Unless you plan to take your baby with you wherever you go and the process always goes smoothly, you'll probably need a breast pump.

As you probably know, these days, "breast is best." The American Academy of Pediatrics, as well as a number of leading professional organizations, including the Academy of Breastfeeding Medicine and the World Health Organization, recommend breast-feeding for the first six months of a baby's life, unless there's a medical reason not to do so, without supplementing with water, formula, or juice.

If you want to continue breast-feeding nonexclusively after that, these groups say all the better. That's because breast milk--custom-made nourishment specially formulated by Mother Nature--offers so many benefits: It boosts your baby's immune system, promotes brain development, and may reduce your child's risk of Sudden Infant Death Syndrome (SIDS) as well as diabetes, some types of cancer, obesity, high cholesterol, and asthma later in life. Breastfeeding helps moms return to their pre-baby weight faster, and may decrease the risk of breast and ovarian cancer, and even osteoporosis.

Breast-feeding is convenient--there are no bottles to prepare and warm--and it's free! There's no formula to buy, which can run you up to an average of $124 per month, depending on the type of formula you buy. But unless you plan to take your baby with you wherever you go and the process always goes smoothly, you'll probably need a breast pump. In fact, a pump can be indispensable for nursing mothers in a number of scenarios: You want to continue breast-feeding but return to work; you need to formula-feed your baby temporarily for medical reasons but want to resume breast-feeding when you get the go-ahead from your doctor; or you need to miss a feeding occasionally because you're traveling or otherwise away from your baby.

A breast pump may come in handy during those first few days after you've delivered, when the breasts can become so full that a baby may have trouble latching on. Things can be sailing along in the hospital, but when you get home, supply can outpace demand. The solution is to express some milk with a breast pump--and to have one on hand before your baby is born, so you're ready to go as soon as you return home after delivery. A breast pump also allows you to store milk (in bottles or storage bags) for later, then bottle-feed it to your baby or mix it with a little in cereal when she reaches the "solid" food stage at around 6 months.

You can refrigerate breast milk safely for 24 hours, or freeze it for three to six months. A housekeeping note: Date it when you freeze it and store it in the back of the freezer, not in the door. That's a warm spot that can prompt thawing every time the door is opened. When the time comes to use it, thaw breast milk in warm water. Don't boil or microwave it; both of those heating methods can destroy valuable immunological components that make breast milk the liquid gold it is. Microwaving can create uneven "hot spots" that can scald a baby's mouth and throat.

There are several types of breast pumps available--from large, hospital-grade pumps and midweight personal-use automatic pumps to small, lightweight, and easily portable manual models that work one breast at a time. You'll want a pump that's appropriate to your particular situation. Pumping can be time consuming and just one more thing to do, but it shouldn't be painful or frustrating. Choosing the right pump can make the difference between meeting your breast-feeding goals and having to stop short.

A baby's natural sucking rhythm is 40 to 60 cycles per minute (one pull per second or a little less). Hospital-grade and personal-use automatic pumps typically operate at 30 to 50 cycles per minute. Other pumps are usually less efficient. As a general rule, the more suction and releases per minute a pump provides, the better it will be at stimulating your milk supply. Efficiency is especially important if you plan to save a large quantity of milk. If you're returning to work, for example, you'll need to have much more breast milk on hand than if you stay home with your babies or are supplementing breast milk with formula.

Once you find the right pump, using it will take a little practice. You'll need to learn how to position it correctly and adjust the suctioning to get the best results. Don't worry--with the right pump, you'll soon get the hang of it. Pumps require some assembling and disassembling for cleaning. Wash any parts of the pump that touch your breasts or the milk containers in the dishwasher, or with hot, soapy water. Drain them dry before each use.

