Breast Pump

GO FOR:

Efficiency. The best pumps are the ones that get the job done most effectively. A well-designed manual pump can do the job but is tiresome. Look for suction control and cycling speed control in electric models. Pumps that work on both breasts at the same time take less time.

Quietness. If you plan to pump at work and there’s no private place to do it, the more silent, the better.

Cleaning ease. You’ll be cleaning the pump daily, so look for easy-to-wash components.

Electric adapters. Don’t just rely on batteries. Get a pump that offers an adapter for electrical outlets, and consider purchasing an optional adapter for the cigarette lighter outlet in your car.

Shield comfort. If you have large breasts, standard breast shields may not fit comfortably. Try special adapter inserts.

Portability. Unless you’re only pumping at home, the pump should come with an easy-to-tote carry case, and be lightweight enough so you can carry it to work each day.

History of reliability. Trust a name-brand pump manufacturer of hospital equipment, such as Medela^® or Omron. Don’t trust a pump from a stroller maker.

AVOID:

Buying a pump before you’re sure you need it.

Used pumps unless they’ve been sterilized.

Cheap battery-operated models without enough suction.

Bicycle-pump-style suction pumps with a bulb, since they don’t work and are no longer recommended because their strong suction can cause bruising and can damage breast tissue.

Small, battery-operated pumps

These small pumps are usually sold as kits in baby stores and drugstores. They come with a pistol-grip handle, a place for batteries, shields for the breast, a collection bottle, collection tubes, and a carrying case. Some may offer adapters for electrical outlets or for the cigarette lighter outlet in your car.

They’re small, fairly quiet, easy to carry around, and less expensive than larger, more “professional” versions.

They don’t work as well as larger pumps, and their small motors have a history of breaking down. They usually have only one milk receptacle instead of two, which makes the process slower than being able to pump both breasts at once.

Midsized electric pumps

These are the “work horses” of the breast pump world. Some are designed for pumping a single side, while others are able to pump both breasts simultaneously, which cuts your pumping time in half. They are normally sold as a kit that includes a small motor encased in a zippered, insulated carry case, tubes that lead from the motor to the breast shields, and collection bottle(s). Most units offer adjustable speed and vacuum levels and can run either on batteries or a wall plug. Some cases also have a special freezer-pack section for holding bottles of breastmilk until they can be refrigerated or frozen. Breast shields (“horns”) may have adapters for larger breast sizes. An optional car charger is usually available for pumping on the go.

Although not very lightweight or quiet, these units offer excellent efficiency when it comes to collecting milk, and they stimulate the breasts adequately to keep up a mother’s milk supply. They’re the most expensive, but if you’re planning to express milk at work every day, the investment will be worth it over the long haul.

They use a lot of power—you’ll need an electrical outlet or a lot of batteries to pump. They tend to be noisy, a concern if you’re trying to pump discreetly at work. Occasionally mothers have problems with the fit of the breast shields, and cleaning the tubes and components can be time-consuming.

Hospital-grade electric pumps

These are huge, heavy units, about the size of a car battery, that are used in hospitals and that usually cost $500 or more. They can also be rented week-by-week very economically from most lactation consultants for personal use at home. They are the most efficient of all breast pumps, and are especially useful if you’ve got a preemie who is dependent on your milk for survival.

They’re the most effective and rapid in gathering milk and they’re useful for emergency situations, such as for providing milk for a hospitalized baby when nursing is interrupted temporarily. (Your breasts need continual suckling to keep producing milk.)

They’re heavy and not very portable, and prohibitively expensive for purchase, but short-term rentals are available. They require an electrical outlet and make a noticeable churning sound that may feel indiscrete in non-private settings.

CAR SEATS

Federal laws and LATCH

All 50 states and the District of Columbia have laws that require young children be restrained in a proper safety seat for their size. Even with these laws, most parents (as many as 80 percent) don’t install their children’s car seats correctly. Part of the problem is getting the seat strapped into the car and having the car seat’s straps properly fitted on the child.

In 2001, federal laws were put into effect by the National Highway Traffic Safety Administration to help remedy the problem of incorrectly installed car seats. The restraint systems that the law requires are referred to as LATCH, an acronym that stands for Lower Anchor and Tethers for Children.

Since fall of 2002, car manufacturers have had to install special U-shaped bars, called anchors, in the crease of the rear seats of every passenger vehicle in two positions— one for each window seat. Children’s car seat manufacturers are also required to provide devices, such as hooks, on the backs of car seats so they can fasten on to these pre-installed anchors.

If you own an older-model car, it won’t have LATCH, but all children’s car seats can also be safely fastened into the car by threading the shoulder and lap belts through special slots in the car seat. Follow the directions supplied by the owner’s manual for your car on how to use its particular belting system, and be sure to follow the directions that come with the car seat, usually found in a leaflet inserted in the back of the car seat.

