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Pumping guide

Start here to learn about pumping at any stage

Choosing a pump

This guide should help you figure out your pump options. 

Step one: contact your insurance

 Most parents find it helpful to call their insurance and ask

1. How much will my insurance reimburse me if I buy a pump out of pocket and what is the process?

2. What DMEs (durable medical equipment companies) can I get my pump from? If you decide to use a DME it can be helpful to check your available pumps with multiple companies as you may get different coverage.

3. Will your insurance cover a rental dual motor multi-user pump in addition to consumer home pump?


Step two: Compare pumps

Factors to consider when choosing a pump:

Note: hospital grade pump is not a protected term and all pumps/bottles claim to be just like breastfeeding. When choosing a pump you want to look at the specifications:

  1. Pump motor 

  • Suctions strength: In my experience clients have the best milk supply outcomes with pumps with a max suction of 270 mmHG or above (EX: Spectra S1/S2/Gold/Gold Portable, Cimilre S5+/S6+, Motif Luna, Pumpables pumps)

  • single vs dual motor consumer pump: Dual motor pumps can be helpful since both flanges are not sharing the strength of one motor. Parents should consider other variables such as pump setting control and portability if they are on the fence between a single motor and dual motor pump. The benefit of dual-motor is you can usually set different suction speeds/strengths on each breast/chest if you need/want to. (Single: Spectra S1/S2, Cimilre S6+, Motif Luna, Pumpables & Double: Cimilre S5+,  Spectra Gold/Gold Portable)

  • Multi-user dual motor pump: A multi-user dual motor pump is a pump that has two motors and is strong enough to be used by multiple people for multiple feeding journeys. These pumps range from $599 dollars to $2000 dollars and are often rented for around 100 a month. (Ex: Unimom Opera & Madela Symphony 

2. Pump settings:  

  • mode button: mode buttons are often seen as hands/droplets/waves/M and they typically switch the pattern of suction speed/strength. Typically you want to start with a fast and gentle suction and switch to a slow and strong suction once you see milk in the flanges. A button to switch between modes is helpful because when pumping you often don't have the time (or hands) to manually change settings. 

  • volume/suction control:

    • Volume/suction controlled separately: pumps that allow you to control the speed and suction strength separately. This can be helpful because not all bodies respond to the same settings. (ex: Spectra S1/S2, Cimilre S5+, Pumpables SuperGenie, Motif Luna, Unimom Opera) 

    • Volume and suction are preset: These pumps are more simple and typically have set settings. Often settings will start fast and gentle and go slower/faster as you go higher. This is helpful for parents who may be overwhelmed by options. Often this is the type of settings for very small pumps. (Ex: Cimilre S6+, Madela Symphony, Pumpables Genie advanced)

3. Flange options:

  • Single-piece flanges vs two-piece flanges: some pumps like spectra come with flanges in one piece and other pumps like Madela come with flanges into pieces that attach. To my knowledge, this doesn't affect function but it is something to keep in mind when ordering new flanges (spoiler alert: most people will not fit in the flanges included with most pumps) 

  • Flange and adapter options size options: As I said above most people will not fit in the flanges included with their pump. This means most people end up buying third-party flanges from a company called Maymom or through another company called lactation hub. Maymom makes spectra-style adapters/flanges (in my experience pumps that work with this adapter are Unimom, Cimilre, and Motif), Madela-style adaptors and flanges, Ameda-style adaptors, and Lansinoh-style adaptors. 

  • Hard plastic vs silicone vs inserts: In my experience clients have better milk production with traditional hard flanges but some parents may need alternative flanges. Inserts are typically your only option with wearable pumps. Alternative flanges like Pumpables Liquidflange and Lacteck Flanges can be helpful for people having trouble finding a comfortable flange. 

4. Portability

  • Size: pumps come in various sizes from hand size to the size of a karaoke machine. 

  • Handles, straps, clips: Handles, straps, and clips can make pumps much more portable if they are rechargeable. 

  • Plug-in vs rechargeable battery: While most parents consider size when thinking of portability, battery type, and handles, straps, and clips can be more important. This is because most parents like to sit when pumping but just need the option to move if needed.  

  • Wearable: There are many wearable pumps on the market. Most IBCLCs agree that these pumps tend to be less effective for pumping especially for larger chests. If you are going to get a wearable pump I recommend one with a suction strength of at least 270 mmHg and be willing to buy/rent a second pump if needed. 