SHOPPING SECRETS

Consider renting. To save money (midweight, personal-use automatic pumps can retail for as much as $350), think about renting a pump. "I rented one from a medical supplies store near my home," says Elisabeth Elman Feldman, a mother of one from Old Bridge, N.J., who breast-fed for three months for a total cost of $150. If you plan to breast-feed longer than three or four months, however, buying is the way to go. But check with your rental vendor. Many offer a price break the longer you rent. For information on pump rentals in your area and referrals to lactation consultants who can advise you on the type of pump you need and where to rent it, contact the International Lactation Consultant Association www.ilca.org or La Leche League www.lalecheleague.org. The hospital where you delivered your baby may have a lactation consultant on staff.

Shop around. You can find deals on new breast pumps online, and at hospital birthing centers. You also can consult a La Leche League leader in your area (check the group's Web site for a leader near you). A little research reveals that there are deals to be had in the online breast pump marketplace once you know what kind of pump you want. (Not sure where to start? Simply type in "breast pump" on a search engine like Google.)

Browse at the hospital. Many hospitals and birthing centers are now in the breast-pump business, offering competitive prices on a variety of pumps, plus advice that can help ensure success. You can also get a recommendation from your hospital's lactation consultant as to the right type of pump for you.

WHAT'S AVAILABLE

Now that breast-feeding has made a comeback (some hospitals organize human breast-milk banks for babies who, for some reason, can't physically breast-feed), the options in breast pumps are dizzying. The major brands, in alphabetical order, are: Ameda), Avent, Dr. Brown's, Evenflo, Medela, Playtex, The First Years, Whisper Wear, and Whittlestone.

Breast pumps come in these basic types: large, hospital-grade, dual-action models, which typically aren't available for sale (you rent them from the hospital where you deliver or from a lactation or rental center); midweight, personal-use, automatic models that are comparable to hospital-grade pumps and can travel with you; small electric or battery-operated units that double- or single-pump; one-handed manual pumps; and "hands-free" pumps that you wear in your bra that pump while you work or do errands.

Here's the lowdown on each:

Hospital-grade breast pumps

These electric powerhouses are about the size of a car battery and can weigh 5 to 11 pounds. Manufactured for users in hospitals and for those who choose to rent, they have sensitive controls that allow you to regulate suction rhythm, intensity, and pressure. Some have a pumping action that's almost identical to a baby's natural sucking, which can help build and maintain your milk supply. A hospital-grade pump can cut pumping sessions in half--to just 15 minutes with a dual pump, which empties both breasts at once. These are expensive to buy, but you can rent them from hospitals, medical-supply stores, lactation consultants, drugstores, and specialty retail stores.

Pros: They're fast and efficient. Many are also light, comparable to a midweight, personal-use automatic pump.

Cons: Even though some come with a rechargeable battery and an adapter for use in a vehicle, many don't come with a discreet carrying case. You wouldn't want to lug one to and from work every day because they can be awkward and heavy.

Price: Expect to pay around $45 a month to rent one. You may also need to purchase your own breast shields, containers, and tubing, which can run an additional $35 or so.

Choose this option if: Nursing is difficult because your baby has trouble latching on; you're not sure how much you'll need a breast pump, but you want one on hand just in case; you plan to pump for three months or less; you must dramatically increase your milk supply and need the power of a hospital-grade pump.

Top brands/models to consider: the Elite Electric breast pump by Ameda; Medela's rental line: Symphony, Lactina, or Classic breast pumps; Whittlestone Breast Expresser (the rental version.

Midweight, personal-use, automatic breast pumpsUsually no bigger than a briefcase and weighing around 8 pounds or less, these electric breast pumps typically are lighter and slightly less efficient than the hospital-grade models. Like a hospital-grade pump, a personal-use automatic can slash pumping time because it has a powerful motor and serious suction. Many personal-use automatic pumps have suction that mimics a baby's natural sucking, which typically begins with rapid, high-frequency suction and changes to a slower, suck/swallow pattern. They're designed to mimic a baby and thereby foster faster milk flow, although some use a constant vacuum, with self-adjusting suction settings. Intermittent action better imitates a baby than a constant vacuum--and it's probably easier on you, too. Some electric breast pumps come with a manual breast pump, so you get two for the price of one.

