Using A Breast Pump

Whether a breastfeeding mother plans to return to work or if she simply needs a break, using a breast pump is always an option. It is an easy, efficient way to maintain milk supply when she can't be with her baby. Many moms worry about using a breast pump, from efficiency, comfort and accessibility to affordability, ease of cleaning and ease of use. However, with the right plan, pumping can be a stress-free and empowering experience. If you have any concerns about breast pump use or simply the emotional toll that expressing milk may have on you, you should speak with a professional, such as a lactation consultant

Types of Breast Pumps

There are many different types of pumps on the market -- manual, single or double electric, hospital-grade -- and it is essential that you obtain the most appropriate pump for your situation. Mothers who feel they will only pump occasionally would be fine with a manual pump; those who are going back to work and need something more powerful would probably require a double electric; mothers who have premature or ill babies in the NICU, or an older baby that is hospitalized and not able to nurse, would need a hospital-grade pump to simulate feeds the baby wasn't getting and to stimulate milk production and supply.

When Do I Pump?

This really depends on the situation the mother is in at the time. If she is pumping for a single "relief bottle", where someone else will be feeding the baby at a later time, she can follow this plan: Milk supply peaks between 1 a.m. to 5 a.m. This does not mean that the mother has to wake up to pump during that time. However, the best time to pump is after the first realistic morning feed (most moms like for the sun to be up). There is plenty of milk to pump after that feed and there will be plenty left for the next feeding. A mother can choose to double-pump if she feels that she's still very full after the baby has nursed. Otherwise, pumping the breast from which she did not feed is sufficient.

For the mother who goes back to work and wants to continue breastfeeding, the plan is different. To maintain a good milk supply, she should pump frequently, generally at the times where the baby would be feeding. In most cases, by the time the mother returns to work, her baby is on a much more predictable schedule and this is a fairly easy routine to follow. It is wise to begin building a bank of milk in the freezer about a month before returning to work. To build a bank, the mother should pump daily in the morning and put it directly into the freezer. This way, there is less stress because there is a nice stock already there and ready to go. The mother can then bring home whatever milk she's pumped during the workday and add to the bank.

There are many ways to safely bank milk such as with freezer bags or milk collection bottles. However, one of the most fantastic concepts in milk storage is the Mother's Milk Mate. It is a rack designed for the refrigerator or freezer and the first bottle in is the first out, just like a vending machine, so it eliminates a lot of guesswork as to which was the oldest or most recently stored milk. The freezer bags are handy and don't take up much room, but many women feel that they are constantly looking at the dates to figure out which bag to use and many of them inevitably end up forced to the back of the freezer when new food is bought. Too many mothers have told stories of having weaned their child and a year later found bags of milk when they were cleaning out their freezers. Breast milk has been called "liquid gold" and it's a shame when it's lost.

How Do I Pump?

Here is a video with appropriate pumping instructions.

The process of pumping is simple. If a mother is using a hand pump, it's a bit more work than using an electric pump, but the plan is still the same (although the timing varies slightly -- 10 to 20 minutes). It is not necessary to sit and pump until the last little drop is forced out. We need to simulate a typical feed and approximately 10 to 15 minutes (electric) should be sufficient. Here is a standard plan for double electric pumping, which is absolutely necessary to maximize levels and decrease the time spent:

• Read the instructions for using and cleaning the pump.
• Wash your hands before using the pump.
• Center the nipple in the flanges (the cone-like parts that go on the breast), lean forward slightly and turn the pump on. Keep the pump at slow speed and low suction. Many women find this advice confusing because they assume that high speed and high suction will get the most milk out the fastest way, but this couldn't be further from the truth. The baby's suck is slow and low, not fast and high, and it is too jarring to the mother's body to pump at such an intense setting. We need to simulate what the baby does and milk supply could drop severely if we don't adhere to these "rules."
• Pump for 7 minutes. The mother may see nothing coming out at first and this is normal. About 5 minutes into the pumping, she will have a "let-down," where the milk starts to flow.
• Stop the pump for 1 minute and massage the breast, combing down from the armpit to the nipple, all around. This gives the breast a break and allows it to reset, in a sense.
• Pump for 7 more minutes.
• Store the milk.

Rules of Storing Milk

Here are the general guidelines for storing expressed milk.

How to Prepare Pumped Milk

Here are the general guidelines for handling expressed milk.

If My Baby Is in the NICU

If you have a low-birth-weight premature baby, you should speak with a lactation consultant about techniques to express milk with low bacteria counts.

Which Bottles to Use?

This really depends on the baby. Some babies are absolutely fine with cheap five-and-dime bottles and others need highly specialized ones. The Avent and Dr. Brown's bottles are popular for avoiding gas, but the favored bottles for breastfeeding babies are either the Playtex Drop-Ins or Second Nature (the nipple mimics the mother's and the baby has to work the same amount as at the breast, making the breast-to-bottle transition smooth.)