Under the Affordable Care Act (ACA) health insurance plans must cover one breast pump per pregnancy. Most insurance plans offer this benefit with no deductible or co-pay; however, additional upgrades or accessories may not be covered under health insurance plans. Check with your insurer to see which pumps are offered through your plan.

 

It is best to avoid using second hand or already used pumps, unless it a hospital grade pump, as their motor may be worn down, which has the potential for being unable to support an abundant milk supply. These pumps may also be contaminated with bacteria or viruses. Choose an electric pump that expresses milk from both breasts simultaneously. Depending on your job, some mothers will find a hands-free pump better suited to their situation.

 

Who needs a breast pump?

 

You may need a pump if your baby is not able to directly breastfeed, if you will be separated from your baby because of hospital interventions, or if you will be returning to work or school. Also, in some circumstances, pumping breastmilk can help increase milk production.

 

Obtaining a Breast Pump from Insurance

 

A referral sheet or ‘prescription’ from your healthcare provider (i.e. O.B., Midwife) is needed in order to obtain a breast pump covered by your insurance company. After you have a referral sheet you can contact an in-network durable medical equipment company (DME). Your hospital or doctor may have recommendations for DME companies.  Once you have shared the referral information via phone, mail, and/or fax, the DME will provide you with a new breast pump. Some DME companies deliver the pumps to the hospital or your home; you may also be able to pick the breast pump up at company locations.

 

Insurance coverage and eligibility for pumps can vary depending on a member’s benefits within each individual insurance company. For example:

 

  • A prescription for a plan benefit may or may not be required.
  • A plan may cover a hospital-grade breast pump for any mom. Other plans will only cover this benefit when a baby shows medical need.
  • A plan may cover 100% of the cost of a breast pump or may cover only a fraction of the cost.
  • A plan may only cover breast pumps during the first 60 days postpartum.
  • A plan may only cover in-network-network benefits.
  • A plan may not offer breast pump benefits at all due to “grandfather clauses.”

 

Find out what you are covered for by calling your insurance company directly! The DME company support staff can also be very helpful with helpful tips once you find out about your insurance plan. If you are unhappy with insurance coverage of breast pumps speak out! Visit our advocacy page for information on how.

 

What if the baby is born before I have a breast pump?

 

Not to worry, if a breast pump is needed before it is received from insurance there are ways to obtain a pump and even express milk without a pump.

  1. Learn hand expression: hand expression (expressing breastmilk using one’s own hands) is important to learn so that there is always a means to express and obtain milk whenever and wherever! The hospital nurses or lactation staff can be available to help teach hand expression. See a hand expression information video here.
  2. Most hospitals can have breast pumps available to moms while they are in the hospital and can guide when it is important to pump based on mom and baby’s needs.
  3. If eligible the Women, Infants, & Children (WIC) Program offers assistance in accessing breast pumps as part of their breastfeeding care before and after a baby is born. See mass.gov Get Breastfeeding Support for more information.

 

Tips for Choosing a Breast Pump

 

  1. Not all pumps are created equal! It can be worth it to buy a reliable pump. Sometimes the less expensive pumps do not work very well, are noisy, break down often, and can even cause nipple damage.
  2. Know the length of the pump’s warranty.
  3. Generally, it can be beneficial to avoid pumps made by companies whose main business is selling bottles, nipples and other supplies needed by mothers who are formula feeding.
  4. Know that each pump company may offer different fit options, a greater variety of fit sizes, and different ways that the “nipple tunnel” may function or fit the breast. More variety and availability of parts is important if a mom’s breasts or nipples may require a part that is different than the standard. A good fit is essential to making sure the pump works well.
  5. Think about how you will be using it: for occasional use, for regular use, for use to increase milk supply and provide breastmilk in the early days after birth.

 

Types of Breast Pumps

 

  1. Manual pumps- Manual pumps are designed for very occasional use, for example, once or twice a week. They carry a 30-to-90 day warranty. Manual pumps use hand power to move a lever to create suction and express breastmilk. The milk is collected in an attached container.

There is a type of manual pump called a bicycle horn pump that has a hollow rubber ball attached to a breast-shield. Some experts discourage the use of this pump because they may be difficult to clean and dry.

