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Saturday, 13 August 2011

Why you shouldn't buy, sell, or borrow a second hand Medela Swing pump

In recent Twitter discussions with some fellow breastfeeding nerds (and I mean that lovingly..) some confusion has arisen about whether or not the very popular Medela Swing Breastpump is suitable for sharing/ selling on/ buying second hand.

At least one blogger has stated clearly that the Medela pumps are NOT built with a 'closed' (and therefore more hygienic) system and should be avoided.  However, elsewhere online you will find conflicting information, some of which states that the Medela Swing Pump IS 'closed' system.  There is confusion, not helped by the fact that the Medela website doesn't actually state clearly whether the Swing is closed or open system.  However, the website does say this:
'All products which come into contact with breastmilk are BPA-free and easy to clean, no matter whether you boil, disinfect or clean them using our microwave bags.'
Sounds good.


Why does it matter whether the pump is 'closed' or 'open' system?

Well, it matters because if the pump allows expressed milk to travel back up the tube towards the pump unit, then there is a risk of some milk getting into the unit itself.  And then you won't be able to sterilise it properly.  With an open system pump unit this is a distinct possibility, with a closed one, it won't happen.

From our (amateur) investigations, we discovered that it all seems to depend upon the location of the 'diaphragm' which is vital to the pump's function as it helps to create the vacuum.  This moveable membrane helps to generate suction in much the same way as a toilet plunger - by moving back and forth creating a 'suck'.  Mini diaphragm pumps are frequently used in medical apparatus.

From wikipedia:
'A closed collection system has a barrier or diaphragm that separates the pump tubing from the horn. In this design, the suction of the pump motor lifts the diaphragm to create a vacuum within the collection system to extract milk. An open system allows for the free passage of air/suction.'
'When an open collection system is used, the pump’s suction can cause milk to overflow it into the collection system tubing, which may lead to milk particles being drawn into the pump motor.'
If expressed milk is not separated from the pump unit by a physical barrier, then it may be able to travel back up the tubes and into the pump unit as the machine sucks.  This creates an avenue of contamination, and mould/ bacteria can (in theory) grow where it isn't possible to sterilise.  

So, since I've just 'treated myself' to a brand new WHO code compliant, closed system double pump (I'm hoping to donate milk once my baby is born, learn more here), my two year old Medela Swing Pump has just been sacrificed in the interests of settling this debate.  Is the Medela Swing pump 'open' or 'closed' system?

I'd read online that expressed milk CAN travel back into the pump unit with the Medela Swing - but I'll be honest - I already knew that because I've seen it happening for myself.  The following pictures should illustrate how this is possible:

This is the traditional flange/ tubing attachment for the Swing Pump (the one it's generally sold with):

1

Inside, the two apertures i) where the expressed milk comes into the flange, and ii) where the pump tubing enters the bottle are really quite close together:

2

Anyone who has expressed milk using a pump will know that sometimes the milk can back-up and collect (above the V-shaped 'lip-valve' or similar one-way valve) before splooshing down into the bottle - especially if you're pumping a lot of milk.  When this happens it's easy to see how the pump could suck milk back up towards itself since the two openings are so close together with no barrier preventing the milk and air flow combining.

And it's also the same problem with this replacement attachment, which I bought separately.  Often people who buy second hand pumps will buy new tubing and attachments such as this with the assumption that it makes the unit sterile.  However, this may not be the case.  

3

Although the opening for the tubing is slightly further away from the milk inlet in this design, there is still no physical barrier separating the tubing and the milk being expressed.  The milk and the air flow into the pump can mix freely.  

4

So my husband and I conducted our little experiment.  We were looking for signs of contamination within my pump unit.  Obviously if milk is being drawn back inside the pump then it's impossible to sterilise the unit without taking it apart completely.  

5

We didn't have far to look I'm afraid.

6

Black mould (dirt?) where the end of the tubing meets the unit itself (about 1cm into the unit) - oh the shame...!  Obviously, this could be superficially cleaned using a q-tip/ cotton bud - so a potential buyer of my second hand breast pump would be none the wiser - but just because something looks clean, doesn't mean it is clean!

Then we opened the pump unit right up.  Here's the view of the area where the tubing enters the pump (bottom right of the picture).

7
And here's a closer look at the clear plastic (silicone) unit which meets the tubing and houses a couple of valves.  

8
What's the white stuff?  My guess - dried milk, but milk which has been exposed to the air and therefore may have grown bacteria or mould.  Nice. 
If anyone wants to test this residue they're welcome to, please get it touch!

