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Pumping Breast Milk – Everything You Need to Know!

Monday, February 15, 2021

As Lactation Consultants, we are frequently asked what pump we would recommend. This is a difficult question to answer as the type of pump that is best will depend on your reason for pumping breast milk.

In this post, we will explore the types of pumps available, situations that require pumping, and what kind of pump would work best for that particular situation. We’ll end with some practical tips to increase your pumping success.

Types of Pumps

There are manual and electric breast pumps available for purchase. Rental electric breast pumps are also available; they are the highest quality pump.

Manual pumps (also called hand pumps)

Manual pumps are the least expensive option for pumping breast milk (around $25-40USD). They are powered by your hand, no electricity required. Women appreciate their convenient size and simplicity of use, but the repetitive hand motion can be tiring.

Manual pumps work well for occasional milk collectionIf your baby is breastfeeding effectively and you have established a good milk supply, a manual pump will maintain your supply (as long as you are replacing less than half of your baby’s daily feeds with pumping).

Electric pumps

The price of electric pumps varies widely.

Inexpensive electric pumps (40-60 USD) may work for breastfeeding mothers who want to pump breast milk occasionally. In most cases, though, they do not provide enough stimulation to maintain your milk supply unless your baby is also feeding at the breast.

Some electric pumps have a battery-powered option. Electric pumps powered by battery tend to work well only when the batteries are fresh. We recommend using this type of pump plugged into an electrical outlet.

The more expensive electric pumps for purchase (150-350 USD) work well for women who have an established milk supply but have to be away from their babies for extended periods (e.g., mom or baby are hospitalized, or mom has returned to work full time). The electric pumps in the higher price range will be the most effective.

If your baby is not at the breast at all, we strongly recommend the rental electric pump option, especially in the beginning. It is the highest quality breast pump. Depending on your milk production, you may be able to switch to a different pump later on.

If you rent a hospital grade pump, you will need to purchase a pump collection kit, the tubing, and flange that connects to the pump. Some pumps allow you to use 2 kits so that you can pump both breasts at once. This is a bonus because it cuts your pumping time in half. “Double pumping,” as it is called, can also lead to a higher overall milk volume.

If you prefer to have a hand free while you pump, check out one of the hands-free options now available.

Choosing the Right Pump

A breast pump is not a prerequisite for breastfeeding. Some mothers will never need to own one. For occasional milk collection, you may find that hand expression works even better than a pump, and it is free! Learn how to do it in this post.

There are other circumstances when a breast pump is very valuable.

– Baby not latching after birth

When a baby isn’t able to latch, it can be very stressful for a new mother! One mom told us, “Breastfeeding is your first job as a new mother, and when my baby wouldn’t latch, I felt I was failing at motherhood.”

If your baby does not latch in the first hour after birth, we recommend beginning to hand express. Hand expression will tell your body to begin making the milk process. If your baby has still not latched by 6 hours after birth, start pumping with an electric breast pump. Most hospitals will have an electric pump available for you to use.

If your baby is still not latching once you go home, we recommend renting an electric pump. A combination of hand expression and pumping will give your body the best stimulation until your baby can begin to breastfeed. The good news is that most babies who do not latch initially will eventually learn to breastfeed. The most important thing you can do is to pump and develop a plentiful milk supply.

Baby is born prematurely or needs special medical care

Babies that are born early or in need of medical attention often go to a special care nursery. In most cases, this means that mom and baby will be separated, at least for a time. If your baby is unable to feed at the breast, you will need to pump to establish a milk supply.

Again, we recommend beginning hand expression within an hour after delivery and pumping with an electric pump within 6 hours of birth. Breast stimulation gives your body the message that your baby has survived and will be needing your milk.

– Milk supply needs a boost

If your baby has been latching and sucking effectively but your milk supply needs a boost, try breastfeeding more frequently. Having your baby at the breast is usually more effective and more enjoyable than pumping.