 

  1. Powered pumps (battery-powered and electric pumps) – Battery powered pumps are good for more frequent use than once or twice per week but not if a pump is required for daily use. Electric pumps (with power cord) can be recommended if moms will be separated from babies because of work or school. Powered pumps can carry a longer warranty up to 3 years and can come in single and double pumping capabilities. Powered breast pumps use a small motorized pump that creates suction to extract milk from the breasts. There can be long tubes connecting the breast-shield to the electric pump. The pump has a control panel with a dial or switch to control the degree of suction. A powered pump is typically held in place by hand or by a nursing bra or band.

 

  1. Hospital-grade electric double pump- Hospital-grade pumps can be recommended for moms of babies who are premature, are too sick to nurse, have physical anomalies which may interfere with breastfeeding, are having difficulties nursing for other reasons, are exclusively pumping, have had breast reduction surgery, with medical conditions (like untreated low thyroid levels) which may make it difficult to produce a full milk supply, are re-lactating or inducing lactation for an adopted baby, are having difficulties nursing for other reasons. Hospital-grade pumps are specially designed to bring in and maintain a mother’s milk supply. They can be sanitized and used by more than one mother.

 

What do I need to know about previously used pumps?

 

Hospital-grade pumps are the only pumps approved to be used by multiple users. If you choose to use a previously owned pump, which has not been approved for multiple users, is like using another mom’s toothbrush. Milk can get into the open system motor, even if you get new tubes and personal milk collection parts. If you are going to use a previously used pump, remember that the average lifetime of a pump is about the length of its warranty because without a warranty if a pump no longer works efficiently there is no manufacturer support. When renting, trading, or borrowing a pump ask how old it is and how long the warranty is good for. Remember, a pump that does not work well may not adequately stimulate your breasts leading to lower milk production.

 

What is double pumping?

 

Double pumping refers to pumping both breasts simultaneously, which is generally accomplished with an electric pump. Double pumping results in higher prolactin levels than pumping one breast at a time, and also may be quicker for the mother.

 

Breast pumps and pumping at work

 

How do I pump at work?

You should pump as often as your baby would nurse. You need to be relaxed, so that your milk will let down — this can be harder with a pump than with your baby. A bathroom is not the best place to pump, but is often the only option for many women. You should have a place to refrigerate your milk, and a sink to rinse out your pump and wash your hands. You should check out the situation well before your baby is born; do not hesitate to ask your employer to help. Tell your employer that nursing mothers miss less work because their babies are healthier.

Some women find that thinking of their baby helps with let-down — a photo of your baby, or something that smells like your baby can help. Other women prefer to think of a peaceful or serene place. A warm drink can also help you relax and let-down. Massaging your breasts or applying a warm compress to your breast can also help.

 

How can I breastfeed once I’m back at work?

If you will be working more than 3 to 4 hours at a stretch, you will need to pump at work to maintain your milk supply. If possible, it is best to be able to bring your baby to work to breastfeed rather than pump. If you are pumping, you may find that your baby will suddenly want to nurse during the night, even if he used to sleep through the night before — do not be alarmed. Your baby is only making up for time away from you, and this means you may need to pump less during the day. It is often easiest for working moms to sleep near their babies.

 

Should I pump at home while on maternity leave?

It’s a good idea to freeze a supply of breastmilk. However, leave your pump in the box until your baby is at least 3-4 weeks old, when your baby should start being introduced to a bottle. Make sure you feel comfortable using your pump before you go back to work. Don’t feel like you should pump every day during your maternity leave.

You can build up a good supply of milk to freeze by pumping in the morning, when you typically make the most milk. Nurse one side and pump the other when you first wake up. Use your baby to stimulate your let-down reflex. Or, pump during your baby’s morning nap.

 

When I’m at work, I don’t get very much milk out. What do I do?

This is very common because pumps are not nearly as effective as your baby in removing milk. You may need to supplement your baby while you’re at work with frozen breastmilk or formula. But don’t despair. Keep pumping to maintain your milk supply, and nurse as often as you can when at home. Your baby may want to start nursing at night more often (“reverse cycle feeding”). Nurse your baby when you are home; use bottles only when you are apart.

 

Need more information?

 

Pumping at Work

Texas Department of State Health Services WIC Program

http://www.breastmilkcounts.com/working-moms/pumping-at-work/

 

Cleaning your breast pump

https://www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/breastpump.html

 

Sample letter from your physician to your employer

http://mbcnew.mystagingwebsite.com/wp-content/uploads/2013/06/doctorletter.pdf

 

Using a breast pump

https://www.marchofdimes.org/baby/using-a-breast-pump.aspx

Pumping tips

http://www.breastmilkcounts.com/your-milk-supply/pump-and-store/

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