And look - it's all the way along this inside of this component:  

9
No matter how clean your second hand breast pump looks from the outside, it's highly unlikely that anyone has opened it up to clean inside.  In their online cleaning instructions Medela do not say that you need to clean inside the pump.  However, elsewhere the pump's literature (and oddly not located within the section 'cleaning and hygiene'?), they say you can run warm soapy water through the pump in order to clean these internal parts:  page 9, section 'if there is an overflow' (thanks to Beth for pointing this out in comments).  


Pumping soapy water through the inside is certainly a good idea if you notice milk/ vapour being pulled back up into your pump, BUT IT'S NOT THE SAME THING AS STERILISING, and therefore it's a bit of a cop out in my opinion.  They give the impression that sterilising the external parts and rinsing out the internal ones is sufficient, but the bottom line is this: you can't sterilise the inside of the unit.  


Quite obviously from the photographs, I didn't realise it was possible to run water inside the pump or I would have done so.  However I was - at least - aware that milk could travel back into the machine causing contamination.  Were you?  


If you were to buy a second hand pump, how would you know if the previous owner had cleaned the inside or not?  Would you know to clean inside the unit this way once you bought it?  Does any of this even matter since you can't actually sterilise it?

Remember that once you switch the pump on, the air is circulating inside the non-sterile pump every single time it sucks, and that air can also mingle freely with the milk you are expressing.  If milk can be sucked towards the pump on the 'in' suck, then of course it can also travel back towards the bottle on the 'out' - potentially bringing with it residue/ spores from inside. 

Doesn't seem like a very 'closed' system to me...

And so we journey further into my ex breast pump...  

[I should state at this point that I was never a 'big time' pumper - I pumped for roughly a year, I never shared my expressed milk and I didn't donate anywhere.  I used it simply when I was apart from my daughter and to store moderate amounts of milk in my freezer for our own use.  Had I been working full-time and having to express several times a day for months on end, the inside might look different again.]

Eventually we found the 'diaphragm' section of the pump.  So it DOES have one!  This membrane ultimately completely separates the pump motor from the tubing and valves.  However, does this mean that the pump is 'closed' system?  

The wikipedia definition of a closed system (where the diaphragm separates the tubing from the flange) would suggest that it's not. 

10
[NB - in locating this diaphragm my pump really did 'bite the dust', so unless you are happy to say goodbye to your unit, I suggest you don't try this at home...]

Hmmm, white residue there too.  

So how does the Medela Swing pump differ from a truely 'closed' system pump?

It's amazing how simple the difference is actually.  Here's the tubing set/ bottle/ flange from my new pump. 

11

The 'flexible membrane pot' forms a complete, impermeable barrier between the tubing and the flange where the milk comes in.  It also acts as a diaphragm, and helps to create the suction when the pump is in operation and as such is airtight.  You can see from the photograph above how easy this all is to take apart, clean and sterilise, and there's no risk of the milk travelling back towards the pump unit.  Replacement parts are readily available and cheap.

So let's talk money.  A Medela Swing pump costs something in the region of £85 - £95 new and something like £50 second hand.  The pump I've just bought costs roughly £139, including the extra flange/ tubing to convert it to a double.  Money well spent since I can loan or sell this pump on second hand with a clear conscience!

Now I need to make something really clear.  Medela do not claim anywhere on their website that the Swing pump is a 'closed' system.  The American version of their website states clearly in it's Swing information that this pump is a single user item.  However, the Swing page on the UK site doesn't say anything about it, you actually need to download the right PDF file to learn this important fact.  
I am quite sure many mums buying and selling the Swing pump don't realise it's actually being sold as a 'single user item'.


They also say that: 
'Use by more than one user may pose a health risk, performance questions, and voids the warranty' (6 months).  
For comparison, the manufacturers of my new pump (read a review of it from a DBM giveaway winner here) say I can resell it without affecting the warranty (400 hours of pumping regardless of when you bought it).  I guess that's tells you all you need to know.

This website explains the important difference between a pump like the Medela Swing, and a closed system pump very well: 

If milk particles in the tubing go unnoticed, mold can begin to develop in the tubes, as well as the pump motor. This puts your expressed breastmilk at risk of being contaminated, since it is exposed to the mold, even if the tubes are thoroughly cleaned or replaced. 
When using a closed system to express milk, the barrier in between the collection kit and the pump tubing prevents outside air from being exposed to your breastmilk. '
One of Medela's 'top of the range' diaphragm pumps (the 'Symphony') does seem to offer the inclusion of something called the 'membrane cap'.  This separates the tubing and the pump unit from the outside, and 'closes' the system in a similar way to the 'membrane pot' shown in picture 11.  It means milk cannot travel back up into the pump unit, solves the contamination problem and it's available to buy separately (and relatively cheaply) as a replacement part.  


