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"I will be returning to work roughly three months after the babies are born. What kind of pump should I use? Should I rent or buy? How much milk will I be able to pump at any one pumping session?"

Between my single born son and my twins, I must have used nearly every breast pump known to (wo)man! I'd love to share my experience and maybe save you some problems and $$$.

Small Electric/Battery Pumps

My first attempt at pumping was with a Gerber electric pump, borrowed from a friend. It was complicated to run and not at all effective. I could only manage an ounce or two at a time. Of course, at the time, I was not a very experienced pumper, and perhaps my performance would have improved. But it was difficult to clean, and I didn't like it.

I then bought a Medela mini-electric for about $70. I loved it and used it extensively with my first son. It has a cycling action which mimics a baby's sucking, and it quickly activated the milk ejection reflex (letdown) which produces the big flow of milk. I returned to work when my son was six months old, and I used it to pump several times a day at work.

What I didn't know, however, (and what Medela only tells you in very small print), is that the mini-electric was never meant for heavy-duty, daily pumping. I was fortunate in that it survived my first son. When I tried to pump for my twins in their first month of life, it couldn't handle the demand and the motor died. When I called Medela to purchase a replacement motor (the warrantee is only good for 3 months), they admitted the pump was only designed for occasional use. A friend of mine calls it a great "movie" pump, the kind you use when pumping enough so that the babysitter can give the baby a bottle when you are at the movies. Despite my good experience with it at first, I don't recommend it as a daily-use pump, especially if you are pumping for twins.

Large Electric Pumps

When my twins were born, the smaller of them had a great deal of trouble nursing. He couldn't latch on, and if he finally did, he wouldn't bother to suck. He had been supplemented in the nursery (much to my regret), and had terrible nipple confusion coupled with an immature sucking reflex. Having had a great experience breastfeeding my oldest son, I was very committed to making it work with my twins. I worked with him for 2 weeks before he caught on, and in the meantime nursed my other twin and pumped enough to feed the problem nurser as well. Even before the Medela mini-electric died, I knew I was going to need something more powerful, so I called La Leche and rented a Medela Lactina for a month and bought the double pump kit. This was the greatest! It was pricey, but their long-term rental rates are something like $1.00 a day. I may be wrong, but I don't think you could formula feed two babies for $1.00 a day.

I understand there is a good electric pump, similar to the Lactina, that you can buy for $150. It's called the "Double-Up" pump, and I've seen it for sale in the Right Start catalog. A lactation expert at a parenting group I attend recommends both the Lactina and the Double-Up. The real difference in them (aside from the renting vs. buying issue) is that the Lactina cycles automatically but with the Double-Up you have to use your finger to control the cycling. I have no personal experience with this pump, though.

Manual Pumps

I received an Ameda/Egnell manual pump (the cylinder type) in my goody bag from the hospital when my first son was born. I used this for short term pumping whenever I didn't use the mini-electric. With the twins, once I'd returned the Lactina and the mini-electric had died, it was my only pump. I used it every day to pump and freeze excess milk. Once I got used to it, it worked fairly well for me. The biggest problem was that it only held 3 1/2 ounces, and I normally pumped about 8 ounces at a time. So I would have to unscrew the cylinders, pour out the first batch of milk, and start again.

Finally I called Ameda/Egnell to see if they made a similar manual pump with a greater capacity. The sales rep said, no, but they had have a new one-handed manual pump. It comes with a 4-ounce bottle, but you can use it with any sized baby bottle. It cost about $25. I decided to order it and am very happy I did. The best thing about it is that I can pump one side while nursing a baby on the other, a very effective way to pump. The only drawback is that it has a few more pieces to wash and keep track of, versus just two pieces for the cylinder pump. I can easily pump 12-16 oz. at a sitting.

Recommendations

In your situation (going back to work at 3 months) I would skip the lower-priced electric/battery pumps and consider investing in the Double-Up or renting the Lactina. Whether you rent or buy depends on how long you plan to nurse and pump, I guess.

Another recommendation I will make is that you begin pumping early. You'll be pretty tired at first, but when the babies are nursing well, say around 3-4 weeks, start pumping and freezing the excess. With both my nursing experiences, my milk flow has been heaviest in the first few months, so take advantage of Nature's abundance. I use the Playtex disposable bottle bags, 8-oz. size, fill them half way with 4-oz. of milk, fold over the top several times, and seal with freezer tape. I freeze each one in an upright position until it is solid, then toss each small bag in a zip-lock freezer bag. My freezer is nearly filled with milk now (no room for ice cream any more, *sigh*). Ironically, I'm not sure I will be returning to work when the babies are 6 months as I had originally planned. Day care for a toddler and two babies is too expensive! But I'll still find a way to use the frozen milk, I'm sure.

