My blog is mostly defunct but here's a post I wrote a few years ago regarding how we safely used a gifted used Medela pump. I thought it might be of interest here.
Embedded links to external articles are on the original blog post:
http://bit.ly/1W5HXrH.
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Here’s not a topic you’ll see on many tech blogs. How to safely reuse a used breast pump.
Obligatory Disclaimer: I am not a doctor nor breast pump engineer. Do not rely on this article for medical advice. I am only describing what we choose to do. For the impatient, skip to the last section.We’re expecting a new baby and madly scrambling to get everything together for the event. You’d think with two kids already we might have our act together but its been six years and we gave away or tossed most of our baby stuff.
One item, our Ameda Purely Yours Breast Pump, had died. We bought it because it was one of the few pumps listed as reusable…alas, made out of plastic it was not to be.
A friend very kindly offered their Medela Pump-In-Style pump to us which is really awesome since electric breast pumps aren’t cheap. But if you google you end up reading very dire warnings about reusing breast pumps. Some of these warnings are well intentioned from other parents. Some of these warnings are a bit self serving from companies.
Here’s the FDA warning provided in many baby forums:
Only FDA cleared, hospital-grade pumps should be used by more than one person. With the exception of hospital-grade pumps, the FDA considers breast pumps single-use devices. That means that a breast pump should only be used by one woman because there is no way to guarantee the pump can be cleaned and disinfected between uses by different women.
The money you may save by buying a used pump is not worth the health risks to you or your baby. Breast pumps that are reused by different mothers can carry infectious diseases, such as HIV or hepatitis.
Buying a used breast pump or sharing a breast pump may be a violation of the manufacturer’s warranty and you may not be able to get help from the manufacturer if you have a problem with the pump.
OMG! HIV OR HEPATITIS! Most sane parents stop considering used pumps right there. Me, I kept googling. A reporter at U-T San Diego looked into this and it turns out that it’s not quite that clear cut.
First, there are no such things as “hospital-grade” pumps as certified by the FDA. The FDA also doesn’t certify any breast pump for reuse. The FDA spokesperson Karen Riley had this to say:
“If a breast pump has a separate breast cover and tubing, then it can be reused once cleaned,” she said, “but the pumps are not labeled as such.
And
“We have allowed breast pumps that clearly separate (no possible contact of breast milk with the pump mechanism) to be marketed as reusable with appropriate instructions for cleaning and disinfection,” Riley said.
So as the article states…pretty much the manufacturer decides whether or not to market their breast pumps as reusable and how easy they make to disinfect.
Gee, I wonder if it is in Medela’s interest to sell everyone a new $300 pump or let folks reuse perfectly good used pumps.
So, can you safely reuse a Medela pump? You can replace all the external tubing (we bought ours from Amazon) and disinfect the front face plate but according to Medela there’s a diaphragm which cannot be adequately disinfected.
The Medela Pump In Style® Breastpump has an internal diaphragm that cannot be removed, replaced, or fully sterilized. Therefore, the risk of cross-contamination associated with re-using a previously owned pump such as the Pump In Style cannot be totally dismissed. Multiple use of single-user breastpump automatically voids the warranty of the Medela product. Each mother who wishes to express milk with a pump should use a clean, uncontaminated breastpump. This is the safest way to eliminate any risk of cross-contamination.
This is sort of true. It used to be that you could buy a replacement internal diaphragm from resellers. Today, these are all listed as discontinued and to contact Medela. I’m guessing they aren’t likely to sell you one for your used pump. So can you disinfect it enough to be safe? They sure don’t want you to think so.
Here’s the solution we started with:First question is there any access to the “internal” diaphragm. Actually yes. Just pop off the front plate which you need to do to sterilize it anyway. Here’s a nice tear down of an older pump in style. The 2008 model we have is largely the same although the face plate was redesigned. The diaphragm looks like this (from Robb’s posting):
It’s not hard to disassemble the Medela breast pump. On the one we borrowed it’s held in via velcro. And unlike the Ameda it’s not glued plastic but a sturdy metal frame. One screw later and you can see the guts. The only somewhat tricky part is accessing the pins for the second plastic face plate that holds the diaphragm in place.
Once you get this far you realize that Medela could have made this a fairly painless thing to do. You also realize that this $300 breast pump consists of about $30 worth of parts and that’s being generous.
Now Robb just used alcohol wipes…which turns out isn’t quite enough to kill Hepatitis C viruses. I found this article regarding disinfecting Goldmann tonometers.
Hepatitis C virus was placed on Goldmann tonometer tips, air dried, and then disinfected by dry gauze wipes, isopropyl alcohol wipes, cold water washes, povidone iodine 10% wipes, and hydrogen peroxide or isopropyl alcohol soaks followed by a cold water wash and dry.
RESULTS:
Percentage of hepatitis C virus RNA remaining after disinfection: dry gauze wipes 95.65%, isopropyl alcohol 5-second wipes 88.91%, cold water wash 4.78%, povidone iodine 10% 5-second wipes 0.72%, hydrogen peroxide soak with cold water wash 0.07%, and isopropyl alcohol soak and cold water wash 0.02%.