However, the instructions for fitting this 'membrane cap' show that it actually attaches to the pump unit itself at the far end of the tubing, and not to the bottle/ flange end.  Therefore it can't be used to modify the Swing pump, or any other Medela pump.    

It's a shame that all Medela replacement bottle/ flange units couldn't be modified to include a space for something similar to the membrane cap, therefore enabling all pumps to be 'closed'?  Surely something like that would be a doddle for a company like Medela?  Such a simple adaptation that I wonder why it is reserved for only the 'Symphony'?


[ETA: Another high-end Medela pump, the Lactina, which is frequently used in hospitals, works on a 'piston system' (it's not a diaphragm pump like the Swing).  This piston can be taken apart and sterilised, so it's different again and I think milk is very unlikely to come into contact with the unit itself.  For a definitive answer about whether the system is 'closed' though, you'd need to contact the manufacturer.]

Speaking personally, I would never sell or lend my Medela Swing pump to anyone (that's why I destroyed it this morning!) - and in future I will ensure that I only recommend a closed system pump to my friends.

What's more - I'll ensure that any pump I do recommend is made by a company who are fully WHO code compliant, such as ARDO*,  Hygeia, or Ameda.  Sadly, Medela are not, neither are Avent, Tommy Tippee, NUK, Nuby, or Chicco (and others).  You can find out more about which companies choose not to comply with the code here. 


You don't have to pay a fortune for a closed system pump.

For the record, I'm sharing this blog as 'information' - because it is topical and because I was asked to.  Information such as this might be particularly relevant to milk-sharing mums or to someone donating to a milk bank.  I think it's also relevant if you're thinking of buying or selling a second hand Swing pump.  It's obvious that I used my Swing pump quite happily and with no obvious ill-effects for at least a year - BUT - I didn't share it, and I never donated or shared milk with another mum.  


If your child is eating solids or sucking on whatever they find on the floor, you may feel there is no need to sterilise at all.  In fact there is a lot of conflicting information about sterilising floating about, and some of it will only apply if you're formula feeding, as breast milk has antibacterial properties of it's own.  However, if you were looking after a vulnerable child or milk-sharing you might want to think carefully about what kind of pump you use, and opt for one which can be completely sterilised throughout.

At the end of the day it's down to each individual mother to make her own decision based on all the available information.  An interesting piece by Nancy Mohrbacher (IBCLC) concerning used breast pumps is here.

* A review of the Ardo Calypso Breast Pump can be found here.

123 comments:

  1. Thank you! I've been yearning to see inside one of those! Your post will be so useful to mothers and us doulas, too, who are asked about pumps all the time.

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  2. Hiya, I do agree with what you are saying but just wondered, in the Swing instruction manual it says to clean it by turning the pump on with the tube in hot soapy water, therefore flushing the system with this, then to follow with boiling water (to clean off the soap). Surely this would clean away the residue etc.
    I'm not saying that this is anywhere near as good as it being a closed system, just explains why they say all parts in contact with milk can be sterilised?

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  3. Hi - Would turning the pump on with the tube in hot soapy water clean inside the pump? I don't know. Medela seem to suggest it isn't necessary to clean inside the pump unit, since according to them it doesn't come into contact with milk in the first place... :-S

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  4. PS - Is cleaning something with hot and soapy water, and then rinsing with hot water the same as sterilising?

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    1. No. Sterilization means killing all micro-organisms including viruses and spores. Hot soapy water does not achieve a high enough temperature or long enough contact time to sterilize. In general, sterilization in an autoclave (using heat/steam) requires a minimum temperature of 121C for a minimum of 15-20 minutes.

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  5. I presume as well it would apply to being single baby use? I have the Medela swing and I know milk backed up into the pump once or twice with my first child. I haven't bothered to express with my second, but wondering if I need to throw away and basically destroy my pump so no one else can use it. I don't think I can use it with my new baby. I will want to use one when we start to introduce solids.

    I see what they mean if you sterilise the tubes or get a new set and the milk isn't backing up into the pump then, especially if you can clean the inside that does come into contact with milk. It's interesting to see the inside of it! Did you manage to put it back together easily enough once opened?