If your baby, however, does not seem to suck effectively, pump for as many minutes as you can manage after breastfeeding (without sacrificing time to eat or go to the bathroom!). A high quality breast pump would work best. You should notice a difference within a couple of days. If you do not notice an increase in your milk supply, see your healthcare provider or an International Board Certified Lactation Consultant. There may be an underlying medical issue for yourself (e.g.: high blood pressure, low thyroid or retained placental fragments) or something underlying with your baby (e.g.: tongue-tie).

– Return to Work

Some women assume they will need to wean when they return to work. Many mothers, however, continue to breastfeed and work either full or part-time. The key is pumping during separations to keep up your milk supply. The health benefits of breastmilk will protect your baby against the new germs at daycare.

The type of pump we would recommend depends on your milk supply and the length of time you will be separated.

  • If your baby is very young and you are returning to work full time, we’d suggest using an electric pump of higher quality.·
  • If you have a good milk supply and will be separated for only a few hours at a time, hand expression, a manual pump, or any electric pump should be adequate.

– Exclusive pumping

There are a wide variety of reasons women may choose to pump exclusively. It is a lot of work, and women need support and recognition for the incredible job they are doing. We consider it a form of success, not a failure!

Regardless of the situation, it is essential to know that pumping breast milk is a valuable gift with benefits for both your baby and your own health.

A high quality electric pump is the best choice for mothers who exclusively pump.

There are many different reasons for pumping breast milk. This post will help you discover the right pump for your situation.

Maximizing the Effectiveness of Pumping

– Encouraging your “let-down” reflex

A hormone called oxytocin is responsible for your let-down. It causes the tiny muscles that surround milk-making cells to contract, squeezing the milk towards the nipple.

Some mothers begin to leak with let-down; others may feel a heavy or a tingling sensation. Still, others do not notice any changes other than an increased flow of milk.

Try using one of these suggestions to encourage your let-down before you pump:

  • Look at a photo or think of your baby.
  • Hold a piece of baby’s clothing or a blanket that has your baby’s smell.
  • Place a warm, moist cloth over your breasts.
  • Gently massage your breasts.
  • Roll your nipple between your index finger and your thumb.

– Pumping more milk

When babies breastfeed, they use both compression and suction. Breast pumps work via suction only. Combining pumping (suction) and hand expression (compression) is recommended to help you get the most milk. Learn how to do “hands on pumping” in this post.

A study showed that warming the breast pump flange (the part that touches the breast) before pumping helped women to pump more milk more quickly.

– How often to pump

If you are exclusively pumping, it’s best to express your milk every 2 or 3 hours during the day and at least once during the night (a minimum of 8 – 12 times in 24 hours). Night pumping is especially important as prolactin, a hormone that helps to make milk is higher at that time. Avoid going longer than 5-6 hours without pumping if you can, especially in the early weeks.

– How long to pump

If your baby is not latching, we’d suggest pumping for about 15 minutes on each side until your milk supply is established. Studies show that a healthy baby will drink about 80% of their feeds volume within 5 minutes. It takes longer with a pump. An effective breast pump removes about 85% of the available milk in 15 minutes. Double pumping (pumping both breasts at the same time) will cut your pumping time in half giving you a few extra precious minutes to rest or cuddle your baby.

Once your milk supply is established, pumping breast milk for a couple of minutes after the last drop of milk is the general recommendation.

Note: Everyone’s milk supply is different, so, of course, adjust your pumping time based on your milk supply.

Pumping Breast Milk Should Not be Painful

If you are having pain during pumping, something is not right. Pumping should not damage your nipples or make you curl your toes or hold your breath.

Check the size of your pump’s flange, the part of the kit you hold against your breast. Be sure to center your nipple in the opening of the flange.

Most pump kits come with a 24mm size, but not all women have the same size of nipples! A good fit will help pumping to be more comfortable.

  • If your nipple rubs against the sides of the flange, causing discomfort, the flange is too small.
  • If some of your areola (the brown area around the nipple), is drawn into the flange, the flange is too large.
  • A well-fitting flange allows your nipple to fit comfortably when drawn into it.

If you have the correct size of breast shield and pumping breast milk continues to be painful, try adjusting the suction. Start on the lowest setting and gradually increase. If it becomes painful, decrease the suction.