Unfortunately, there are no laws that address the second serious problem: parents not installing their children correctly in the seat. The seat needs to be so well strapped down that it won’t budge more than a few inches in any direction.

    WARNING! You Must Have a Car Seat

All babies weighing less than 20 pounds and less than one year of age should ride facing rearward in the backseat of your car. This is because babies have undeveloped, weak spines and necks, and large heads in proportion to their bodies, which makes them vulnerable to whiplash.

During a crash, a baby’s head and body will be thrown forward in seconds and then slammed backward. By placing your baby’s car seat facing rearward, you are offering firm, solid support to the head and spine to help prevent head, neck, and spine injuries. Plus, being a backseat passenger provides your baby with a “buffer zone” of air space should you have a front-impact collision.

  Tip

The American Academy of Pediatrics recommends that all infants born earlier than 37 weeks gestational age be observed in their car seats before leaving the hospital to make sure they don’t have potential breathing problems in the semireclining position of car seats. If your baby does have this problem, you may need to bolster up under the seat base to make your baby’s position more reclined, or consider purchasing a horizontal baby car bed.

A key to car seat terms

• Buckle. A three-piece metal fastener that secures all of the straps together in the center of the baby’s body, just above the thighs.

• Three-point harness. Found on some models of infant-only car seats. There are three straps: the two that restrain each shoulder that buckle together with a between-the-legs strap.

• Five-point harness. Found on some models of infant-only car seats and all “convertible” seats. There are five straps: one strap for each shoulder, one for each side of the waist, and one for between the legs.

• Harness clip (or harness tie). A plastic fastener resembling a large hair clip, positioned at the level of a baby’s armpits to keep the two shoulder straps together so the baby won’t be ejected outward between the straps during a crash.

• Harness slots. Slits cut into the rear of the car seat’s back and upholstery for adjusting the height of shoulder harnesses to fit babies as they grow. Straps should be threaded into the frame at, or below, a baby’s shoulder level.

• Metal locking clip. A flat, H-shaped metal piece that can be found tucked in the back of a baby’s car seat. It’s used to cinch retracting, one-piece lap-and-shoulder belts in some vehicle models. Using the clip to cinch off the lower, lap portion of the belt may be the only way to hold a car seat firmly in place.

• Tether. A sturdy nylon strap that attaches at the rear of convertible seats when they’re used in the forward-facing, upright position. It mounts using a hook that is bolted either using hardware in the shelf above the car’s rear seat or to the hardware on the floorboard of a van or station wagon. The strap stabilizes the seat in the upright position if there’s a crash.

The type of car seat to buy for your baby

There are basically three types of car seats suitable for newborns through the first six months of life: rear facing, infant-only seats; convertible seats; and baby beds for special circumstances.

  Tip

If it costs more, it’s safer, right? Wrong! All car seats have to pass rigorous safety standards mandated by the National Highway Traffic Safety Administration (NHTSA). It’s more important to find a seat that fits your baby and your vehicle, and to install it securely. In fact, the extra add-ons of a costlier seat may make it less safe during a crash. The American Academy of Pediatrics (www.aap.org) maintains an excellent site for comparing car seat features.

Rear-facing, infant only seats are shaped like small tubs with a slanted, padded seat inside, and a folding, U-shaped carry handle. They’re made to protect babies who weigh 5 to 20 pounds, or sometimes 22 pounds, depending upon the brand.

Some models use a 3-point harness system, but most now have 5-point harnesses. A harness clip latches the shoulder straps together at armpit level. Most harnesses can adjust to several heights using slots in the seat’s back. And most of these seats come with a separate base that fastens down in the car either with LATCH hooks, or by using the car’s shoulder and lap belts so the seat can simply be lifted out, leaving the base behind.

Federal regulations require that the infant seat be equally as safe strapped down in the car without using the base so you can transfer the seat to another car without using the base if you have to.

CONVERTIBLE SEATS

Larger than infant-only seats, convertible seats have an upright back and resemble an upholstered chair without legs. These seats are designed to recline and face rearward for babies weighing up to 22 pounds; then when baby’s a year old, they “convert” to face forward in an upright position for restraining toddlers up to 40 pounds in weight, or approximately four years of age. Most models use a five-point harness system and offer a series of slots for adjusting shoulder-belt heights as the baby grows (not an easy process). A harness clip holds the shoulder straps together at baby’s armpit level. All seats in this category come equipped with a top tether strap that is only to be used in the upright, forward-facing position to fasten the seat to the car’s fram as directed.

   WARNING! Watch out for Used Car Seats

Don’t buy a used infant seat unless you’re sure it isn’t on a recall list from the National Highway Traffic Safety Administration or the U.S. Consumer Product Safety Commission (CPSC; www.cpsc.gov) and that it hasn’t been damaged in a crash, which could compromise its safety.