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  6. The pump is no more ;) There was no way it was going back together after our dissection! I choose not to re-use it for another baby or for expressing milk to donate. Having seen inside it, it WOULD be possible to suck in water to clean inside the pump without destroying the motor (in theory). However, this still isn't the same thing as sterilising IMO, unless maybe you suck up Milton liquid for the designated time? I certainly don't recommend opening it up and trying to clean it that way.

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  7. Am struggling to see an instruction about to run the pump in hot soapy water in this instruction manual? http://www.medela.com/default/dms/global/breastfeeding/products/pumping/swing/pdf/ga_swing_en_de_fr_it_nl.pdf It does say to let it run dry if there is moisture in the tubing, but could you let me see a link to the other info? Thanks! ~ a

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    1. This link must not be to the same manual being referred to in the Page 9 comment by Beth a couple of comments below as page 9 is now about assembling your pump.

      Can you link to the new or correct version again as I am due in jan with #2 and want to clean my medela.

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  8. Thanks, I'd sort of figured it was written off as had read about open / closed systems already, which was why I hadn't used it. I don't think you'd be able to know for sure that you had cleaned or flushed the inside out even with sterilising liquid from tablets or milton? :/

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  9. It's on page 9 about flushing the inside out if milk gets into the pump. I don't see what the difference is between single user and single baby. There is info about that on page 9 too and about disposal so it can't be used 2nd hand. Bit of a contradiction if you can flush it out, but it's deemed single user, because of the health risk.

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  10. Oh ok - thanks! Funny that this info is in a different section to 'cleaning and hygiene' though :-S

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  11. Fab post! I love that you dissected your breast pump! xx

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  12. I don't follow the logic that it isn't closed and therefore it is a risk if you borrow one or buy one second hand. If the concern is that milk residue can make it into the pump itself and then breed bacteria that could then circulate in the air that is used for the suction, surely that is just as much a risk for a single child receiving expressed milk as for multiple?

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  13. Yes, I see what you mean... It's Medela who state that it's only a potential health risk if used my multiple users. I also agree that if (for example) I'd gone on to use this pump for my second child there would also have been that same potential risk. Theoretically it's even a potential issue for a single baby although you would think the mum & baby would be exposed to all the same bugs and have mostly the same immunity, for at least a period of time? Where you draw the line I just don't know! It's probably different for everyone. The blog came about because of confusion over the 'open' or 'closed' status of this one brand of pump, as you frequently hear of them being sold on. I think I've answered that question. I agree with you that it's far from clear why the pumps are being sold as 'single user' when perhaps that isn't the real issue here.

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  14. Excellent article and much-needed. I shall be sharing.

    My opinion is that breastpumps in general covertly sabotage the breastfeeding relationship. But that's for another article...

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    1. Or, they make it possible for a baby unable to nurse due to physical issues to receive breast milk. I was able to give my daughter 8 months of my milk that would have been impossible with my hospital grade pump.

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  15. Thanks :) I'm not sure I agree with you about that 'in general' they sabotage the relationship though... I recently supported a mum whose little one was too tired/ small to feed. She was able to express well enough to stimulate a good supply for him (arguably you could also do this by hand), and feed him until he was strong enough to suckle effectively himself. Many babies continue to receive breast milk when their mums go back to work, or under other circumstances, and using a pump (especially a double) can make this a lot easier for some people. Admittedly the 'pumping culture' such as (necessarily due to the poor maternity rights!) exists in the States is NOT one we'd want to see develop here in the UK. However if a company is WHO compliant and the product is a good one, I don't think we should be against it's use. Companies who rush to produce what they try to call 'natural' bottle-feeding supplies fit into a different category IMO. Expressing breast milk does not have to = bottle feeding. It can be given by cup, at the breast, it can be shared etc. I'm sure many women would argue that a pump saved their breastfeeding relationship. xo a

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  16. Wow. I had no idea. I bought a 2nd hand Medela mini twin and bought the replacement valves etc. I didn't use it much as I never managed to pump much, but was just about to pass it on to my friend who has a newborn and will now be thinking twice.

    It's a difficult situation - we couldn't have afforded an electric pump at all new, and had I been fit enough to back to work earlier, I would have had to give up feeding without an efficient pump. I'm trying to work out which is worse in my mind with an older child (as for me the pump wasn't necessary with a young baby) :s

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  17. Beyond interesting. I never would have taken mine apart. I bought mine new and never thought of selling it. Now I wonder though: if I am done with pumping forever, where should the pump go? I wish they could be recycled, or cleaned somehow.