If these tips are not helpful, please see a breastfeeding specialist in your area for assistance.

When Not to Pump

In the first week or two after birth, if your baby is nursing well, try to avoid pumping when your breasts are overly full. Your milk supply is regulating itself during this time. Extra stimulation from pumping can prolong the discomfort of oversupply. Instead, nurse frequently. Your breasts will soon adjust to the amount your baby is drinking.

We would also discourage you from pumping as a way to tell how much milk you produce. The amount you can pump is NOT a good indication of your milk supply. Your baby is much better at accessing your milk than any pump. Remember, a baby’s suck uses both compression and suction. Breast pumps work by suction only.

Before You Buy

Before buying a pump, check to see which company makes it. Look for one that is made by a company that solely manufactures breast pumps and other breastfeeding equipment. Those that have ties to formula companies may not have your best interest at heart. KellyMom explains more in this post.

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References:

  1. American Academy of Pediatrics. “Expressing Breastmilk On The Job.” HealthyChildren.org, 2009, www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Expressing-Breastmilk-on-the-Job.aspx
  2. Bonata, Kelly. “Establishing and Maintaining Milk Supply When Baby Is Not Breastfeeding” KellyMom.com, 16 Jan. 2018, https://kellymom.com/bf/got-milk/basics/maintainsupply-pump/
  3. Bonata, Kelly. “Resources: Working & Pumping Tips • KellyMom.com.” KellyMom.com, 27 Mar. 2018, https://kellymom.com/bf/pumpingmoms/pumping/bf-links-pumping/
  4. Bonata, Kelly. “Your Rights As a Breastfeeding Employee” KellyMom.com, 8 Feb. 2018, https://kellymom.com/bf/pumpingmoms/employed-moms/your-rights-as-a-breastfeeding-employee/
  5. Centers for Disease Control and Prevention “How to Keep Your Breast Pump Kit Clean: The Essentials”,www.cdc.gov. 2019, www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/breastpump.html
  6. Fok D, et al. “Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial.” Singapore Med J. 2019. https://www.ncbi.nlm.nih.gov/m/pubmed/29876577/
  7. Hayes, Donald K., et al. “Comparison of Manual and Electric Breast Pumps Among WIC Women Returning to Work or School in Hawaii.” Breastfeeding Medicine, vol. 3, no. 1, 2008, pp. 3–10., https://www.ncbi.nlm.nih.gov/pubmed/18333763
  8. International BreastFeeding Centre “Expressing and Pumping Milk.”, 2009, https://ibconline.ca/information-sheets/expressing-breast-milk/
  9. Kent, Jacqueline C., et al. “Effect of Warm Breastshields on Breast Milk Pumping.” Journal of Human Lactation, vol. 27, no. 4, 2011, pp. 331–338., https://www.ncbi.nlm.nih.gov/pubmed/22048756
  10. La Leche League International, “Pumping Milk.” www.llli.org. 2019, https://www.llli.org/breastfeeding-info/pumping-milk/
  11. Meier, P P, et al. “Which Breast Pump for Which Mother: an Evidence-Based Approach to Individualizing Breast Pump Technology.” Journal of Perinatology, vol. 36, no. 7, 2016, pp. 493–499., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920726/
  12. Mohrbacher, N. “To Pump More Milk, Use Hands-On Pumping.” Nancy Mohrbacher.com, 27 June 2012, www.nancymohrbacher.com/articles/2012/6/27/to-pump-more-milk-use-hands-on-pumping.html
  13. Newborn Nursery “Maximizing Milk Production.”, Stanford Medicine, 2019, https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html  
  14. Office On Women’s Health “Pumping and Storing Breastmilk.” Womenshealth.gov, 9 July 2018, www.womenshealth.gov/breastfeeding/pumping-and-storing-breastmilk
  15. Walker, Marsha. “On the Trail of Code Compliancy” KellyMom.com, 4 Feb. 2018, https://kellymom.com/bf/advocacy/trail-of-code-compliancy/

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