89% of Hepatitis C virus RNA left after 5 second Isopropyl wipes isn’t so good. It probably means some are still active. What I did was to pull the pump unit out so I could set it on it’s back on a flat surface. Then I filled the concave diaphragm with 70% isopropyl alcohol and left it for 5 minutes and then carefully dumped it out with soaking the motor. I wiped down the edges with more alcohol and finally took tissue, saturated it with alcohol, and left it across the diaphragm for 5 minutes. A lot of this was random experimentation to figure out an adequate way to “soak” without taking the assembly apart and actually soaking.
Replicating the cold water wash was pretty much impossible without risking the electronics board, again because I wasn’t willing to pop the diaphragm out of the pump. I wasn’t really sure I could actually reassemble it. So I wiped it several times with a wet cloth. If there were any hepatitis virus (which I doubt) contamination on the surface it was probably down below 1% at this point.
Given that I didn’t believe there was anything wrong in the first place and I repeatedly soaked and wiped the surface with alcohol (wasn’t going to risk iodine) I would have gone with this as a 99%+ safe solution.
As for HIV and herpes and other viruses it seems they are less hardy than Hepatitis. Wiping with an isopropyl alcohol swab and then allowing the alcohol to evaporate seems to “inactivate” these viruses.
If you are using any Medela pump (new or used), I recommend wiping down the diaphragm regularly with an alcohol swab, let evaporate and then wipe down with water anyway. Milk CAN get in there and you can get mold growth on the surface. That’s pretty nasty and a complaint you see on Amazon.
Here’s the Actual Solution We’re Going To Use99%+ safe isn’t actually 100% safe. Even assuming I got any viral contamination down to 0.02% some parents are still likely unwilling to take the risk. Given that I wasn’t able to do the full cold water rinse it’s probably not that low anyway.
Remember that I said we have a broken Ameda Purely Yours breast pump?
The reason this kind of pump can be safely reused is because it’s a fully “closed” system. Meaning the part that touches milk is fully contained in the replaceable breast shield. You can never get milk into the pump portion and there’s no air exchange between the two sections. What happens is that the pump creates suction which collapses a diaphragm inside the breast shield assembly…creating localized suction within the shield. The only parts that milk can touch are the fully sterilizable or replaceable parts.
Ameda claims:
The HygieniKit is the only milk collection system approved by the FDA to protect against cross contamination. It also safeguards the purity of expressed milk from bacteria and viruses by keeping milk and outside air separate from one another.
The Medela pump generates the same amount or more suction than our broken Purely Yours did. The tubing is same size so I plugged the Ameda kit into the Medela pump. The external diaphragm in the Ameda breast shield collapses just fine despite some minor leakage and the combo probably works better than the original Ameda pump (don’t ask how this was tested). Certainly better than when it was half working.
As far as I can tell (remember disclaimers above) this is a 100% safe solution regardless of how contaminated the diaphragm is on the Medela. There’s simply no contact with the air used for suction. Milk can never get in the tubing nor ever touch any part of the Medela pump.
You can buy the Ameda parts from Amazon. I believe that the full replacement kit should work and even comes with a one-hand-manual pump as a bonus. I’m not sure since we already have all the parts I need. I may buy it anyway since our kit is 6 years old and a little worn anyway. If I do, I’ll report what I find.
This technique should be able to work with any breast pump that uses similarly sized tubing for suction.
Important note:This worked on the Medela Pump-In-Style 2008 bag model because the Ameda tubes fit tightly into the front face plate. The Medela tubes are harder than the Ameda ones but the same size. Newer Medela models have a different face plate but the replacement Medela tubes I purchased fit all of Pump-In-Style ones but the only model I tested (because it’s the only one I have access to) is the 2008 model.
The price at the time of writing for the replacement Ameda kit is $46 from Amazon. Because these components are single user use they are not returnable if opened. If it doesn’t work with your used pump you will be out the price of the kit although you can still use it as a manual pump.
Also, since my wife isn’t pumping yet it may be that the Medela kit simply works better than the Ameda kit. Medela is a popular brand for a reason. One, they seem to be built better. Second, they may simply work better.
If that’s the case, we’ll likely go with just using the Medela tubing and breast shields since I already bought all the parts and opened them (again, single user). For me, I’m reasonably certain I did enough to kill anything that might have been on that diaphragm.
Also consider, as stated by Medela, if you are reusing someone else’s pump the warranty is automatically void.
Links (Active on Jan 2012)
http://www.fda.gov/medicaldevices/productsandmedicalprocedures/homehealthandconsumer/consumerproducts/breastpumps/ucm061939.htm#4Why does the FDA tell consumers that breast pumps can’t be reused? | UTSanDiego.com.
Can you reuse a breast pump safely? What is Medela hiding? | Medical Noise.
Are used breast pumps a no-no?
