1. Dwyer, Diane RN, BSN

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BECAUSE SHE WAS returning to work, a lactating mother needed to use a breast pump to express and maintain her milk supply. After buying and using a battery-powered breast pump, she complained of breast and nipple pain and decreased milk supply; she had to use formula as a supplement. Her health care provider advised her to use a different breast pump to reestablish her milk supply.


What went wrong?

Breast pumps can be manual, battery-powered, or electric. Different pump designs may be better for different women. The Food and Drug Administration (FDA) receives few reports of adverse events or patient problems related to breast pumps, but pain is the most commonly reported problem. For each type of pump, a few women have reported breast or nipple pain that requires medical follow-up. In this case, the mother switched to another breast pump.


What precautions can you take?

Teach breast-feeding mothers that breast and nipple pain can be caused by engorgement, plugged ducts, or mastitis.1 A health care provider should assess mothers who find breast pumping painful and infants with feeding difficulties to determine the cause. Mothers having difficulties with breast-feeding should seek a lactation specialist or another specialized health care provider for help with maternal and infant comfort measures, breast and nipple care, breast-feeding, and breast pumping. For example, lactation specialists can teach pumping techniques (including hand pumping) that may reduce pain and improve flow.


Teach mothers these tips:


* Never buy a used breast pump or share a pump. A used pump may carry infectious diseases.


* You can safely rent hospital-grade pumps, which can be reused safely.


* Choose a breast pump with a breast shield that's the appropriate size. You should be able to comfortably center the nipple inside the breast shield.


* The first few times you use a breast pump may be uncomfortable, but pumping shouldn't be painful, make your nipples sore, or cause bleeding.


* If you're injured using a breast pump or have persistent pain or bleeding, contact your health care provider immediately.


* If you have problems with pumping, contact a qualified health care provider. If your pump isn't working, contact the manufacturer.



Lactation specialists can be a valuable resource for educating and supporting mothers who are using breast pumps. Tell mothers who are breast-feeding and your colleagues about the FDA breast pump Web site at




1. Mattson S, Smith J (eds). Core Curriculum for Maternal-Newborn Nursing, 3rd edition. W.B. Saunders, 2004. [Context Link]