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  18. Pumping saved my breastfeeding relationship due to low milk supply. Now things are great and I only pump for extra milk.

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  19. I agree with another person's comment about the pump being single baby - as opposed to single user. If there is a significant risk of mold growth because of the open system, it really seems that that would be just as big of, if not bigger, than a health risk by multiple users of the same pump. I'll be recommending breast pumps from WHO compliant companies only from now on.

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  20. This makes me wonder about my Medela Pump-in-style breastpump. I use it at least 3x a day 5x a week (oh the joys of being a full-time working mother, and having a child who is EBF!), and I've never tried cleaning the system! I have cleaned the parts that come in contact with the milk, obviously, but that's it. I notice a tiny bit of condensation just near the bottle sometimes, but I've never seen milk in the tubing. Regardless of whether or not I see condensation, I always let it pump for a minute or two without being attached to the bottles after I'm done so it can dry up. Any thoughts on that particular pump? I want to clean it now, but I've scoured the material and haven't found a way to clean (that the company listed)! I am also jealous of the cost of your closed-system pump! The only "closed system" pump I could find here was $1500! My Medela pump-in-style (double pump) was $250.

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  21. I don't get it. Why are people making such a big deal about whether it's safe to share pumps? In my opinion, the BIG question is whether they're safe to use AT ALL. If milk has a chance of being contaminated by milk residue and mold from previous uses, why would it be any safer for the original owner/baby pair than for a second owner/baby? It doesn't make any sense to me. I don't want my kids getting mold in their milk!

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    1. This is EXACTLY what the CDC says. Milk is exposed to contamination, the minute it hits the environment. They also make a huge point of stating, INCLUDING the mother pumping from a brand new pump, and their own breastpump from DAY ONE. Thank you for this comment.

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  22. I have a Hygeia pump- which is multi-user friendly CLOSED system pump. All the next user needs is new tubes, the filter and flanges (of course you could always steam sterilize the tubes and flanges). It cost $299.99 for the unit with the rechargable battery, carry bag, tubes, flanges, bottles, etc. I have used both the medela and hygeia and prefer the hygeia. I also know that I can safely pass it along to another mom after I am done using it. I was using the medela symphony- which is a closed system. I rented that until the purchase of my hygeia. My suggestion to anyone who has any thought of selling or passing along their pump- buy the hygeia. Their website is hygeiababy.com

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  23. @Kitsune. I had a look on Medela's US site to see if I could find information about cleaning inside the system. I couldn't find any, so I looked on the UK site. http://www.medela.com/UK/en/breastfeeding/products/pumping/pump-in-style-advance.html Here you can download the instructions for using the 'Pump in Style'. This information includes instructions for fitting a 'diaphragm cap' onto the pump unit itself. I don't know if this is the same as the pump you have? The guide states that the diaphragm cap can be cleaned 'when cleaning is necessary' but your guess is as good as mine as to what exactly that means. The inside of the machine is therefore theoretically separated from the external parts. Page 9 of this instruction guide DOES, however, give instructions for how to clean the unit in the event of an 'OVERFLOW' such as is possible with the Swing pump.
    'If milk accidentally gets into the tubings or behind the diaphragm cap
    1. Turn off the pump and unplug from power source.
    2. Refer to cleaning instructions «Tubing care».
    3. Use a damp (not wet) cloth to wipe the diaphragm and bag. Do not
    immerse the motor unit or any of the bags in water. If necessary clean
    the pump kit.
    4. When components are completely dry, reassemble breastpump and kit.'
    This all suggest to me that IT IS possible for milk to get behind this 'diaphragm cap'. That would introduce a potential avenue of contamination such as discussed above. These overflow instructions don't include pumping water through the system, as suggested for the Swing. I strongly suggest you contact the company directly for a conclusive answer as to whether your pump is closed or open system. I do wonder why the diaphragm cap is mounted on the machine and not more easily accessible at the other end of the tubing, thereby separating the tubes and the milk flow. This would mean there was no chance of milk or vapour getting anywhere near the machinery at all...
    @Rachel: Regards the pump I have bought, it is from a relatively new company here, ARDO UK, and I don't know if they currently sell in the US - although it may be worth an ask. http://www.ardomums.co.uk/ The pump I bought was a Calypso, with the double adaptor. I should state clearly have not been paid or given any inducements whatsoever to write this piece (!) & my decision about which pump to buy was only influenced by two things: 1/ the pump needed to have a closed system 2/ the manufacturers needed to comply with the WHO code. Hope that helps. ~ anne

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  24. My 2nd child is almost 6 weeks old and I've been pumping 1x a day to prepare for my return to work. I've been using the Medela PISA I used with my son, the pump is almost 4 years old. I'm now worried I need to buy a new pump.

