The question of the season seems to be: My __________ is due in the new year and I want to get her something special for the new baby. What type of pump should I buy?
Okay so how as a lactation consultant do I answer this question.
First off, congrats to the pump makers, the marketing is working. Somehow and in some way all of these companies: medela, playtex, evenflow, ameda, etc. have made their way into the US public mind through the advertising and connected breastfeeding with pumping. In fact, it is to the point where when a nurse walks into a room and asks if the mom has any breastfeeding questions, she may state I want to pump only and not breastfeed.
So, what is wrong with this? A few things.
Answer Part 1. It is nice that we are thinking breastfeeding but breastfeeding is not synonymous with pumping. Especially not in the first 3-5 days. When you look at the amount the infant needs and the stimulation needed both hormonally and physically to bring the milk out of the ducts (where, by the way, it has been since the end of the second trimester) and down to the baby the pump, even the hospital grade pump, is not enough. Your hand, that's right I said it, your hand and hand expression is going to in fact bring more milk to the baby than a pump can. The massage that the hand provides mimics the massage that the baby provides with its mouth far better than a pump ever can.
So then why do we give a pump in the first 3-5 days if mom is not with baby or the milk is delayed? The answer is simple and complex. We need to simulate the same stimulation as the baby's mouth and this is done with the hand. But we also need to create stimulation to the both breasts at the same time with suction for 20-25 minutes every 2-3 hours 24 hours a day just as the baby would.
So, let's see... if I said to a mom you need to pump your breast with your hand for 20 minutes every 2-3 hours would we really have anyone breastfeeding through delayed milk supply and mom and baby separation? The answer is a loud, no. In fact, I am guessing the mom in this case might actually throw something at the person stating this process and think they were a true lunatic. (At least that would be my own response). From a physical therapist, weight trainer, or even a musician's standpoint this would more than likely sound ludicrous as well since that level of exercise in repeated motion for that amount of time is outside the bounds of what would probably be deemed acceptable for these professions.
Hence why we have the pump and say- pump 20 minutes with massage every ten minutes and warmth and then hand express for 5 minutes. This way the breast gets the best of both worlds without the baby. The Stanford Hand Expression video demonstrates this and explains this process quite well.
Answer Part 2: What pump to give as a gift? If you follow the marketing ploy you are going to end up with any number of pumps from electric ones that are not hospital grade to powerful portable electric ones that are not going to provide enough stimulation to get a mom through a 40 hour work week. My advice.... wait until the baby gets here. Then depending on the baby and mom's needs make a decision.
If mom is going to stay home with baby and not return to work and there is no milk delay all mom really needs is a hand pump or a simple electric pump. If mom is going back to work at 6 weeks or 3 months and her work day is less than 8 hours a day and less than 3 days a week and breastfeeding is going well then a powerful double pumping portable pump is good. But, if mom is going back to work 40 hours a week or working more than 8 hours at a time, or if there is any milk delay or separation of baby and mom for more than 24 hours in the first 2 months then your best bet is a hospital grade pump.
What we need to remember is that breastfeeding the baby at breast with a good latch and positioning and support comes before the cold, plastic, motorized pump that in no way looks, smells, or acts like a baby at the breast. So, if you want to get that mom something, search out a local lactation consultant (an IBCLC) and prepay for a lactation consultation. This gift will last that baby the rest of its life and the health benefits will carry on into the next generation.
