Over the last few years I have really dug deep into the breast pump education space. As a lactation consultant supporting military families, breast pump education was an area where my patients really needed support in. Also, if you are a Tricare beneficiary then you also receive a breast pump, supplies, and milk storage bags for every birthing event. See the current Tricare policy on breast pump coverage here.
Let's break down my method of helping moms find a breast pump that is best for them individually. This is not a cookie cutter one size fits all situation. In fact there is not a single pump on the market that I can confidently say I would recommend to every single mother. This is genuinely based on your situation, history, preferences, and lifestyle.
Is this going to be your only pump?
If yes, then we need to consider a few things. This is going to be your only pump, therefore it is ESSENTIAL that this pump meets my three pillars that quantifies a pump as a reliable primary breast pump. These pillars include: the pump is strong enough to establish you milk supply, maintain it, and able to increase your supply if needed. Realistically not every breastfeeding journey will go perfectly to plan. Sometimes difficult situations do arise that make it more challenging than you initially thought. So having a reliable pump that you can lean on if you are struggling is so important. For those who are having a hard time, having a reliable primary type pump can be the difference of meeting your goals or not. If baby is not latching, or you have to be separated maybe for a NICU stay, or you find yourself feeling that you have a low supply the breast pump is often the primary tool you will use to establish, maintain, or increase your milk supply. Every mother should always have a reliable/primary type pump first and foremost. There are a few different features available to choose from. We will breakdown some key features later in this article.
If no, then this may give you a few more choices. If this is not your only pump what pump do you already have? Is the pump you have a primary pump or a portable/wearable pump? If you have a wearable pump already then it's time to pick out a reliable primary pump. How old is the pump? If it's older than 2-3 years the battery life may not be as long as you need for this next round of your pumping journey. I would replace the pump and pick another reliable primary pump if it is older than 2-3 years. When a pump sits in storage for long periods of time the motor and the battery life can be affected making both these things not as strong as it was when it was new. When you have a low functioning pump that may cause a decrease in supply if used regularly. Also consider the history of the pump: was is used frequently (6 x a day 5 days a week with your work schedule?) Or was it just used here and there? If you used it to exclusively pump or very frequently like with a work schedule I would also imagine the life expectancy on the pump to be short so you likely will need another primary pump.
If your older pump is under 2 years old and wasn't used super frequently it is likely good to be used again. Just replace the replaceable parts: tubing, duckbills, backflow protectors, and flanges. Now if your other pump is a wearable/portable pump I'd still recommend to pick a primary pump. But if your other pump is in working condition and it is a reliable / primary pump then it is a great time to get a wearable or portable pump! We will go over key features on wearables later on.
Will you be returning to work?
If yes, consider your duties at work. Will you reasonably have time to sit down and pump at work? Do you have access to a lactation room at work to pump and store your milk? Is there any situation where you will likely still need to perform on task duties while pumping? Also, how long is the commute from home to work, and daycare to work?
In a perfect world every mother should have time to sit and pump as she needs without interruptions and without being required to perform for work while pumping. But many mothers still struggle with these work aspects. If you find that pumping at work may be struggle you may need consider at least some wearable pumping options or possibly a reliable wearable pump.
But first, I highly encourage you to learn more about your workers rights as a lactating employee. There are new Fair Labor Standards Act protections for employees to pump at work. This federal law was passed in 2022 and implemented in 2023. It requires nearly all employers to provide a suitable lactation room and reasonable time to pump. Your employer doesn't legally have to pay you to pump, but they do have to allow you space and time to pump as needed. Learn more about this here.
If you feel you may still struggle with managing your time, or maybe you can't afford the loss of pay for pump breaks, a reasonable way to balance these could be wearable pump cups. I personally recommend both the Spectra Cara Cups and Wearable Pump Cups from Legendairy Milk. They are closed system additions that will maintain the closed system benefit of your pump without potentially creating issues where bacteria can grow inside your pump
If you need a primary reliable pump but struggle to manage pumping a work this would allow you to use a reliable pump and use wearable pump cups to be hands free without sacrificing the benefits of reliability in your pump choice. Or if you have a primary pump already a wearable pump may be a good option at least for the times where you need your hands while you pump at work.
History
Let's factor in some history pieces. Do you have a history of any of the following: low supply with previous breastfeeding relationships, PCOS, thyroid conditions, fertility treatments, diabetes history, no breast changes while in your pregnancy, cancer history, bariatric surgery, breast augmentation, breast reduction, pain or discoloration in your hands/feet when exposed to extreme cold, breasts that have wide spacing between them(you could fit your hand between your breasts), or breasts that are more tubular vs rounded, or very asymmetrically sized breasts?
