Expectant couples frequently ask “We are planning to breastfeed. What type of pump should we buy?”
Do I need to pump?
Many breastfeeding mothers will never need to express their milk. Other mothers will choose to store some milk for an unplanned separation from their baby. Still others will find themselves needing to express on a regular basis.
Hand expression can be very effective for occasional milk expression and it is free! You can learn more about hand expression here.
For those who prefer to use a pump or those needing to pump on a more regular basis, here are some answers to frequently asked questions.
When is pumping recommended?
- For mothers who have to return to work or are separated from their baby.
- For mothers with a premature baby, an ill baby or a baby who is not ready to feed at the breast.
- If baby is unable to effectively nurse at the breast. In this case, your breasts may need some extra stimulation in order to keep up your supply.
- For mothers with low milk supply wishing to increase their supply. Note: If your milk supply is low but your baby latches and sucks well, breastfeeding more frequently will be more effective and more enjoyable than pumping.
When is pumping not recommended?
- When the breasts are overly full in the first week postpartum. If your baby is nursing well, continue to nurse frequently and your breasts will adjust to the amount the baby takes.
- To evaluate the volume of milk the baby is getting at each feed. The amount pumped is NOT a good indication of milk supply. A baby is much better than a pump at accessing milk. A baby uses both suction and compression whereas, a pump uses only suction.
When is the best time to pump?
If you are pumping to increase your supply, the best time to pump is immediately after a feed. This will ensure that your breasts are as full as possible the next time baby is ready to feed. Try not to focus on the amount of milk you collect. Regular expression will tell your body to make more milk; pump as many times per day you can.
How often and how long do I need to pump?
If your baby is not feeding at the breast, pump every 2 -3 hours during the day and at least once at night (a minimum of 8 – 12 times in 24 hours). Pumping during the night is especially important as the prolactin level, a hormone that helps to make milk, is higher at that time.
What type of pump should I choose?
There are manual pumps, personal electric pumps and hospital grade pumps available. Your reason for pumping will determine which type of pump is right for you.
Before purchasing any breast pump, check to see which company makes the pump. Look for a pump made by a company that solely manufactures breast pumps and other breastfeeding equipment. In our experience, pumps made by Medela and Ameda Egnell have worked well for mothers.
Manual pumps are the least expensive option. They work well for occasional milk expression. They do not stimulate the breast well enough to build up a milk supply or maintain a supply if the baby is not at least partially breastfeeding.
Mother’s appreciate a manual pump’s convenient size and simplicity of use but tend to find the repetitive motion required very tiring.
Electric pumps are available in a wide price range.
Inexpensive electric pumps may work for breastfeeding mothers who want to express occasionally. They are not usually adequate to keep up a mother’s milk supply if the baby is not at the breast (e.g. if baby is in NICU).
Battery operated electric pumps tend to work well only when the batteries are fresh. It is better to purchase a pump that can be plugged in.
The top-end electric pumps for purchase will work well for women who have an established milk supply and are away from their babies for long periods (e.g. return to work).
Hospital grade electric pumps
Hospital grade electric pumps are available for rent. This type of pump is recommended if:
- You need to build your milk supply.
- You want to maintain your milk supply when your baby cannot be at the breast for long periods (e.g. baby in NICU).
You will need to purchase a kit for your rental pump. The kit is milk collection parts that connect to the pump. Some pumps allow you to use 2 kits and pump both breasts at the same time (“double pump”). Double pumping may lead to a higher overall milk volume.
Some of the mothers we have worked with like double pumping because it takes half the time. Still others prefer to single pump to allow one hand to be free. There are some hands-free pumping options now available.
When a baby breastfeeds, he uses both compression (from the tongue against the breast) as well as suction. Breast pumps work via suction only. Combining pumping and hand expression may therefore be best at stimulating milk supply.
Instructions for pumping
- Wash your hands.
- Assemble your pump equipment and anything else you need to make yourself more comfortable (e.g. glass of water, your phone, a snack).
- You may want to stimulate your “let down” prior to pumping (see below).
- Center your nipple in the flange (see below re: fit)
- Start the pump on the lowest setting. Gradually increase the suction. If it is painful, decrease the suction.
- To increase the amount of milk you are able to pump, you may want to gently squeeze or compress the breast near the chest wall while pumping.
Encouraging your “let down” reflex
A hormone called oxytocin is responsible for starting milk flow from the breast. Tiny muscles contract around the cells that produce milk, squeezing the milk into the ducts. Some mother will begin to leak with let down; others may feel a heavy or a tingling sensation. Still others do not notice any changes.
To encourage your “let down” prior to pumping you could try:
- Looking at a photo or thinking of your baby.
- Holding a piece of baby’s clothing or a blanket that has your baby’s smell.
- Placing a warm, moist cloth over your breasts.
- Gently massaging your breasts.
- Rolling your nipple between your first finger and your thumb.
Fitting a pump flange
The pump flange is the part of the kit that is held against your breast. A good fit will help pumping to be more comfortable. Flanges come in different sizes. The size refers to the diameter of the opening for your nipple.
Most pump kits come with a 24mm flange. You can purchase other sizes (e.g. 16mm, 18mm, 20mm, 26mm) if the standard size is not right for you.
To check the fit of the flange, place it on your breast and turn on the pump.
If the flange is too small, your nipple will rub against the sides of the breast flange, causing discomfort.
If the flange is too large, you will see your areola (the brown area around the nipple) be drawn into the flange.
A well fitting flange allows your nipple to fit comfortably when drawn into it.
**Please refer to the instruction manual specific to your pump for cleaning and sanitizing instructions. If your baby is in NICU, ask for specific instructions for pump kit care.
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References and More Information:
- “Expressing Breastmilk On The Job.” HealthyChildren.org. American Academy of Pediatrics, 21 Nov. 2015. Web.
- Newman, Jack, MD, FRCPC, and Edith Kernerman, IBCLC. “Expressing Breast Milk.” nbci.ca. International Breastfeeding Centre, 2009. Web.
If you would like to learn more about storing your breast milk, see 10 Tips for Breast Milk Storage and Creating a Stash of Breast Milk.
Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.
Photo courtesy of Flickr: treehouse1977