Lactation is a powerful tool for improving health trajectories and promoting reproductive justice. Multiple new human milk–expression technologies are available. Although direct feeding is optimal and feasible in many circumstances, understanding human milk–expression technology and counseling patients appropriately represents one of the ways physicians can support patients in meeting their feeding goals. Breast pumps and breast pump accessories may help patients establish and maintain breastfeeding, but these technologies continue to evolve and are not always intuitive. The core components of a pump are the attachment at the breast, valves, tubing, motor, device programming, and reservoir. Whereas closed systems can be used by multiple patients, open systems are single-user and they are not able to be sterilized. Mobile pumps may help support breastfeeding individuals who are unable to remain stationary for the time necessary to express milk. Nonelectric pumps represent an important adjuvant technology. There are a wide variety of pump accessories that may help patients overcome specific breastfeeding challenges. Obstetricians remain uniquely positioned to support patients in achieving their lactation goals, which is enhanced by familiarity with the supportive technologies available.