If you said yes to any of that, this tells me you have one or more risk factors for a possible low milk supply. Many of these situations don't equate to low or insufficient milk supply. But they do hold statistical significance for concern. If you said yes to any of those I highly recommend you make sure you have a reliable pump just in case. But also, do not let that discourage you from breastfeeding. I have worked with hundreds of moms with at least one of these risk factors that went on to have a beautiful breastfeeding journey. We just want to make sure we give moms who have a risk factor for low supply a little bit more support and a little more of a safety net. If you have concerns please work with an IBCLC to help you on your journey.
Lifestyle
What does your day to day life consist of? Are you a busy mom with multiple kids, maybe you feel limited on time for more or extra responsibilities? Do you have really long work schedules? Maybe you are a first time stay at home mom and have time to take things more slowly? Are you leaving the house or traveling frequently? These things do matter in your pump choice.
If you find you may not have time to sit and pump regardless if its at work or home. You may find you also need a solution to balance it all. This would be another area I recommend wearable pump cups for busy moms. If you need a reliable primary pump but also need support in making time to pump, then a wearable pump cup or pumping bra would support you in allowing you to be handsfree while still keeping the benefit of getting a primary pump.
If you are traveling frequently and you need a primary reliable pump you may want to look into smaller more compact pumps.
Wearable Pumps
As you could have guessed from this article I am not the biggest fan of wearable pumps, generally speaking. So many moms gravitate towards them for their convenience which should be an amazing feature. But what you are getting in convenience you are often lacking in reliability. Most wearable pumps have such tiny motors in them as a wearable pump unit that the suction levels and battery simply dies over time. Theres also a few that have very limited control over the settings. If you can't manually adjust the controls it may not be able to support you if you need to increase your supply ever. Then some wearable pumps have the continuous suction where it never release your nipple which puts abrasive uncomfortable stimulation on the nipple. This feature is often incredibly painful for most moms. They also don't usually have a strong suction like a reliable primary pump, which again can be problematic. I definitely do not recommend wearable pumps for every mom. A lot of times I see wearable pumps not fully emptying moms out even when they have a good supply. This may be from the suction levels, cycle speed, or simply the way the pump attaches to the breast.
The times that I do see a wearable pump being successful is usually with moms who have a good supply or an oversupply, when they use a stronger more reliable wearable pump, when using the right fitting bra, and right flange size for their nipple size. These are most often the best outcomes but even in these situations some still struggle to fully empty their breasts.
At this time the two wearable pumps I do recommend are the Elvie Stride and Willow GO.
The Elvie stride has an external pump motor with wearable pump cups. It gets up to 300 mmHg (vaccum pressure), user control over the stimulation and expression modes as well as suction level. It has an app if you'd like to use it to track or change the settings. This one does come with some tubing, but this external pump motor is in part why this pump is more reliable than other wearables.
The Willow Go pump is very similar to the Elvie stride but without the tubing. It is a completely wearable pump, gets up to 280 mmHg (vacuum pressure), user control on the stimulation and expression mode and suction levels. It also has an app to track your pumping and to adjust the settings while using the pump.
Both of these pumps are very similar. If you find you absolutely need a wearable pump and will be using it regularly I would recommend one of these options. I do believe the Elvie Stride is generally more accessible as more insurance plans will cover the cost of an Elvie Stride as compared to the Willow GO.
Pump Features
There are many facts and features about each pump which can get pretty overwhelming, quickly. What do these features mean and how do you know if they are actually important to have or not? Let's break it down.
Internal Battery
Personally and professionally this is my deal breaker. If the pump doesn't have a battery, I do not care how great it is, I don't want it. Moms are so busy. Moms have so many balls they are juggling and the last thing they need is to carve out time at an outlet to pump. What are moms supposed to do with this when they're out of the house? It makes pumping 1000x more of a chore than it should ever be. You will notice all pumps in this article has an internal battery.
Modes
Most pumps have two modes. Each pump may have different terms but they do roughly the same thing. Typically stimulation mode is when the pump has very short fast bursts of suction. This is supposed to mimic a baby's latch at the start of the feed that helps bring on the faster flow of milk, aka a let down. Then there is the expression mode which generally has longer stronger pulls of suction. This mimics the suckling pattern of a baby once mom is having a let down. It is supposed to remove more milk with this strategic patterns of suctions. Some pumps also have a third mode usually called a hybrid or mix mode. Generally you will see 10 quick sucks from the stimulation mode followed by 1 long strong pull of suction from the expression mode on repeat. Most pumps don't have this feature, it's a nice option but I don't see it as providing a significant difference in milk expression.
