A few weeks ago my daughter, my grandson and I shopped at one of those mega-baby stores. Curious, I checked out the breast pump aisle. I was amazed to see the variety. The whole aisle was full from floor to ceiling! All the pumps were bright, attractively packaged and appeared to be very effective. Prices ranged from $30 to $300.

If I were an expectant first-time mother, I would have been overwhelmed. I would probably have chosen a mid-priced pump made by a brand I was familiar with from baby magazines. I would probably think most pumps worked about the same, except some were manual, some were electric, some were single and some were double. As a new mother I would have trusted that they were all fairly good pumps.

There are some advantages to age. Having been a lactation consultant for 13 years now, I know a lot about breast pumps. I have talked to thousands of mothers who have used all the different varieties of pumps, and I know darn well that the majority of them don't work – at all. Yes, they do create a suction, and yes they do make a noise if they are electric, but so what?

Breast pumps that work effectively mimic the sucking of a baby. No pumps truly duplicate a real live baby. Babies work by an exquisite suckling method. Pumps work by creating a vacuum and a suctioning cycle. However, some brands come a lot closer to copying a real baby than other brands.

If I had a large trash bag, I could have skipped down the aisle gleefully tossing most of the pumps in the bag. I had the urge to do just that or perhaps to take a big black marker and write on the good ones "BUY ME!" and on the bad ones "DON'T EVEN THINK ABOUT BUYING ME! USELESS! PAINFUL TO USE! WASTE OF MONEY! YOU'LL BE SORRY!"

I don't think the baby store would have appreciated my help, so I am going to share with you some helpful hints about choosing a pump. You deserve to know. After all, if you need to pump, you need to pump right.

The Effective Pump
How often does a real baby suck? Oh, about 50 times a minute. And what kind of suck does a real baby do? A short, quick suck. How often do most of the little pumps on the market suck? Five times a minute. And what kind of suck do they do? A harsh, squishing, long, drawn-out suck. Very different!

After your baby is born, your body becomes accustomed to real baby suckling, which when done right is not painful. When an ineffective breast pump is used, your body gets very different sensations – pain, pinching and a totally different feel than your real baby. Often it is difficult for your body to recognize this pump as something it should allow to get that precious milk, so your body says, "NO WAY AM I LETTING DOWN!"

I often hear women say, "I couldn't get a drop of milk with my breast pump!" or "I pumped an hour and got a half an ounce!" These mothers sound so sad that they were pumping "failures." They thought it was their fault.

The Ineffective Pump
I am hopeful that someday all the pumps that don't work will be taken off the market. Honestly, if an electric razor just buzzed around and didn't cut hair, would it still be for sale? How about if it buzzed around, was painful to use and still didn't cut hair? Would you feel like a failure because your hair didn't come off when using the razor – or would you take the thing back, get a refund and write a letter to the company telling them how unhappy you were with their product? More letters need to be written about breast pumps.

Another tip: If you know of someone who has been injured by a faulty, poorly-made breast pump, please ask them to file a report to MedWatch at 800-FDA-1088 or via their Web site.

The Choice
So what should you do about choosing a breast pump? First of all, do you really need one? If you are going to stay at home and don't plan to leave your baby with a caregiver, then you probably don't need the expense of a breast pump. Learning to hand express your milk may be enough. (Hand expression is free, easy to learn and very effective once you master the technique. It works to relieve engorgement and to pump the occasional supplement.)

Manual Pumps
If you are staying home but plan to pump occasionally, you may want to look into purchasing a manual breast pump. There are several brands on the market that work quite well. They are not as expensive as the electric ones, but that doesn't mean they don't work well with a little practice.

Ask your friends who have used one, or go to a La Leche League (LLL) meeting and talk to other moms who pump. They will give you good suggestions. In addition, you can check out the LLL catalogue online. They offer some of the more effective breast pumps.

A well-chosen manual pump may work well for you at work too, especially if you have the type of job that allows plenty of time for breaks. Some mothers buy two of the type that may be operated with one hand and double pump manually. Avoid the ones that have a ball to squeeze or the "bicycle horn" type of pump. The bicycle horn one is difficult to clean and may harbor bacteria.

Electric Pumps
It would be hard to recommend a small, single electric breast pump from my point of view. Most of the ones I have gotten reports on have been very ineffective and are basically a waste of money. One works fairly well but has a very short warrantee. Ask around. There are some new pumps coming out that sound promising. Remember that babies suck around 50 times a minute and your breast pump should too.

For moms who are seriously interested in keeping a generous milk supply going while working, the more expensive double electric breast pumps which are for sale (between $200 to $300) or for rent at breast pump rental stations work wonderfully for most mothers. These pumps are quiet and pump with a short quick "suck" (48 to 60 times per minute), so that several pumping breaks at work would be feasible. The cost is high, but the alternative to not pumping is purchasing artificial formula. The cost of this is usually over $100 a month. Taking that into consideration, the pump's cost doesn't seem quite as prohibitive.

Double pumping cuts pumping time in half, so most mothers can finish the whole pumping session in 10 to 12 minutes. Studies show that double pumping usually stimulates more milk production. One company makes a wooden foot pedal pump that works very well for double pumping, and it is not very expensive. (It reminds me of the old treadle sewing machines, which most of you have never seen!) Using that pump, moms get milk and exercise at the same time.

The Technicalities
Using a breast pump should never hurt! If you are using a pump and it is painful, make sure that you are using it correctly. Lower the suction and see if it is more comfortable.

Some pumps come with different size flanges to fit different sized breasts. Perhaps a larger flange should be used. Many mothers find that if they lubricate the inside of the pump with fresh water or a small amount of olive oil that pumping goes smoother and more comfortably. Do not continue to use a pump that is painful or your sensitive breast tissue could be damaged.

Breast pumps should be cleaned thoroughly between each use. Wash your hands before pumping, and take care to keep the containers you are going to store your milk in very clean. If you are pumping for a sick or premature baby, use extra care in collecting and storing your milk.

When you are practicing with your pump, most mothers find that pumping once a day in the morning is enough to begin saving some milk and to become familiar with their pump before returning to work. Milk can be frozen for many months in clean, hard-sided containers. Some of the one-hand manual pumps or automatic electric pumps can pump one breast while the baby is nursing on the other. Pumping this way takes advantage of the baby inducing your milk to let down.

Babies are always better at removing milk than pumps. Their sucking action is quite different. If you are pumping and worry that your baby may not be getting enough because you can't pump a lot of milk, look to your baby. If your baby is growing on target, wetting and stooling adequately, your milk supply is just fine. It's your breast pump that isn't.

Want to see more?

• Expressing and Storing Breastmilk: A Working Mother's Guide
• Express Yourself! How to Successfully Combine Breastfeeding and Work
• You're Not My Mother: Introducing a Bottle to a Breastfed Baby
• Talk about it!