The Two Doulas Guide to Breast Pumps

Dairy cow
I’ve never felt closer to another species.

Breast pumps. Two words you likely never uddered before you got pregnant. (Yes, that was a terrible pun. Sorry not sorry.) Now that you’re growing a baby – or you’ve just brought home a fresh one – those two little words are featured rather prominently in your vocabulary, amirite? But, what’s the deal with breast pumps, anyway? How do they work? And which kind is best?

As a postpartum doula and a working mother of two, I’ve spent a fair amount of time around breast pumps. I’ve assembled them. I’ve sterilized their parts. I’ve rented and purchased them. And yes, I’ve used them. A lot.

Two Doulas gets a TON of questions from clients about them, so we thought we’d share this handy guide to breast pumps.

BREAST pumps: A history

That’s right, fellow nerds. We’re starting from the beginning.

Victorian-era breast pump
We’ve come a long way, baby.

Tools to extract human milk have existed, in some form or another, since ancient Greece. However, the first patents for mechanical breast pumps were filed in the mid-1800s. These were marketed as “works of mercy for afflicted mothers”  who suffered from the pain of engorgement, had inverted nipples, or had babies who were too small or sick to nurse effectively. (If, like me, you’d like to go down that particular rabbit-hole, there is an amazing collection of images of early breast pumps here.)

The modern-day breast pump was invented in 1956 by Einar Egnell, a Swedish engineer who studied various methods of human milk extraction and figured out that intermittent versus continuous suction was more efficient and prevented injury to the breast (this action also more closely simulated a baby’s suckling). Through his work, Egnell established guidelines for safe vacuum and suction cycles that are still used today to judge breast pump performance. In 1991, Medela released the first commercially-available electric-powered vacuum breast pump to be used outside of hospital settings.

So which breast pump is right for me?

There are scores of breast pumps out there, all of which will help to express milk, though they may suit different needs. Two Doulas will never recommend any one brand over another, but here’s a breakdown of the different types that are out there to give you a good idea of what you might be looking for.

Manual Breast Pumps

Manual breast pumps
A manual breast pump.

For occasional pumping (say just once or twice a week at most, or here or there when the nursing parent goes on an odd outing away from baby) many people get by with a single, manual pump. They are inexpensive, lightweight and handheld. They do the job nicely, though the pumping session generally takes a little longer, as you are using your own hand and only pumping one breast at a time. Some people buy one of these regardless of how often they plan to pump, just so they have something smaller to pack with them when they go out and will miss a feed (for example, you’ll be going to a wedding and this is an easier, more discreet option for bathroom pumping than a double electric job). Yes, there may be bathroom pumping in your future.

Electric Breast Pumps

Single electric breast pumps
A single electric breast pump.

For more regular, everyday pumping (such as people who go back to work and need to provide milk for their baby’s daycare or caregiver), you may want to consider an electric pump. These are larger, more expensive, and can be rather noisy. They are best used when you have access to a private area, a comfortable chair to sit in and a nearby electrical outlet (though battery-operated pumps do exist). The advantage is that they usually take less time to collect milk than manual pumps, and are generally better for maintaining milk supply during longer separation periods (such as an eight-hour workday). For parents who will be away from their babies regularly and will need to pump more than once a day, a double pump might be worth the extra investment, as it cuts the pumping time in half.

Double electric breast pumps
A double electric breast pump.

Most people can eventually figure out how to hold both flanges in place with their forearm, while working the dials or buttons of their pump with their other hand (it’s a little awkward at first, and may require a support person in the early days), but some parents prefer to invest in the least sexy bustier on Earth for hands-free pumping.

Hospital-Grade Breast Pumps

Hospital-grade breast pumps
When it’s time for the big guns: A hospital-grade breast pump.

Finally, there are hospital-grade pumps. These are very, very expensive and most people rent them from hospitals or pharmacies rather than purchasing them outright. They serve a unique purpose, in that they are often used to increase milk supply, as the amount of suction is quite a bit higher than with commercial-grade pumps. They are recommended if the baby and nursing parent will be separated for long periods such as NICU stays, or for parents with a low milk supply due to milk transfer issues or rarely, physiological issues that hinder milk production. These kinds of pumps are enormously helpful to increase or maintain supply while working with a lactation consultant. Also, if you have a prescription from your care provider, you may be reimbursed part of the cost of rental or purchase from your private insurer. 

I’m still pregnant. Should I buy a Breast pump right away?

Before you invest, do some research. Ask your friends, relatives and co-workers (if you’re close enough) which pumps worked best for them. You can read some great customer product reviews online ( or to get an idea about specific models and brands. You can also drop by a baby supply store such as Babies R Us or Melons and Clémentines here in Montreal to speak to a salesperson who will walk you through the options in person.

Breast pumps used incorrectly
So long as you don’t use it like this, you should be fine.

If you are still pregnant, and are planning on staying home for the first few weeks or months of your baby’s life, it might be a good idea to hold off on purchasing a pump until you have a good idea of what your needs will actually be. Much of the talk about breastfeeding is theoretical until you have an actual baby doing it. Instead of putting a pump on your registry now, you might want to ask for a gift card towards a future purchase.

I should also mention that the very best way to improve your odds of breastfeeding success is by exclusively breastfeeding for the first four to six weeks of baby’s life. Babies themselves are the most efficient pumps out there and the more time spent at the breast, the better they get at breastfeeding, and the better established the milk supply. Of course, it is always nice when a baby is able to take a bottle so that you can have a break from time to time, even if you’re taking an extended parental leave, but it is generally recommended to wait at least four weeks to introduce them, unless medically indicated of course. If you are experiencing breastfeeding difficulties or simply want to get off to the best start possible, you can drop by your local breastfeeding support group, or book an appointment with an International Board Certified Lactation Consultant.

1 reply
  1. Juanita Marchand Knight
    Juanita Marchand Knight says:

    I rented the Medela hospital grade pump with all 3 babies because I had supply issues and, living in the US, I had to go back to work very early. I also invested in the handheld, which was $50 and I LOVE having the option to just throw it in my purse on date night. Yes, there has been a lot of bathroom pumping – I even famously dropped one handheld pump in a toilet (FYI, I bought a new one after this incident).

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