Isabella Ferraris

The Evolution of the Breast Pump & A Mother's Dependance on it

The breast pump is no longer seen solely as a medical device, but an essential on baby registries across the country. As Jessica Martucci, a historian of medicine at University of Pennsylvania states, “The breast pump became this almost indispensable part of what it means to have a baby.” Not only has the main purpose and technology of the breast pump changed, so has a mother's profound dependance on one. From the mid 19th through the late 20th century, mothers used breast pumps to relieve minor, temporary difficulties in relation to their breasts and their babies’ strength (1). Furthermore, breast pumps were not always practical or easy to use compared to present day. Today, breast pumps are an ubiquitous necessity mothers rely on throughout their day to day life. 

Mothers are reliant on breast pumps today due to the fact that they have only become more practical than they used to be. Infant feeding has become increasingly more effortless with new technological advancements that have emerged since the mid 19th century. Breast pumps have allowed most mothers to pump milk faster and more efficiently. Women say that although their milk supplies are great and the babies are satisfied at their breast, they can’t seem to get the pump to work efficiently. This could be due to a multitude of reasons. Many mothers are going back to work, stress and anxieties are high, and they’re getting used to their new reality with an infant (2). For these mothers who are having difficulties filling the container attached to the pump with milk, it could be argued that for them, a breast pump is not an indispensable item they can’t live without. 

Before the breast pump was invented or became widely available, women used wet nurses, who were “women who breastfeed another woman’s child.” This began in colonial America as a wet nurse became a whole profession where contracts and laws were implemented to regulate its practice. Families would hire a wet nurse to either reside in their homes or send the infant to live in the nurse’s home and pick them back up after he or she had been weaned. Additionally, having a wet nurse became a form of “status” as many wet nurses had to leave their own children to feed another infant. Wet nurses were selected with the utmost care as it was believed that the quality of milk determined an infant’s future “disposition (3). Many Ads were put out in newspapers to show what mothers wanted in terms of what they looked like, and what they'd pay (Figure 1).  Southern wet nurses were often black while Northern wet nurses were often immigrants (Figure 2). This continued until bottle feeding became possible in the 1920’s. With an alternative feeding method in place, wet nurses slowly began to decline into extinction (4). 

Figure 1: Ads were placed in newspapers for wet nurses – above from Baltimore Sun 1858

Figure 2: Wet Nurses in the 18th & 19th Century 

The beginning of the breast pump began with the first U.S. patent for one presented on June 20th, 1854 by Orwell H. Needham in New York (Figure 3). It used hand operated bellows in order to produce suction and get milk out of a woman’s breast. The bellow was fitted into a box, which also may have been used to pack other parts of the pump when not in use. Along with that was a flexible tube the projects from the injunction valve, connecting the bellow pump with the shield. The pump contained an indian rubber cup made to fit over the nipple (5). The purpose of this newly described pump was to give patients with engorged breasts or weak infants the ability to operate it themselves. At the time, the only way for a mother to extract breastmilk to an infant was by doing it manually with her hands. 

Figure 3: O.H. Needham's Patent for Breast Pump – 1854

Another improvement in the breast pump was in 1898, when John H. Hoover added a spring to the vacuum technology to make the suction more gentle (Figure 4). He stated, “to provide a breast pump not so sudden in its action as to produce pain when the breast pump is distended and sore and at the same time produce a continuous flow of milk accompanied with the pulsating movement which occurs when an infant is at the breast.” Although this new invention gave their breasts more of a relief from all the soreness, it was still not all that comfortable. Many of those who were inventing these pumps were not women or doctors, so they did not know the level of comfort that mothers needed. As said on Romper, a leading digital destination for millennial moms, “I can’t help but think that if a female had been part of this creation process, comfort would’ve been a priority from the start." (6) 

Figure 4: J.H. Hoover's Patent for Spring Vacuum Breast Pump Breast Pump – 1898

Technological advancements continued to increase as the 20th century began.  In 1908, a “hands free” breast pump was introduced, where breastfeeding could now be done with only one hand with the development of two bulbs to a single pump (7). Another patent in 1910, created by H.B. Cunningham, was created that shows a full-torso device that strapped onto a mother’s chest under her clothes (Figure 5). This was seen as a medical device but more to “avoid unpleasant and embarrassing situations” while in public and nursing (8). As mentioned earlier, the pumps from this time often did not take into account the basic physiology of breastfeeding or comfort. This is likely due to the fact that these pumps were invented by engineers or broad inventors that were men – as opposed to doctors or medical workers. For mothers in the late 19th and early 20th century, breast pumping was tedious, time-consuming and also uncomfortable. As shown through multiple advancements, practicality in these breast pumps was still not the case. It wasn’t until the early 20th century that the growth of hospitalized childbirth and postpartum care led to the significant shift of manual to motorized breast pumps (9). 

