A Babe’s Guide to Pumping

by Fleur Bickford, BSc., RN, IBCLC | November 30, 2011 8:21 pm

Whether pumping at work, pumping at home for the occasional night out, or pumping to protect milk production while managing breastfeeding challenges, many mothers these days use a breast pump at some point during their nursing relationship. Regardless of the reason, it’s important to have good information, so below are tips to help you ensure that things go smoothly.

1. Remember that what you are able to pump is NOT an indicator of how much milk you have.

Many moms worry when they are pumping that their milk production is low because they feel like they are not pumping enough. It is very important to remember that the amount you are able to pump is NOT an indicator of how much milk you have. We respond very differently to a pump than we do to our babies. When you are nursing your baby and can see, hear and smell her, and feel her skin against yours, the hormones released help you relax and trigger your milk to let down. The cold hard plastic of a breast pump doesn’t produce the same kind of hormonal response. Some women just don’t let down well for a pump despite the fact that they have more than enough milk to feed their baby.

2. Make sure you have the right type of pump for your needs.

The type of pump you need depends on what you are going to be using it for. If you’re just pumping for occasional feedings while you have a night out or go to an appointment, then most women do well with either hand expression[1], a manual pump, or a single electric pump. If you are pumping at work, then a double electric pump is a good investment. If you are pumping in the first couple of weeks after birth due to breastfeeding challenges, a hospital grade pump is needed. They are the only pumps designed to establish milk production in the early weeks when a baby is not nursing, or not nursing effectively. Hospital grade pumps are usually available as a rental from hospitals, International Board Certified Lactation Consultants (IBCLCs), medical supply stores etc.

3. Hands on for best results!

If you are having challenges with breastfeeding in the first few days after birth and you need to supplement your baby, hand expressing[2] your milk and spoon feeding it is usually the best approach. Colostrum is thick and small in volume which is perfect for a new baby who has a tiny tummy and is still learning to coordinate sucking, swallowing and breathing. Colostrum tends to get lost in the pump parts, and many women find that pumping is not very effective during the early days. Hand expression is a skill that all women should know. If you’re a pumping mom, you never know when you may be in a situation where you need to pump but are unable to for some reason, and your hands are always with you!

Once milk volume increases (usually around day 3), using your hands while you pump can increase the amount you are able to get. In one study, moms who were using hands-on pumping  increased their average daily volumes by 48%! Watch this video[3] to see how.

Along with using your hands to increase pumping output, you can also use the settings on your pump to help. If the pump you are using has separate controls for speed (cycles) and suction (vacuum), then start out your pumping session with the cycles higher, and vacuum lower, and then after a few minutes, switch by decreasing the cycles, and increasing the vacuum. To give a visual, start with the cycles at 2:00 and the vacuum at 10:00, and then switch (this is a general guideline, adjust to your own comfort if the vacuum is too high). This mimics the pattern of a baby nursing. Initially, a baby sucks quickly, but with not a lot of vacuum to trigger mom’s milk to let down. Once her milk lets down, the baby’s sucking changes so that the vacuum is higher, but the sucks are longer (fewer cycles). You can repeat this later in the pumping session as milk flow slows down, to try to trigger another let down. If you are using a pump that has a let down feature, it changes the cycles and vacuum at the beginning of the session automatically, and you can press the let down button anytime during the pumping session.

4. Pumping should be comfortable.

Just like breastfeeding, pumping should not hurt. If it does, then something is wrong. When using a pump, it’s very important to make sure that your flanges (the part that fits over your breast) are the correct size[4]. If they are too small, pumping will likely be uncomfortable, and flanges that are either too small or too big can decrease the amount of milk you are able to pump. Sometimes, the size of flange that you need may change over time due to your nipples expanding during pumping. If pumping has been comfortable but is suddenly painful for you, check to make sure that your flanges still fit properly.

It’s also very important to understand that more vacuum does NOT mean more milk. It can however mean more pain! Turn the vacuum up only to where it is comfortable for you.

5. Frequency matters more than duration.

A very common question from moms who are pumping is “How long should I pump for?”. For most women, 15-20 minutes is enough (total if double pumping, and per breast if pumping one side at a time). Frequency of pumping is more important than duration. If you’re trying to increase the amount that you pump, pumping more frequently will help more than pumping longer. Even if you’re only able to pump for 5 minutes or so, adding in those extra pumping sessions whenever you can fit them in, can help to increase your milk production.

6. Make sure your pumped milk is being fed appropriately.

For parents who are working, I often hear concerns that they are not able to pump enough to keep up with the amount of milk their child is drinking while with their care provider. Before panicking about your milk production, it’s important to first look at whether or not your care provider is perhaps overfeeding your baby. Traditional bottle feeding methods can result in unintended overfeeding which can make it seem like your baby needs more milk than they actually do. Make sure that your care provider knows how to feed your baby in a biologically appropriate manner by sharing information about baby-led bottle feeding.

7. Troubleshooting!

When things aren’t going well with pumping, most moms are very quick to assume that something is wrong with their milk production, or that they are doing something wrong. Before jumping to that conclusion however, consider that it might not be you at all! If pumping doesn’t seem to be working well, or if you are suddenly getting less milk after establishing a good pumping routine, check your pump first. Make sure that everything is put together properly, and check for any damaged pieces. Valves and membranes can wear out, and break or tear which affects the suction your pump is able to produce. If you’re not sure where to find replacement parts then check with the manufacturer or a local pump supplier, IBCLC etc.

When a decrease in pumping output is related to mom rather than the pump, it usually has more to do with having trouble letting down for the pump rather than an actual decrease in production (although if the situation is prolonged, it can eventually lead to a decrease in milk production due to decreased milk removal). This goes back to number 1, and the fact that hormonally, we just don’t respond the same to a pump as we do to our baby. Many moms find that having a picture or video of their baby to look at while pumping helps with triggering letdown. You can also try smelling something that your baby has worn. If you’re feeling anxious about the fact that you’re not getting enough milk, try covering the bottles with a blanket and focusing on something else, because stress can inhibit let down. Along with this, if you are pumping at work, know your rights, and find support.

8. Simplify the process.

Pumping is hard work! If you’re pumping regularly, you can simplify things by NOT washing everything between each pumping session. According to the guidelines for milk storage[5], milk is good at room temperature for up to 6-8 hrs, which means that after you pump, you can leave everything set up and ready to go for next time without washing, as long as your next pumping session will be within 6 hrs or so (pour the milk into another container and store in the fridge after pumping to avoid the risk of it being spilled). Some moms put everything in the fridge between feedings which would give more leeway between feedings. When it is time to wash your pump parts, rinse them with with cold water first as hot water can cause the milk to stick to the pump parts, making them harder to clean. Many moms find that sanitizing wipes while at work, and a steam sterilizer or sterilizing bags at home can simplify the process of cleaning.

Go hands free! When I posted on Twitter and Facebook asking people for their tricks and tips to make pumping easier, the number one response was “hands free pumping”. Whether you buy a hands free bra, or make one of your own out of an old nursing bra, having your hands free while pumping can make the whole process easier and more enjoyable.

Do you have any other tips or tricks for pumping? Tell us your pumping stories!

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Source URL: http://www.bestforbabes.org/a-babes-guide-to-pumping/

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