Using a Breast Pump

Whether a breastfeeding mother plans to return to work away from home or simply needs a break, using a breast pump is always an option. It is an easy, efficient way to maintain milk supply when a parent can't be with their 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 the emotional toll that expressing milk may have, 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. Via the Affordable Care Act, your health insurance must cover a free electric breast pump. Even if you plan to pump only occasionally, take advantage of this benefit.

Mothers who are going back to work outside the home will probably require a double electric pump. Mothers who have premature or ill babies in the NICU, or an older baby that is hospitalized and not able to nurse, may need a hospital-grade pump to simulate feeds the baby isn't getting and to stimulate milk production and supply.

When to Pump

This really depends on the situation. If a parent is pumping for a single "relief bottle," where someone else will be feeding the baby at a later time, they can generally pump first thing in the morning. Milk supply peaks between 1 a.m. and 5 a.m., but this does not mean waking up to pump during that time.

There is plenty of milk to pump after the first morning feed and there will be plenty left for the next feeding. Most babies feed from both breasts, so pumping both breasts after a feeding is sufficient, even if the breasts don't feel very full.

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 while she's away, 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.

To build a bank, pump daily, after the first breastfeed of the day, and store that milk. This way, there is less stress because there is a nice stock already there and ready to go. Whatever milk is pumped during the workday can be added to the bank.

There are many ways to safely bank milk, such as with freezer bags or milk collection bottles. One concept 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. It eliminates a lot of guesswork as to which was the oldest or most recently stored milk.

Freezer bags are handy and don't take up much room, but many parents 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.

How to Pump

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.

However, it is important to pump for 15 minutes, even if the milk stops flowing. The pumping stimulates the breasts to maintain milk supply. Some moms (not all) notice that their supply decreases over time if they only pump a few minutes until the flow stops.

Here is a standard plan for efficient double electric pumping. This plan should help maintain milk supply.

• 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.
• Simulate what the baby does or the milk supply could drop. 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.
• Pump for 7 minutes. You may see nothing coming out at first and this is normal. A few minutes into the pumping, you will have a "let-down," where the milk starts to flow.
• Stop the pump for 1 minute and massage the breast, coming 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 and then store the milk.

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

Best Bottles to Use

This really depends on the baby. Some babies are absolutely fine with inexpensive bottles and others need highly specialized ones. Avent and Dr. Brown's bottles are popular for avoiding gas. Many breastfeeding babies do well with Playtex Drop-Ins or Second Nature bottles.