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  25. Thank you for taking the time to explain and share your findings with us! As with all matters related to raising children, I feel mom's discretion is best.

    On a side note, for those that argue the pump is sabotaging the breastfeeding relationship, I disagree 100%. Some moms encounter real conditions and challenges with nursing, but will do everything in their power to feed breastmilk to their child. To suggest anything wrong with the choice to pump is ignorant and cruel.

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    1. Thank you! My boy was too sleepy to feed and wouldn't latch on so we had to express, initially by hand and then by pump, and we fed the colostrum to him by syringe and breastmilk by a cup with a soft lip. He eventually learned to latch on after a few weeks, and every single feed I would try to get him to latch on with varying success, but in the meantime the pump did wonders for our breastfeeding relationship as at least he was able to get the milk and I was able to protect my supply! In retrospect I perhaps could've done some things maybe to prevent the latching difficulties, but you have to go with the situation you have. Anyway, that is my wonderful experience of using the marvellous invention that is the breast-pump!

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  26. @Kitsune I just looked at 36D post and link, since I was worried about my PISA too. I used it intermittently for my first 3 years ago and have done the same with my now 7 mo old.

    Anyway, I looked at the Medela pdf and my pump and it is a closed system. I took off the diaphram cap (it's just a plastic frontplate/bezel. You can take yours off too and not hurt your pump).

    There is no way that milk can enter the pump and motor. The diaphram cap just provides the suction for the pump where your hoses are attached.

    Hope that makes you feel reassured. I certainly felt better upon looking at it.

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  27. Hi Amy, thank you for your comment. I'm glad in your case there wasn't an issue. I am starting to wonder what effect the humidity in the atmosphere also has on the inside of the pumps as I have read numerous other anecdotal stories (of which I admit mine is just one!), online where to the posters DID feel their units were compromised. Doubtless there are many factors at play. I just don't understand why Medela would admit an overflow can occur into the pump unit (as per the instruction guide), if it weren't a possibility here? I think it would be interesting to collect used pumps from a variety of sources and test the irreplaceable parts in order to see what (if anything) could be found.

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  28. This is the best article i have ever come across on the mouldy medela issue. Thankyou for going to the trouble, especially breaking your pump open for the photos.

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  29. I have always told other women to NEVER share/sell/pass on breast pumps unless they are 100% sure it is a closed system. IMO, it just isn't worth the risk.

    I just recently purchased a Hygeia pump because it is a closed system, recyclable, & they are WHO compliant. With the recent healthcare changes in the US concerning breastfeeding supplies, this should now be an option for most Mothers.

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  30. So it isn't safe to share because of mold... but mold is okay for single use? That doesn't make sense either the whole pump is garbage once milk goes in and gets it moldy or the mold can be cleaned and is safe to use after cleaning... that's how I'm reading this.

    ReplyDelete
  31. I've used a 2nd (or was it 3rd?!) hand Medela PISA before and the milk did backflow into the tubing many, many times. Could be a humidity factor as I live in sunny Singapore. Of course I never gave it a second thought before reading this article and used to just flush out/boil the tubes. Now that I'm pregnant again, am definitely not going to be cheap and will just purchase a new closed-system pump like Ameda or Hygeia. There's just no point cutting corners when it comes to baby's health!

    ReplyDelete
  32. I took my pump apart too (and blogged about it with pictures: http://m0mumental.blogspot.com/). I have a PIS. Mine wasn't nasty inside, but I am still concerned after seeing your post and doing further research on WHO code and open vs. closed system pumps. Thank you for this informative post!

    ReplyDelete
  33. I was like Maggie, wondering about the PIS. So I opened the one a friend of mine had given me. She stated she had barely used it over a 2 week period. Nevertheless, after the investigation of whether PIS is a closed or open system, I came across this site. It was very informative. The PIS seems to be safe to use second hand (depending on where you're getting it from) if all the pieces are replaced. I have not used it yet, as my baby is not due until Oct. I was examining thoroughly it to find out if I needed to purchase any more pieces or if I should by a another. My friend said that the time she did use it, she never had the milk flow into the tubing. Therefore, never reaching the diaphragm. I'm planning to call Medela as well as a lactation consultant to find out what they have to say. I'm still not sure if feel comfortable enough to use this one. It would help out alot if I could. But if not, I'll so what I have to do for the safety of my baby.