Figure 5: H.B. Cunningham's Patent for a Full-Torso Breast Pump – 1910

The most effective electric breast pump was produced in the 1920’s with a collaboration of two men – Edward Lasker, a German immigrant who was working for a cow milking manufacturer, and Isaac Abt, an American pediatrician (10). Lasker had the idea to build a design similar to what is used for the milking of cows, and Abt ran with it and asked Lasker to build something he could use at his hospital in Chicago for “premature infants who were too weak to nurse." (11) The advantages of this new device was that it could take as fast as three to four minutes to empty a breast, one pump will do the work of six nurses, relief of pain to mothers who had engorged breasts, and more. On the other hand, the recent electric pump also had its downsides, – it was loud, large, and required a nurse there to help utilize it. In contrast to breast pumps today, it did not offer cycles of suction and release, but instead exerted continuous, no mercy suction (12). Another contrast was that compared to the use of the breast pump today, this newly released electric pump was only used in hospitals as a medical device. Additionally, these devices were very expensive and most women could not afford to pay thousands of dollars for one. Women could rent and return it instead, but this was still known to be out of many mothers’ price budgets (13). Many physicians thought that manual expression of the breast pump was better for women to use at home as it was free, could be easily learned by the mother, carried little risk of contamination, and by teaching it, doctors and nurses could educate women on how their bodies worked. The notion that the pump was a “necessity” to mothers of infants did not exist yet as it was not widely accessible for them to take home a motorized pump as they have the opportunity to do today. 

As the 1930’s and 1940’s rolled around, there was a decline in breastfeeding as many women viewed it as old-fashioned and thought of nursing babies as being “tied down.” World War II also played a role in this decline as many women's roles had gone from homemaker to worker outside the home, which led to infants being fed formula instead of breast milk. By the 1950’s, most households included babies who drank formula from bottles (14). During the 1960’s, commercial formulas became popular and by the mid 1970’s they had all replaced the standardized evaporated milk formulas. The percentage of women who breastfed reached an all time low at this time partially because of the belief that formulas were “medically approved” to provide optimal nutrition for young infants. By 1971, about 76 percent of birth mothers never breastfed their infant even one time (15). To encourage acceptance of formula feeding,  many formula companies were providing inexpensive or even free formula to hospitals in “ready-to-feed” bottles. Mothers who witnessed how well their infants accepted these prepared formulas were often convinced to continue this practice at home. Although pediatricians did not necessarily persuade mothers not to breastfeed, it was not strongly encouraged, as it is today (16). 

  It is important to note that despite the universal acceptance of formula feeding, a small group of mothers who continued to breastfeed their infants expressed that they were pushing against hospital policies and culture norms. This was known as the “Back to breast” movement and dated back as early as the 1950’s, with middle-class and college educated women as the base of the population. These women gathered their beliefs based on both scientific and cultural ideas about maternal instinct, infant development, and more (17). Although these groups were passionate, there were not many additional technological advancements of the breast pump until the late 20th century. 

It was in 1991 that the first electric, non-hospital use breast pump was brought to the United States. Medela, a Swiss company that is still known as a leading manufacturer of breast pumps today, founded this new pump that was vacuum-operated (18). It began to produce heavy marketing for this new device, which was a portable, double electric breast pump. Following that, in 1996 Medela came up with its prevailing “Pump in Style,” which was marketed towards “active and working” mothers. This was revolutionary as it included everything a mother on-the-go needed – expressing, storing, cooling, and transporting their milk (19). There couldn’t have been a better time for the invention of this breast pump as by 1990, almost 50 percent of women were working outside the home (20). This advancement was the start of women having more balance in their lives when it came to working and motherhood. For most of the mid 19th century through the late 20th century, the breast pump’s main purpose was for temporary, short term crises. Such crises included supplying milk to an infant who was too weak to nurse, strengthening milk supply, giving damaged nipples a time to heal, and sustaining lactation when a mother was ill. But moving into the 21st century, the uses and reliance of pumps begin to change with the newly invented at-home ones. As they became accessible to women around the country, the use of breast pumps developed – women thought they ought to have them in their postpartum days. Reasons included returning to work, sharing feeding responsibilities with a partner, or being on-the-go in public (21). In 1993, Florida and North Carolina put laws in place that granted women the freedom to breastfeed in any public or private location (22). Moreover, because pumps were now portable and electric, they gave mothers the hope that they were able to return to work while continuing to reach their breastfeeding goals.