Though my situation is a bit different from yours (I was able to stay at home after my twins were born), I did pump for a bit and had a pump I loved! I bought a Medela hand pump from the hospital, and then rented the electrical connection from a pharmacy. The hospital also had the electrical part in the NICU, so I pumped at the NICU, and then also at home until the girls came home. I continued to breastfeed for a year, and when the girls were 7 months old, went away for a weekend, and used the hand pump and it worked great! I can't remember what the pharmacy charged to rent, but it couldn't have been too costly, or I probably wouldn't have done it.

I started by renting a Medela electric pump from Nursing Mothers' Council for $45/month. I soon found a used pump for $400 which I sold for $300 after using it for a year. The hospital gave me the attachments for the Medela pump (be sure to ask for one with the capability for double-pumping). Otherwise you can buy it for about $30. I used a luggage cart to haul my pump case (looks like a fishing tackle box), Igloo cooler with blue ice for storing milk (and lunch) and my briefcase and laptop. I got lots of comments and sometimes said I was hauling lunch for my family. I had to reserve conference rooms with doors that did NOT lock. I would tape up a sign and cover the peephole and barricade the door with a chair. Then I was glad that I had learned relaxation techniques to prepare for labor! I also made a little cape out of two flannel baby blankets and diaper pins to "get in the mood" for pumping and to ensure privacy if someone barged past my barricade.

I lobbied to get my company to start a lactation program with the company that makes Medela pumps. Now nursing mothers can borrow a free pump at the health club or nurses station and just bring their own kits.

I pumped before work and 3x/day at work until my babies were eating solid food (at 6 months) and then tapered down as they needed less milk. Make sure you get plenty to drink and eat and plenty of rest! We never had to use formula.

Sorry this message is so long, but I think that giving your babies mothers' milk and nursing are really special and employed moms and their babies should not miss out. Good luck!

I rented a Medela Lactina for $30 per month and bought a double pumping kit. I went back to school 4 days a week when the girls were 4 months. (But I started pumping at about 1 month so my husband could give them expressed milk once a day & so I could build up a reserve of frozen milk.) My view was that pumping was going to be a serious undertaking, it was part of going back to work, & going to require time from my day, so I wanted excellent, professional equipment that would maximize the yield. Since I often nursed simultaneously, I thought that pumping simultaneously would be the most efficient. I ended up renting for a long time, but I knew I was saving a lot of money on formula and giving my daughters the best possible food. I never had to supplement. The girls are still nursing. You can find out where to rent this pump by calling Medela at 1-800-TELL-YOU.

When my identical twin girls were born eight weeks early, neither were able to nurse. I still wanted them to have breastmilk so we rented an electric pump and I proceeded to pump breastmilk for them while they were in the NICU for a month. Although I continued to try to encourage them to nurse, they just never quite got the hang of it. So, for various reasons, I continued to pump breastmilk for them until they were seven-and-a-half months old. They had breastmilk exclusively until that point.

I used an electric double pump; it was the most efficient method. I did not go back to work so pumping at the office never became an issue for me.

Pumping for seven-and-a-half months was a challenge but I am proud to have done it. However, my situation will not be everyone's situation, of course, and it's so important to do what will work for you.

I used a breast pump while my boy/girl twins were in the NICU. I rented an electric one that had attachments to do both sides at once. It also converted to a manual pump. It's been awhile, but the rent was $40 per month. I'll leave the purchase vs. rent option to those with experience.

I *did* feel like a cow, but the electric pump was effective and quick. I had some nurses tell me at the time that they had brought theirs to work and used them successfully.

As a Lamaze instructor and mother of three I highly recommend the Medela Lactina. If you plan to nurse and pump, this allows you to double pump, or pump only one side while you nurse on the other. It is electric, has good suction and is extremely efficient. The battery operated or electric pumps you can buy don't have nearly the power of this type of pump (which can be easily rented). If you plan to pump regularly then this is the best option. If you plan to pump only in an emergency, then you might be ok with a store bought model. I hear from too many women that they don't pump because it is such a hassle, takes too long and they get very little milk. These are always the women who try the hand held battery, manual or electric models, not the industrial type. It is well worth the money to rent and in the long run is still cheaper than formula and the benefit to the babies, well, I'm sure you already are aware! Good luck!