User Control
Honestly it's a 50/50 if a pump has full user control or partial user control. Pretty much every pump allows you to adjust the suction level. Some pumps let you adjust cycle speed or toggle between stimulation and expression mode. My biggest thing is I want moms to have a pump they can enter stimulation and expression mode as they wish. When moms are trying to increase their milk supply one of the most efficient ways to do this is by power pumping. To do this effectively you need to control when you enter expression mode. If you can't manually toggle into stimulation or expression mode this may not support you with increasing your supply. That is a deal breaker for me in a pump.
Cycle Speed
Most pumps don't allow you to choose your own cycle speeds, some do but it's not the standard on the market. Cycle speed controls how many times the pump sucks per minute (cycle per minute.) I wouldn't say not being able to adjust the cycle speed is a deal breaker but I do recommend this feature if possible. Some moms genuinely get more milk or have a better response with faster or slower cycle speeds. You will see the fast cycles are in the stimulation mode and slower cycle speeds are in the expression modes. I would say control of cycle speed is a preference but not a necessity.
Vacuum Suction
This one does have a big impact on milk expression, but it's not a one size fits all situation either. Some moms have more sensitive nipples or even conditions causing severe nipple sensitivity; Raynaud's Syndrome. For sensitive moms they need lower suction. Then some moms simply will not respond to the pump without high suction. But, there is no way to know which side you will prefer until you pump. This makes it very difficult to pick a pump without fully knowing what you need. This is why I like pumps that offer a large range of suction. So if you need lower, medium, or high suction there are options for you. Most pumps start at around 60 mmHg. The max suction does vary greatly between brands. I find that anything at or above 60-270mmHg is good for most moms. I would not recommend a pump that has anything less than 250mmHg for their max suction as there's a potential that you genuinely could need higher suction without being able to get that feature with that pump.
Dual Motor
This is a newer feature on the pump market. But I do think this is an absolute game changer for so many moms. Let's talk single motor pumps first. Previously when a pump said max suction was 270mmHg, the mom never REALLY received that 270mmHg. Because the pump on max strength was capable of producing 270mmHg, but this vacuum pressure was being released by two outlets, one for each breast. So the pump was producing the 270mmHg but the suction each breast was receiving was only ever 135mmHg. Single motor pumps meant cutting your suction level in half to provide suction to each individual breast. This is why we saw so many moms utilizing the single pumping practice to generate higher suction levels which yielded more milk pumped.
Now, dual motor pumps was such a genius invention. This gave each breast it's own motor which allowed for significantly higher suction, and higher amounts of milk expressed with this feature. So for dual motor pumps each breast can receive the max suction of 270mmHg (or whatever that individual pump's max suction level is.) If you are looking for a reliable primary pump a dual motor pump is the ultimate feature for reliability in my opinion. It also allows you to adjust the vacuum suction for each individual breast. So if you have a slacker boob where one breast produces less than the other you can have higher suction on that side to help even out your supply.
Here are a few available dual motor pumps.
Unimom Opera+: This is probably my favorite primary pump and my favorite dual motor pump. It is more expensive but definitely worth it! I like it so much because it is so customizable. It has every feature combination a mom could ever need. Dual motor, 280mmHg per breast, cycle speed control, single pumping, dual pumping, stimulation and expression motor control. Pretty much any feature you need, it is there. But, it is on the pricier side. Most insurances don't fully cover it so there's often a co-pay and it is a little more on the complex side, which can be intimidating for some moms.
Spectra Synergy Gold Portable: This is another really great pick for the dual motor pump category. If you are a fan of spectra, this is a fantastic upgrade to the Spectra S1 and S2. It is slimmer, fits in your hand, has dual motors which makes it stronger (270mmHg per side), same user control between stimulation and expression mode, and vacuum suction control. One downfall is you cannot control the cycle speed with this pump. But it is very simple to use!
Cimilre S5+: The Cimilre S5+ is also a good pick for dual motor pumps. It is very small and compact, has hospital grade suction (300mmHg per breast), user control on the stimulation and expression modes, vacuum suction control which you can change per side. A few downfalls is you also can't control the cycle speed with this pump. I do find this pump has the slowest cycle speed with a lot of time where the pump is not sucking. This might not work for every mom. Also, the way you enter expression mode from stimulation mode is by the suction level. Some moms may never be able to get into expression mode because it requires them to increase the suction to do so. That my be a deal breaker for moms with nipple sensitivities. But it is also very simple to use and is probably the cheapest option for a dual motor pump. And the customer service with Cimilre is just amazing.