Many mothers found it hard to maintain their breastfeeding schedules alongside trying to maintain their careers in the late 20th century and early 21st century. Many workplaces impeded on breastfeeding as many women could not do it in private, as often, or have a place to store and maintain the milk supply (23). This slowly began to change as the century went on, as US breastfeeding laws steadily increased from 1993 to 2004. Beginning in 1998, laws were executed that supported breastfeeding in the workplace. Minnesota pronounced a law that said that employers must give a break time as well as a private space for mothers to breastfeed (24). But, in a 2001 study examining women’s attitudes toward employment and breastfeeding, 43% of mothers reported that they found it difficult to integrate breastfeeding and employment (25). Women still didn’t feel fully supported by their employers to pump while being in a work environment. It was in 2010 when breastfeeding laws started to increase for mothers across the country. Effective March 23, 2010, the Patient Protection and Affordable Care Act modified the FLSA to require that employers give women who were nursing a reasonable break time to breastfeed one year after having a baby(section 7(r) of the Fair Labor Standards Act). Along with that, the amendment required that employers also have a place where nursing employees can privately pump. This had to be a place other than a bathroom, as well as private from coworkers and the public. The privacy began to ease mothers into pumping after having a baby as opposed to before these accommodations, where they couldn’t have this seclusion. The electric pumps allowed them to do this fast and efficiently so that way they could go back to work and still continue to meet their career goals. This was furthered in 2022 when a Pump For Nursing Mothers was enacted. On December 29, 2022, President Biden signed the Consolidated Appropriations Act, 2023 into law – which includes the “Pump Act.” This law extended to more nursing employees the rights to get a break time to pump and a private place to pump at work. This extension was also made to agricultural workers, teachers, taxi drivers, and more (26).  Today, a mother of a multitude number of careers can breast pump during working hours in a private space. 

As compared to the late 20th and early 21st century, mothers today are constantly feeling like the indispensable breast pump is something they “cannot live without.” Not only can they balance having a career and being able to provide nutrients for their babies, they can also travel and live separate lives aside from just being a mom. The breast pump has made that possible. A mother can now leave her husband many bottles of her breast milk to feed to their infant while traveling as well as continue to pump while gone, even on a plane. TSA breast pump policy allows passengers to bring a breast pump either in their checked bag or their carry on (27). In addition, it takes an average of 20 to 30 minutes to pump, letting mothers do it quickly on-the-go. Although this has not always been the case, technology as well as other factors have made it possible for breast pumps to become a crucial and dependable item for mothers in terms of infant necessities. As Katherine Harmon Courage states in an article for Smithsonian magazine, “For a multitude of reasons, behind closed office, closet and bathroom doors, millions of people everyday are hooked up to electric motors, pumping breastmilk to feed their babies.” (28) 

Figure 6: Early Breast Pump Ad

Citations

(1) Smithsonian Magazine. "The Sucky History of the Breast Pump." Smithsonian.com, Smithsonian Institution, 12 Jan. 2016, https://www.smithsonianmag.com/innovation/sucky-history-of-the-breast-pump-180980653/.

(2) Exclusive Pumping. "Flying as an Exclusive Pumper: How to Pump on a Plane with Your Baby." Exclusive Pumping, 9 Oct. 2019, https://exclusivepumping.com/flying-as-an-exclusive-pumper-how-to-pump-on-a-plane-with-your-baby/.

(3) Lederman, Rena. "A Concise History of Infant Formula: Twists and Turns Included." Contemporary Pediatrics, 14 June 2016, https://www.contemporarypediatrics.com/view/concise-history-infant-formula-twists-and-turns-included.

(4) Meikle, William. "The Physiological Basis of Breastfeeding." National Center for Biotechnology Information, U.S. National Library of Medicine, 1 June 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684040/#bib6.

(5) "Improvement in Breast-Pumps." Google Patents, filed 14 Apr. 1855, issued 28 Feb. 1856, https://patents.google.com/patent/US11135.

(6) Kriss, Jennifer. "The History of the Breast Pump Is Surprisingly Fascinating." Romper, 25 Aug. 2016, https://www.romper.com/parenting/history-of-the-breast-pump.

(7) Central Coast Childbirth Network. "The Evolution of Breast Pump Technology." Central Coast Childbirth Network, 18 Apr. 2019, https://www.centralcoastchildbirthnetwork.com/post/the-evolution-of-breast-pump-technology.

(8) "Breast-Pump." Google Patents, filed 12 Feb. 1909, issued 15 Feb. 1910, https://patents.google.com/patent/US949414.