I rented my Medela breast pump from my Lactation Consultant. It cost about $30 a month, plus a $40 up-front expense for the double pump kit. I did some research on buying a pump beforehand, and I discovered that a great many of the pumps commonly found in stores are manufactured by subsidiaries of formula companies. Hmmm...what do you suppose that means? Basically, most of the breast pumps you can buy are pieces of crap. Once I got used to pumping, 10-20 minutes and I was done (it takes longer once you have more milk). I would HIGHLY recommend going this route. Although I personally did not go back to work after my babies were born (we were about to move cross-country), I have many friends who rented the same pump and used it successfully at work.

I rented a pump from the hospital. It was a Medela with dual ability. It was great. It took 10 minutes. For the first weeks I was only pumping so being quick was great. After the babies came home I kept the pump for about 3 more months as they were not good nursers. I finally returned the rented pump and bought a hand held Gerber pump. That was the end of my pumping, and therefore nursing as well. It was slow and not very powerful. It would be too slow to use at work.

You can buy the more expensive pumps (anywhere from $150 - $1000). It depends how long you think you will breastfeed. I would probably have kept the rented pump for longer if I had known how much better it was. It rented for about $30 month.

I have been pumping since my return to work in September when my girls were 4.5 months old. I have rented this super pump from Mother and Me, it's a local store here in the South Bay of California. But the pump they rent is by Medela. The pump is large and somewhat heavy but it works great and I couldn't have kept this up as successfully without it. I also have a Medela mini-electric that I got as a shower gift. It can run on batteries or electricity and only pumps one breast at a time. I used this a lot when we were in the car. It's good but noisy.

I too was told by Medela that the mini-electric was not meant for heavy duty pumping. The motor will not last is what the sales rep told me. I rent the big one (Medela Lactina is what I found out it's called) and it costs me $150 for five months. I'm now on the ninth month of renting it and it really works great. My mini Medela is good for just when I need to pump one side or if I pump while we're driving somewhere while away from the girls. I have an adapter so that it runs off of the cigarette lighter in the car instead of batteries because the batteries die quickly.

I have had similar experiences as others with the Medela mini-electric and Lactina. I used the mini-electric for my first son, from the time he was 4 mos. to 9 mos. The motor about died and when I called Medela, they sent me (free) three more! They all were pretty weak, though. It is still good having it around for emergencies; it can also be used with batteries. I now used the Lactina. I used it for the five weeks the boys were hospitalized, and since I returned to work, when they were four mos. It's *great*, you can crank up the speed in addition to the suction and really get that milk out fast! I figured since I've gone this long I'll go a few weeks more until they're a year, and then just breastfeed morning and night, and they can have whole milk during the day. Even though they get some formula during the day now, the rental price is still cheaper than that amount of formula, not to mention the other obvious benefits. I strongly recommend pumping to anyone who can do it! It's worth it! (I always read the twins digest when pumping, and read other work-related material).

I breastfed my daughter for 19 months, I started out having to pump because she was in neonate nursery and couldn't nurse for a few days. The first pump I had was the Gerber electric, this was after I went home, it did not work for me at all. So I ended up renting the Medela electric with dual cups to pump both breasts at the same time. It worked great but I was planning to breastfeed long term with working so the 35.00 a month fee through the area lactation consultant was not really cost-effective. I ended up buying one which did cost about $500.00 + the double pump kit, but all in all it was worth it especially since I did plan on having more children and I planned on nursing them also. It managed to keep my milk supply up until she was old enough to switch to regular milk which was around 12 months. And then if I was ever apart from her at the pm time I could still pump. I would strongly recommend the Medela, and if you plan on using it long term or plan on nursing more children, I would recommend purchasing it.

I am a childbirth educator/labor assistant and work closely with the Medela people. I used to recommend other brands, but now I would really suggest the Medela Pump In Style. You can get it for about $180 and it can be shipped via UPS. This is the best. I am NOT a Medela rep, just think it is great.

Our boys are 8 months old, and I'm still breastfeeding them (and I plan to until they wean themselves). Once you get proficient (by six months for sure), you may want to continue indefinitely! It really does get easier. I went back to work (full-time) when the boys were 4 months old, so I rented a Medela pump for use at work and in the evening. By now, I have probably bought the pump with the amount of $$ I've put into renting it. I would suggest looking into buying one if you plan to pump for 6+ months. Anyway, I use the double pump, the only way I can see pumping successfully for two (at least in a reasonable amount of time). I have not supplemented with formula (she says, proudly), but I do keep the samples around in case of dire emergencies. But I have a freezer full of breastmilk that would go first! You definitely have support here if you decide to breastfeed. I think it is wonderful ;-)

I used the Medela Lactina also and agree! I used it for about 6 months (rented for about $45/month from the local Nursing Mother's Council). It worked great. It took a little bit of time to become comfortable with pumping. Initially it took all my concentration and I just got a few ounces from each side. Within a week or two I was able to sort of prop the bottles on my lap so that I could read e-mail and talk on the phone while pumping. I pumped two full bottles (16 oz) twice a day on weekdays and nursed on weekends.