    ReplyDelete
  34. Thank you Maggie :) I'm glad your pump wasn't as manky as mine! However, I'm still not sure that even with regular cleaning inside the system, and a pump that looks clean, we can state conclusively that the pump is clean. Spores and bacteria are invisible. Some people have accused me of 'scaremongering' with this blog... I'm really not trying to do that at all here, and I have tried as far as possible to stick to facts. However this blog has been read widely (nearly 10,000 times :-O) and recently I was contacted by someone via email who claims a good (industry) understanding of these pumps. They wanted to make some concerns known in confidence.  I hope it's ok to share the gist of their comments.
    - back flow can be invisible to the eye and can exist as minute particle 
    spray, and so a user may be unaware of contamination. 
    - It is very difficult to "dry" and eliminate moisture from the inside of 
    fine bore tubing, and that would also apply to the inside of the pump. 
    - even if you manage to flush out any back flow and eliminate the milk residue, the flushing itself would still leave moisture which could support bacterial growth. 
    - Thrush spores can't be destroyed by flushing through with boiling water, and so sharing/selling a pump with replacement parts could still be problematic. 
    (^ paraphrased by me).
    This is obviously one person's PERSONAL OPINION but I would say that what is really needed in order to settle the question is independent scientific assessment of a variety of pumps. I don't see why a pump manufacturer would have a problem with this if they had confidence in their products. It would certainly stop the discussion going round in circles, and possibly bring peace of mind to a lot of people!
    Of course that costs money... :-S

    ReplyDelete
  35. Surely if this is a pump *sucking* air out of the unit, it doesn't matter if any milk gets sucked up the tubing as that will never be able to make it back down the tubing again?

    Obviously it's a bit yuck to think that there's dried milk in the pump, but we can be a bit over cautious about these things...

    ReplyDelete
  36. I had no idea about this. I just bought a new pump :) Thanks!
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    ReplyDelete
  37. I have a 10 year old PIS that has been through 8 kids, that I am now dying to tear apart - LOL.

    I can't wait to see the surprises inside..

    I have 4 Medela pumps total. Two PIS's, one Advanced backpack and the freestyle. All but one was used solely by me - so I'm not concerned about someone elses contamination - but I am concerned about mold. Even in all my research on buying a pump in the past, I never thought about mold, nor did I read anything about it. I just read about how CMV, HIV, etc could be transferred from user to user. So now after spending nearly $800.00 in pumps less than 2 years ago, I get to buy another in a few months for #3 I guess...

    ReplyDelete
  38. Great article. I think I'm going to dissect my Tomme Tippee...

    ReplyDelete
  39. A baby is technically an automatic pump.

    ReplyDelete
  40. I just read about how CMV, HIV, etc could be transferred from user to user. So now after spending nearly $800.00 in pumps less than 2 years ago, I get to buy another in a few months for #3 I guess...

    ReplyDelete
  41. I never thought about mold, nor did I read anything about it. I just read about how CMV, HIV, etc could be transferred from user to user. So now after spending nearly $800.00 in pumps less than 2 years ago, I get to buy another in a few months for #3 I guess...

    ReplyDelete
  42. Hi... can you please recommend a pump that is "closed" that is well priced... I just got a second hand medela swing and don't want to use it but can't afford a brand new machine. Please help!

    ReplyDelete
  43. hi there- I use the Ardo 'Calypso' as it's an ethical and reasonably priced alternative to the swing. It can also be used as a double pump which is great for making the most of your time as well as upping your prolactin levels. A bit more about this pump is here: http://mythnomore.blogspot.com/2011/12/dbm-festive-giveaway-win-ardo-calypso.html x a

    ReplyDelete
  44. Hi -- wow, your pictures really tell a thousand words. Yuck!
    I believe that Ameda is going to be WHO Code compliant again as Evenflo are now selling their bottle business (Jan. 2012).
    Very interesting indeed, as always, thank you DBM!

    ReplyDelete
  45. Thank you so much for all your helpful information. I was going to buy a used Pump in Style but abruptly changed my mind after reading what you had to say.Im now looking to buy an Ardo,a brand which is still relatively new here in the Netherlands,but one that should be used more since it has a closed system. Thanks again.

