital-grade pump isn't cost effective.

Important Features: Breast pumps

Reviewers say the following about shopping for a breast pump.

• Don't buy or borrow a used breast pump. Except for hospital-grade pumps and the Ameda Purely Yours discussed above, all breast pumps are considered by the FDA to be single-use devices. Because the pump mechanism itself can't be sterilized, there is no way to guarantee that disease-causing organisms like HIV or hepatitis won't be transmitted from one user to the next. Besides being potentially dangerous, buying a used breast pump voids most manufacturers' warranties, so you won't be able to get product support if you need it.

• Consider your individual needs. Not all mothers need a professional-grade pump. For occasional use, and if pumping speed is not a primary concern, a small single electric or even a manual breast pump may be all you need. If you're returning to work full time or need to boost your milk supply, you'll probably need to invest in a professional-grade pump. If you're pumping milk for a premature or hospitalized baby, you're better off renting or buying a hospital-grade pump.

• Consider renting. Some experts say it's usually best to rent a hospital-grade breast pump for at least the first week or two. Since retail breast pumps are non-returnable under most circumstances, renting is the only way to try one out before you buy. Once you know which features are important to you, you'll be able to make a more informed purchase. For some moms, a short-term rental may be all they need.

• How work-friendly is it? For those who plan to pump at work, size, portability and noise are all important factors. If you'll be carrying the pump back and forth every day, make sure it's not too heavy, and consider a model that comes with a carrying case and insulated milk storage compartment. Noise can also be a factor at work, so make sure the one you choose has a noise level you and your co-workers can live with.

• Go for adjustable suction features. Comfortable suction levels vary from woman to woman, so it's best to buy a breast pump with an adjustable suction level. It's also important to use the correct size of breast shield. Make sure the pump you're interested in comes with breast shields that fit you or find out if you can purchase them separately.

• Check the warranty. Breast pumps have moving parts that can break down. Experts say it's best to buy a brand with a one-year warranty, especially if you'll be using the pump regularly.

Our Consensus Report shows how many times products are top-ranked by reviewers included in our
All The Reviews Reviewed chart.

# of picks	Model (with Retailer Links)	Details from Amazon.com
4	Medela Pump in Style Advanced (*est. $325)	details
3	Medela Pump in Style Original (*est. $220)	details
3	Avent Isis Manual Breast Pump (*est. $50)	details
3	Ameda Purely Yours (*est. $160 without carrying bag)	details
2	Medela Harmony (*est. $40)	details
1 each	Medela Swing , Medela Symphony , Medela Breast Pump (original) , Medela Pedal Pump , Whittlestone Breast Expressor, Bailey Nurture III , Dr. Brown's Manual Breast Pump , Ameda One-Hand Breast Pump , Ameda Elite

The Medela Pump in Style -- the Original and the Advanced -- tops both user and expert ratings. The Advanced receives slightly higher ratings for its updated expression system, but users say the Original also does an excellent job. The Ameda Purely Yours performs almost as well in reviews and versions sold without a carrying case sell for less than half the cost of the Pump in Style Advanced. The Avent Isis Manual Breast Pump is the most popular manual pump, but we find slightly better user reviews for the Medela Harmony, which is a bit less expensive and can be used with most standard baby bottles (the Avent Isis requires Avent bottles or special adapters).

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