Many models come housed in a black microfiber tote bag or backpack, which is ideal if you're working outside your home. They're often equipped with an adapter for your car's cigarette lighter or a battery pack for times when you're not near an electrical outlet. Most come with all necessary attachments, including removable cooler carrier and cooling element, battery pack, AC adapter, and collection containers, lids, and stands.

Pros: This is a quick and portable way to double-pump and fill up a bottle in minutes.

Cons: It's probably more than you need if you plan to pump only occasionally.

Price: $195 to $350 to buy.

Choose this option if: You'll be returning to work full- or part-time and you need to pump throughout the day to maintain your milk supply and express milk for missed feedings.

Top brands/models to consider: Ameda Purely Yours Electric breast pump, Avent Isis IQ Duo or Uno, Evenflo's Elan Feeding System, Medela Pump in Style Advanced or Original, Playtex Embrace Electric Double Breast Pump, Whittlestone Breast Expresser (the personal-use version.

Small electric or battery-operated units

Using widely available AA or C batteries or household current, these lightweight, compact devices can fit discreetly in your purse or briefcase. They're relatively quiet, but the suction can be sluggish, although the vacuum on some models can be regulated for maximum comfort. Others, though, have a constant vacuum that can cause nipple discomfort.

Pros: They are relatively inexpensive and portable. With the battery pack, you can pump anywhere, anytime.

Cons: If you use this pump more than occasionally, you may find that pumping takes too long. Consider one of these for occasional use only.

Price: $65 (single pump) to $130 (double pump) to buy.

Choose this option if: You need to pump only occasionally because you'll be away from your baby now and then, for a night out or a couple of hours during the day.

Top brands/models to consider: Medela Single or Double Deluxe breast pump.

Manual breast pumps

With these small pumps, you produce the suction yourself by squeezing a bulb or lever or by manipulating a syringe-style cylinder. There are many designs of manual pumps on the market. Cylinder, or piston-style, pumps usually allow you to control pressure and minimize discomfort. Some manual models can be operated with one hand. They're easier to use than those requiring one hand to hold, one to pump.

Pros: They're less expensive than electric models and don't need an electrical source or batteries, and often are compact enough to fit in a tote or purse.

Cons: Manual pumps often are markedly slower than other pumps. We recommend these only for occasional use, such as when you're traveling.

Price: $35 to $50 to buy.

Choose this option if: You're a stay-at-home or work-from-home mom and you need to miss only a rare feeding because of a night out; you're traveling or you have plugged milk ducts or sore nipples. A manual pump is also ideal for pumping on the go, in places where electricity may not be available. Look for one with an ergonomic handle, not a bulb, though any small pump could tire your hand and arm and cause repetitive strain injuries if you use it frequently.

Top brands/models to consider: Medela Harmony, Avent's Isis manual pump, Dr. Brown's manual breast pump, (www.handi-craft.com).

Hands-free pumps

Placed inside your bra, this battery-operated pump, which is no bigger than a bagel and comes with an AC adapter, mimics the feel and sucking pattern of a baby. Milk travels through a flexible stem and collects in a self-sealing, spill-proof bag.

Pros: You don't have to drop everything you're doing. You can pump while you're reading, working, or talking on the phone. It's the ultimate in multitasking.

Cons: Some women report that you need a super-tight bra and must position the pump exactly to work this pump. Otherwise, milk won't collect properly. Since you place the pump inside your bra, your chest size will expand considerably, so you may need to wear a large sweater or blazer to camouflage the fact that you're pumping, if you do so in public. We also hear this option isn't quiet, so you'll probably want to pump in private. Moreover, the milk collection is relatively slow. It takes three to five minutes for milk to begin collecting in the bag. In the world of breast pumping, that's an eternity.

Price: $110 (for a single pump) to $200 (double pump) to buy.

Choose this option if: Your schedule is hectic and you'll be pumping only occasionally.