Step three: consider your situation 

Factors that may affect your choice:

  • If you can afford a second pump: if you can afford a second pump you may choose a more portable pump and buy a workhorse pump if needed or you may choose a workhorse pump and purchase a portable pump later on if needed.

  • If you cannot afford a second pump or a pump out of pocket: I recommend choosing the strongest pump available to you with the most customizable settings. (often this is Spectra S2, Spectra S1, Cimilre S6, or Motif luna)

  • Your time-management skills: If you struggle to do multi-step tasks you may choose a stronger portable pump (baby buddha or pumpable genie advance) or at the very least a workhorse pump that is rechargeable (pumpables genie advance, baby buddha, spectra s1, motif luna, cimilre s5+/s6+, or unimom opera)

  • Whether you will be going to work later: If you have a desk job you will probably be fine with any workhorse pump (Pumpables supergenie, Spectra s1/s2/gold/gold portable, Motif luna,Cimilre s5+/s6+, Unimom opera, Madela symphony). If you have a job where you are more mobile you may consider a pump that is more portable but still strong (Pumpables genie advance, baby buddha, Spectra s1, Motif luna, Cimilre s5+/s6+, or Unimom Opera). 

Flange Sizing

This guide should help you figure out your size or sizing options

Why does flange size matter?

  • The wrong size can cause pain and discomfort when latching

  • The wrong size may not let you pump at high suction

  • The wrong size does not stimulate your milk production as effectively

Signs of a flange that may be too big

  • The nipple enters the tunnel but won't stay in the tunnel (usually causing the milk to leak down your breast)

  • The part of the nipple closest to your chest touches the tunnel but not the sides of the nipple near the tip. This often means your areola is being pulled in and the nipple is not getting stimulation 

  • Your nipple or areola looks swollen when coming out of the pump. 

  • Your nipple/areola look tubular when they did not look this way before

Signs of a flange that is properly fitted

  • ​You should see the sides of your whole nipple touching the tunnel (this stroking is what helps the body release hormones for making and releasing milk)

  • You should see your nipple gliding in the tunnel easily

  • Your nipple feels comfortable (not just tolerable)

  • You should get a letdown within 2-5 minutes (in my experience the properly fitted flange gives a milk release within 1 minutes)

  • You are producing enough milk for your baby 

Type I sizing: Measuring and adding 1-3 mm

  • When is this method used?​

    1. Before your baby arrives: this method can be helpful when you are pregnant/inducing. Most people don't fit in standard sizes so measuring prenatally​ can get you a better size before we can see how your milk flow responds to size (see Measuring type II)

    2. When you need a better size sooner: A lot of parents are sent home pumping with little output due to flanges that are too large. This method can help when a full flange fitting is not possible. 

  • Tools you can buy 

    • Electric or plastic calipers: These are typically bought off Amazon and are around $5-8 dollars. ​I prefer calipers 

    • Silicone nipple ruler from Amazon: these are typically silicone and include circle cutouts. 

  • Tools you can print for free​​​​:

  • Do I pump before measuring?

    • No, you can nurse before but I don't recommend pumping beforehand. This is because your flange is likely too big for you and can cause you to swell. 

Type II sizing: Trying on various sizes 

This is the ideal way to fit flanges and you should ideally do it with an IBCLC

Step 1: measure both nipples horizontally and vertically. 

Step 2:  Set up your pump for single pumping

Step 3: Try on various sizes starting at the flange size closest to your nipple size (Your IBCLC should flanges for a full flange fitting)

Step 4: Try on each flange for 2 minutes: observe the comfort, how long it takes for you to release milk, and how milk flows out (drops vs sprays).

Pump Basics 

What to know when using a pump

What settings do I use?

  • When you first start the pump ​(stimulation mode)

    • Gentle/fast suction

    • Your pump may have a button to switch modes (often a wave, M, or hand)

  • Once the milk is coming out (expression mode)

    • Strong/slow suction that is comfortable (not just tolerable)

    • Your pump may have a button to switch modes (The button may be a symbol of a drop or you may press the stimulation button to turn off stimulation mode)

How long to pump for:

  • If pumping after nursing:15 minutes or 5 minutes after the milk stops coming out (not to pass 30 minutes)

  • If pumping to replace nursing: 30 minutes 

When to pump:

  • When your baby gets a bottle

What if nothing comes out?

  • Even if nothing comes out the pump is still providing nipple stimulation. I recommend checking flange size for optimal nipple stimulation. 

Free Nipple Ruler

Print, cut, measure

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