Primary Reliable Pumps
Now lets talk a little about some primary reliable pump options. All pumps talked about on this blog do include an internal battery and are a closed system pump.
Spectra S1: The Spectra S1 is probably the most popular primary pump and is covered by most insurance plans. This is a great reliable pump. It has many suction level choices 60-270mmHg, cycle speed control, stimulation and expression mode control, and a night light. It is very simple to use. A few downfalls is it is awfully big and clunky which makes traveling with it outside the house a bit more difficult. It also has a single motor pump which has many moms using single pumping to increase suction on this pump. But overall it is reliable, accessible, and simple to use.
Luna Motif With Battery: Functionally, this pump is identical to the Spectra s1. The only difference is the suction range is 60mmHg-280mmHg. Everything else is the same just with brands and shape of the pump. It is generally covered for insurances that don't fully cover the Spectra S1 like for the BCBS Fed or Medicaid plans.
Wearable / Portable pumps
We already talked about my top two wearable pump recommendations: Elvie Stride and Willow Go. I am not going to list every single pump available but rather pumps I do recommend based on a mom's situation. Here I'm also including some portable pumps. Although they have tubing like the reliable primary pumps they each have some type of factor that prevents these pumps from being in my primary reliable pump list because they don't meet my three pillars for a primary pump: can't establish, maintain, or increase milk supply. But if you already have a reliable pump they could be a good option for you!
Elvie Pump: The Elvie pump is a fully wearable discrete breast pump. There are no tubes and it sits right in your bra. If you already have a primary pump but want a wearable option to use occasionally this could be a good pick for you. It gets up to 220mmHg, has stimulation and expression modes (it will only toggle into expression mode after you pumped about half an oz), and has an app. It is very simple to use. If you know you respond best to high suction, this may not be an ideal pump for you.
Medela Freestyle Flex - Hands Free: This is a portable and wearable pump. It could be a great option for those who already have a primary pump that want a smaller and wearable pump option. The cups have only 3 pieces which is a nice feature. The pump gets up to 245mmHg, has suction control, can toggle between stimulation and expression mode at any time, and is very simple to use.
Baby Buddha Pump: The baby buddha breast pump is certainly a unique option! It is one of the strongest pumps on the market at 320mmHg. It is tiny, but mighty! This one is a little less simple and you do have to really know the settings. This pump uses they hybrid/mixed mode feature that has 10 fast suction bursts followed by 1 long strong pull of suction. But this long pull of suction does reach 320mmHg which can be painful for many moms. And in stimulation mode the pump automatically increases the suction level about every 30 seconds. So you either have to watch it and roll down the suction every 30 seconds or you can avoid both the increasing suction and mixed mode by switching into expression mode. If you know you like really high suction and want something compact this could be a great option for you!
Momcozy M5: The Momcozy M5 pump is the best pick for their wearable Momcozy line of pumps. Momcozy is known to be affordable wearable pumps. But their biggest down fall is the battery life on their pumps. Over time the pumps will have a loss of suction and eventually the battery just dies. Like I mentioned earlier wearable pumps motors just die frequently likely due to the very small size. But when this pump works, it works great! But many moms do experience these issues at some point with most Momcozy pumps. I do really like the widen angle on the flange that mimics a baby's angle of their mouth on the breast. I do think this helps get a better latch between the pump and nipple! It has a faster cycle speed than their other models and gets up to 300mmHg. It does have 3 different modes: stimulation, expression, and a mixed mode. I do appreciate a mixed mode as an additional option for more choices with mom's pumping experience.
Getting Your Pump
Getting your breast pump is usually very simple even when ordering online. Most insurances have a policy for breast pump coverage. In your pregnancy ask your ob for a prescription for a double electric breast pump and supplies. Some insurances may have a stipulation about when you can receive this prescription. For Tricare you won't receive your prescription until you are around 28 weeks gestation. This can vary dependent on your insurance.
Once you get your prescription you can take it to any DME that works with your insurance. Even Medicaid will cover a breast pump! Some places you may have a co pay for more popular/expensive pumps but there should be at least a few choices that is fully covered by your insurance. After you found your DME you take the prescription with you to the store your upload it online in addition to adding your personal and insurance information then check out.
Flange Sizing
The last little nugget of information I will leave you with is this: please size your nipples and use the right flange size for your specific nipple shape and size. New education in the last two years has taught us how those standard 24mm flanges really don't support about 90% of moms. When moms use the right flange size they feel significantly more comfort while pumping and get more milk in shorter amount of time. This is one of the biggest game changers that just entirely changed the way I am able to support pumping mothers. Read my blog on how to find the right flange size for you here.
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