(9) University of Virginia School of Nursing. "Flashback: Breast Pumps." University of Virginia School of Nursing, 29 Mar. 2017, https://www.nursing.virginia.edu/news/flashback-breast-pumps/#:~:text=Prior%20to%20the%201920s%2C%20the,expression%20and%20produced%20poorer%20results.

(10) Tartajubow, Nicolas. "Edward Lasker and the Electric Breast Pump." The Patented Electrical Appliance Blog, 26 Nov. 2019, http://tartajubow.blogspot.com/2019/11/edward-lasker-and-electric-breast-pump.html.

(11) Pound, Charles E. "A Short History of Breastfeeding in the United States." National Center for Biotechnology Information, U.S. National Library of Medicine, 1 May 2006, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1654674/?page=1. 

(12) Smithsonian Magazine. "The Sucky History of the Breast Pump." Smithsonian.com, Smithsonian Institution, 12 Jan. 2016, https://www.smithsonianmag.com/innovation/sucky-history-of-the-breast-pump-180980653/.

(13) Kriss, Jennifer. "The History of the Breast Pump Is Surprisingly Fascinating." Romper, 25 Aug. 2016, https://www.romper.com/parenting/history-of-the-breast-pump.

(14) Labbok, Miriam H., and Wendy L. Brodribb. "Breastfeeding and the Law." Journal of Human Lactation, vol. 24, no. 1, Feb. 2008, pp. 18-32, https://journals.sagepub.com/doi/epdf/10.1177/0890334408324452.

(15) Labiner-Wolfe, Judith. "History of Infant Feeding." National Center for Biotechnology Information, U.S. National Library of Medicine, 1 Apr. 2006, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448139/.

(16) Lederman, Rena. "A Concise History of Infant Formula: Twists and Turns Included." Contemporary Pediatrics, 14 June 2016, https://www.contemporarypediatrics.com/view/concise-history-infant-formula-twists-and-turns-included.

(17) Apple, Rima D. Vitamania: Our Obsessive Quest for Nutritional Perfection. University of Chicago Press, 2015, https://press.uchicago.edu/ucp/books/book/chicago/B/bo21163141.html.

(18) Allen, Lawrence. "Baby Food." The New Yorker, 19 Jan. 2009, https://www.newyorker.com/magazine/2009/01/19/baby-food.

(19) Medela AG. "Medela Company History." Medela AG, 2013, https://www.medela.co.uk/dam/medela-uk/company/documents/general/Medela-History_EN_-2013.pdf/null.pdf?uuid=jcr:8a38954f-3e0a-43c5-acd3-fed6a4fada83.

(20) Simmons, Rachel. "Building a Better Breast Pump." Wired, 24 Apr. 2017, https://www.wired.com/2017/04/building-a-better-breast-pump/.

(21) Smithsonian Magazine. "The Sucky History of the Breast Pump." Smithsonian.com, Smithsonian Institution, 12 Jan. 2016, https://www.smithsonianmag.com/innovation/sucky-history-of-the-breast-pump-180980653/.

(22) Barrera, Christina M. "A Review of Breastfeeding Legislation in the United States." National Center for Biotechnology Information, U.S. National Library of Medicine, 25 Oct. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860490/#:~:text=The%20first%20breastfeeding%20law%20was,any%20public%20or%20private%20location.

(23) Joffe, Naomi. "The Breastfeeding Rights of Employed Mothers: A Global Health and Human Rights Issue." American University Washington College of Law, Health Law and Policy Brief, vol. 3, no. 1, 2009, pp. 20-28, https://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1357&context=jgspl.

(24) Barrera, Christina M. "A Review of Breastfeeding Legislation in the United States." National Center for Biotechnology Information, U.S. National Library of Medicine, 25 Oct. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860490/#:~:text=The%20first%20breastfeeding%20law%20was,any%20public%20or%20private%20location.

(25) Joffe, Naomi. "The Breastfeeding Rights of Employed Mothers: A Global Health and Human Rights Issue." American University Washington College of Law, Health Law and Policy Brief, vol. 3, no. 1, 2009, pp. 20-28, https://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1357&context=jgspl.

(26) U.S. Department of Labor, Wage and Hour Division. "Break Time for Nursing Mothers." U.S. Department of Labor, 2010, https://www.dol.gov/agencies/whd/pump-at-work.

(27) Transportation Security Administration. "Breast Pumps and Travel." Transportation Security Administration, https://www.tsa.gov/travel/security-screening/whatcanibring/items/breast-pump.

(28) Smithsonian Magazine. "The Sucky History of the Breast Pump." Smithsonian.com, Smithsonian Institution, 12 Jan. 2016, https://www.smithsonianmag.com/innovation/sucky-history-of-the-breast-pump-180980653/.