    ReplyDelete
  46. Thanks so much for sharing! My son was a prem and contrapted Echoli Menangitous at 3 days of age. He was flowen to our state childrens hospital. While he was in the NICU and unable to suck for the first three weeks, I was encouraged to express my milk. There were about 15 mums using the same machines (4 of them) we weregiven USED parts that we were told to wash with just warm soapy water. At the end of your stay they ask for all attachments back so they can re use them. I think it's gross!!!! My baby was fighting for his life with an infection and I knew nothing more in regards to sharing pupms, but in future I will be taking my own pump. Thanks so much for all your info!!!

    ReplyDelete
    Replies
    1. I expect the parts were autoclaved prior to you receiving them, therefore rendering them sterile. Anything else would be breaking numerous health codes.

      Delete
  47. Does anyone know anyone who has actually had a health problem after using a second-hand pump? Everything I read is theoretical, and I can't find any evidence there's ever been a real, documented problem other than possible low motor power.

    ReplyDelete
  48. I wonder the same thing Jennette. Theoretically speaking of course, mold spores and other invisible nasties could be living and thriving in the tubes as well. That is for open or closed systems. What about that? Wouldn't that be a daily threat? I just don't buy into the hype without proof.

    ReplyDelete
  49. I told a woman about this article today who was in line to buy a medela pump instead of a closed system pump. She was shocked & went to find another pump

    ReplyDelete
  50. Can I ask what brand and model your new pump is?

    ReplyDelete
  51. This one: http://www.ardobreastpumps.co.uk/Calypso-Electric-Breastpump x anne

    ReplyDelete
  52. I would like to start out by saying, Thank you for such a detailed blog. It help me make my mind in going out and purchasing a new Ameda unit. However after my further investigation. I've noticed that with my new closed sys diaphramed flange which is now closed from the rest of the world, I can hook the end of the tubes to the old suspect Medela pump and still get a closed system due to the diaphram that will not allow any contamination to the expressed milk.The diaphram that is placed on the top portion of the flange is the missing link to it all. It's the seperator! you can try to get milk to pump back into the old medela pump all you want. the truth of the matter is the diaphram seperates it all.If anything the contamination stops right at the point of the diaphram. so now i have two pumps. so for all the women that are freaking out like I was. Just go buy the parts for the Ameda pump sys. With the help of a handy husband, you too can have a closed sys pump regardless what you are using. I would not have even tried this experiment had my wife not said, " I liked the way the motor on the medela pump worked." I'm guessing she meant the sucking power it provides. So with a lil brainstorming, TADA!

    ReplyDelete
  53. I may have opened Pandora's box! with this info, recycling of pumps seem to be an actual viable option for those that are tight with money. The flange kit for the Ameda kit seems to be no more than 45-50 bucks. So if you have a pass me down pump, regarless what kinda sys it is (open or closed), it can be transformed into a closed system with just the used of the diaphram flange sys that the Ameda system uses.

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  55. One of their best sellers, the Medela Freestyle breast pump, can be used, hands free, by just attaching it to the nursing bras. It also has a top quality double pump feature, which can be used for extreme breast pumping, and it is perfect for working moms. It is also perfect for mothers, who pump milk on a regular basis.

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  56. So this is just an issue with electronic pumps, right? You're fine with hand-powered pumps because there's no internal mechanism that can't be sterilised... I know some people need the power for pumping on a deadline at work, for instance, but if you're not in that situation and you're worried about the mould issues, just buy a hand pump! Way cheaper and no tricky tubes or motors that are difficult/impossible to clean properly. Problem solved.

    ReplyDelete
    Replies
    1. Not accurate, the hand pumps are even more open than the motorized. You cannot achieve a high enough temperature for adequate sterilization to kill HIV and yeasts.

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  60. This is the best article i have ever run over on the rotten medela issue. Thankyou for heading off to the inconvenience, particularly tearing your pump open for the photographs.

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  61. HA! This just confirms my refusal to buy a medela electric pump! Open circuits is a no go especially when you can get a lansinoh or ameda for a fraction of the cost of a medela

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  63. had a momentary panic about the 2nd hand medela swing I bought off ebay and used for months then went on a google... apparenlty HIV cant actually survive outside the body for long. yeah they can get mouldy but any real; nasties would die long before you got anywhere near it, HIV dies in minutes out of the body.

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  65. Hi,
    Thanks this blog was very useful - I know it's been a while since it was written so perhaps this has been worked out already, but it is possible to modify the medela swing to be a closed system. I bought a medela swing maxi/freestyle connector on ebay and then a new medela swing maxi tubing on amazon (total £24). This puts the membrane at the bottle end with no risk of contamination.

    ReplyDelete
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    1. Can you share the pictures or describe in details about your suggestion? (I have a freestyle, and want to modify it to closed system)

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