Manual pumps are portable and relatively inexpensive. They are fine for occasional use, or for the mother who has an abundant milk supply and an efficient let-down reflex. All manual pumps work on the principle of creating a vacuum that creates pressure which causes milk to flow from an area of high pressure in the breast to an area of low pressure in the pump. It is important to remember that no breast pump is as efficient as the baby at removing milk, and manual pumps are generally less effective than electric ones.
There are three types of manual pumps: the rubber bulb pump which looks like a bicycle horn (avoid these - they are terribly inefficient, hard to clean, and can damage your breast tissue), the cylinder type which consists of two cylinders, an outer one and an inner one, which generates a vacuum when it is pulled in and out, and the squeeze handle pumps. Squeeze handle pumps generate suction when you squeeze and release a handle. They can be very effective, but can cause your wrist and arm to tire quickly with the repeated use, so are not a good choice if you have arm or hand problems such as arthritis or carpal tunnel syndrome.
Make sure that the flange (the funnel shaped part) of the pump fits correctly.(See diagram). Some, such as the Medela pumps, come with adapters that fit inside to adjust for different size breasts and nipples. The nipple and areola should be surrounded by the flange. The flange should not extend way past the areola, and the areola should not extend way past the flange. If the flange fits correctly, part of the areola and all of the nipple should slip comfortably and easily into it. While Medela's pumps have a flange size that fits most mothers, (most don't need to use the plastic inserts), some mothers with very large nipples may need the PersonalFit Breastshield kit, which can be used with any of Medela's pumps and contains two different size flanges. (see product information for details on how to order the PersonalFit Breastshield kit).
When you are ready to start pumping, moisten the flange (or you may want to use a few drops of olive oil) and center the nipple in the flange. Follow the instructions on the pump, because the technique will differ depending on which type of pump you are using. If the pump has an adjustable vacuum (and it should - all of Medela's pumps do), start out on minimum and increase as your milk starts flowing. Most pumps will give the better results on the higher suction settings, but if your nipples are sore or your breasts are tender due to engorgement or infection, keep the pump set on the lower setting. Some mothers get better results with medium suction levels and higher cycling speeds if you are using a pump like the Pump In Style which allows you to adjust the cycling.
Follow the manufacturer's instructions on cleaning the pump. Only the parts that actually touch the milk need to be cleaned, and usually hot soapy water or running them through the dishwasher is all that is needed, although they can be boiled as well.
The earlier suggestions about encouraging let-down and alternating breasts apply to manual as well as hand pumping.
There are a number of electric pumps on the market. Some are terrible, some are not so bad, and some work quite well. In general, the small semi-automatic pumps like the Gerber and Evenflo are not very effective. Because of their small size, relatively low cost, and battery options, these are big sellers in the department and baby stores. Many people buy them without realizing that there are tremendous differences in electric pumps. Anyone who has told you that she tried and electric pump and it didn't work, or it hurt, was probably talking about one of the small semi-automatic models rather than the more expensive hospital or professional grade models.
Some of the problems with these pumps (besides the fact that most of them just don't work well and many mothers say they hurt) are the fact that they are noisy, and use up batteries quickly, so they become expensive to operate. If you do run a pump on battery power, use alkaline batteries, and replace them frequently because as they wear down, the pump will take longer and longer to generate suction and you will get fewer cycles per minute.