However, my biggest tip to mothers thinking about pumping is to start *way* before you go back to work so you have a nice little supply in your freezer. As I mentioned, it can be slow at first so you'll want to have some extra put away so you don't stress about not having enough milk when you're also dealing with the stress of going back to work. I started only a few days before going back to work and was disappointed with my milk production initially.

I prefer to use only one breast per feeding, and pump the other (for storage). When my boys were 2 weeks old, we started giving them a bottle every other day. At the time, I barely had enough milk for them, so we did use formula. (I had gotten some samples from the hospital.) Now, I have quite a bit a milk stored in the freezer, and hardly ever have to use formula, unless I go out too many times unplanned. I try to pump 2 x's a day. Once after the 5 am feeding, and then at 10:30 pm. If you plan to express milk, get yourself a good pump. When my oldest was born, I purchased a Medela pump, and I love it. It is cheaper if you buy it directly from Medela instead of a dealer. (I got mine for about 1/2 the price.)

The best pump that I have seen/used is the Medela Lactina. You can pump both breast at once, and it is really strong. While pumping for my singleton, I was able to increase my supply by using the pump at work, and nursing at home. I also use it with my boys, although I am not working out of the home any longer. You can also get a Medela hand pump. You can purchase or rent the pump. When I bought mine, it was cheaper to buy than to rent for 6 months. I spent $475 + tax + shipping. I bought it from Medela directly.

Starting at about three weeks, after they nursed at about 5 am I got up and pumped before going back to sleep. The amount I was able to pump rose as my body learned that I would be extracting milk at that time. Using a Medela Lactina double pump I got 12-16 oz. in 15 minutes. I froze all this to have reserves for when I went back to school.

Starting at about five weeks, I also had my husband give them one feeding per day of breastmilk via bottles. So I pumped at that time & got similar amounts. Since they only drank about 5 oz or so between them, I froze the excess. After the reserve milk began to fill the freezer I dropped the 5 am pumping.

Having the reserve supply was crucial. At about 3 months, I guess my body finally adjusted to the demand and I wasn't able to pump as much, and the amounts fell even more when I went back to school. I have managed to get through the first year without needing formula because I filled in all the gaps of not being able to pump enough with the frozen milk.

I was able to nurse my girls until they were past age 1. I worked most of that time and usually pumped 1-2 times per day while at work. Fortunately, I was able to pump enough to keep up with their demand, so they never did get any formula. I fed them at the same time until they were about 5 months. Then I would usually feed them separately, unless they were really hungry at the same time. I would suggest getting a good pump, if you will be using it often. I bought one called Nurturer III for about $120 including the kit for dual pumping. I know I saved much more than this on the cost of formula. I was very lucky to be able to successfully nurse for this long--I had a lot of things in my favor like 2 barracudas for babies, a private office at work with a lock on the door and a flexible schedule for convenient pumping, and I lived only 10 minutes from work and could get home to feed and back to work quickly if necessary. I also think I persevered in part because the thought of washing and fixing all those bottles every day just seemed like too much work!

I went back to work 75% time (6 hr. days) when my twins were 10 weeks old and pumped once a day during that time. The hard part was getting a stockpile *before* going back to work so that Dad could thaw some breastmilk while I was gone. I admit that it did get to be a real energy drain and we also supplemented with formula at times.

I have a private office with a lock on the door and just put out a little sign that said call me or come back later when I was pumping. I'm sure that everyone knew what was going on from the noise coming from behind that locked door! I carried a cooler--pumped into plastic disposable bottles (bags) and kept them cool with blue ice in the cooler until I could freeze them when I got home. (Don't microwave breastmilk to thaw it; it destroys all the good stuff including nutrients and antibodies.) You should let it thaw at room temp or in lukewarm water.) I could easily get 4 oz per breast to fill an 8-oz or 2 4-oz bags. It takes a lot of perseverance and watching your food and fluid intake (lots). But it was worth it. The girls weaned themselves at 16 months--they were just getting the evening feeding by that time.

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