Top brands/models to consider: Whisper Wear is the only brand of hands-free pump we know of on the market.

IMPORTANT FEATURES

Suction settings. The best pumps mimic a baby's natural nursing rhythm by automatically pumping in two distinct modes: rapid, to simulate a baby's rapid sucking to begin fast milk flow, and slower, to simulate a baby's deeper sucking to produce the most milk flow. Together, the two phases offer a more authentic breast-feeding experience with greater comfort, increased milk flow, and quicker nursing time. "Closer to Nature" brands/models on the market that purport to pump more like a baby include Medela's Pump In Style Advanced shoulder bag or backpack, its hospital-grade Symphony, and its Harmony manual breast pump. Others, such as Avent's Isis iQ Duo and Isis iQ Uno electronic dual and single breast pumps, allow you to automate the pumping rhythm, speed, and suction at the touch of a button instead of relying on pre-set controls.

Warranty. If you'll be using your personal-use breast pump every day, look for a pump that has at least a one-year warranty on the motor. A generous warranty typically is a sign of quality and durability.

Adapter/batteries. If you're pumping on the road or you don't have access to an electrical outlet (say, for example, you don't have a pumping room at work and you're relegated to a restroom stall), look for a pump that can run on batteries or that includes an adapter that can attach to your car's cigarette lighter. However, even if you have a "hands-free" model, we don't recommend pumping while driving because pumping can be distracting.

Double-pumping. If you'll be pumping at work or pumping often, get a double hospital-grade or midweight, personal-use, automatic pump. By expressing both breasts at once, you can complete a pumping session in 10 to 15 minutes. Besides being fast, double pumps are better for milk production. Double-pumping increases levels of prolactin, the hormone responsible for milk production. Smaller pumps or a single pump may not be able to maintain your milk supply long-term and can quickly become frustrating to use.

Carrying case. If you'll be commuting or traveling, a professional-looking pump "briefcase" or sporty backpack is the way to go. Most models, other than the hospital-grade ones, come in a chic, black microfiber case with a shoulder strap. Some models, such as Evenflo's Elan Feeding System and Medela's Pump in Style Advanced, also feature a removable cooling compartment and pump motor, so you can lighten your commute by leaving a section at work.

Insulated storage compartments. Look for compartments in the pump's carrying case if you'll be pumping on the go and need to store your milk for later. But be sure to keep an ice pack or two with your breast milk in the storage compartment.

LCD display. Some breast pumps have gone high-tech, such as the Evenflo Elan, offering an LCD panel that displays speed and suction settings as well as the time and length you last pumped--even which breast you pumped last.

RECOMMENDATIONS

Consider renting a hospital-grade breast pump if you're not sure how long you'll need to use a pump or if you know you'll need to pump for only a short time and you plan to be home with your baby. If you expect to use a breast pump regularly, especially if you plan to return to work, buy a top-quality midweight, personal-use, automatic model at the best price you can find. This caliber of pump will help you get a significant volume of milk in a given time and will be your best bet for maintaining your milk supply. If you plan to use a breast pump only occasionally, a manual pump or a small electric or battery-operated one will probably be all you need. They're appropriate and made for occasional use only.

Since using a breast pump can be tricky, most manufacturers now supply informational brochures with their units. You also can call manufacturers' customer-service lines if you encounter problems with a specific pump. Many manufacturers offer a 90-day warranty on parts and will repair or even replace a product without charge. But keep your receipt or the printout from your baby registry as proof of purchase.

There's a host of information on the Internet about breast-feeding in general and specific guidance on such issues as how to get into a pumping routine after you return to work. The La Leche League, at www.lalecheleague.org, is a good place to start. This Web site offers a breast-feeding bulletin board, an online community of other mothers you can turn to for ideas on how to overcome breast-feeding obstacles, answers to your most pressing questions, and podcasts on breast-feeding and parenting.

Copyright © 2003-2007 Consumers Union of U.S., Inc.

For the latest information on this and many other products and services, visit www.ConsumerReports.org.