How do we feel about them? Just “super”, right? Pumping has become so commonplace on social media and parenting blogs that most parents purchase their pump prior to even having their baby. Marketing companies have positioned the breast pump as a necessity in the world of infant feeding. Is it really so necessary?
While a breast pump is a SUPER handy tool, it certainly isn’t required in the way car seats or cribs are. Sure, pumping is great for expressing and storing milk for other care givers to feed the baby, for when you are returning to work, or if you just want a night out. Many people need to pump in order to boost milk supply, if their baby is in the NICU, or if their baby is working on correct latch and sucking skills.
Daily use of a breast pump can be a drain.
I have never heard a mom say that she looks forward to using her breast pump every day. Sure, the results can be worth it when you are using your pump for the right reasons (and no, building a freezer stash to show off on social media is not the best reason). You are doing something amazing for your baby, and it can be encouraging to visualize your milk being expressed (unless your pump extracts mere drops, in which case, pumping can be INCREDIBLY frustrating).
The added chore of cleaning and storing and assembling and replacing parts over and over can be tiring. Plus, breast pumps can be confusing and intimidating. Have you tried shopping for one? How do you even begin to choose which one is right for you?
Manual, electric, double, single? Which brand is best? Which settings do I use? Why do they need so many parts?
You will find the answers to all of these questions (and more) throughout this blog entry.
If you already have a deluxe, double electric pump, it might seem crazy to purchase a manual pump. However, they can actually be really useful.
- great for breast stimulation during those first postpartum days when you and baby are still getting the hang of latching and feeding. I find hand expression is the best for really removing colostrum but a manual pump can help kick start that milk production!
- a fabulous backup for emergency situations. They are small and simple with just a couple of parts. They can be stored and carried around easily for when you can’t get to a power source (or your power source fails you), or a part on your electric pump malfunctions.
- Clogged ducts! If you have a stubborn clogged duct a manual pump can help you really target the specific spot. You can also bring it into the shower with you- the hot water coupled with the pump will help remove that clog! A one-piece silicone pump (like the Haakaa) is incredibly useful for this as well.
- Night pumping. If you are trying to space out the night feeds and pumping sessions (note: night feeds are super important, but so is sleep). A manual pump at your bedside can help you pump just enough for comfort without having to get up and set up your double electric!
- This strategy works for weaning as well. When you are cutting down on pumping and feeding sessions, you may find yourself uncomfortable and sometimes prone to clogs. Again, your manual pump can easily express just enough milk for comfort and have you on your merry way.
Electric pumps, while intimidating at first, can be a very useful tool for many mothers. They can be a considerable investment, so I usually recommend people do their research prenatally, but hold off on purchasing one until you have an actual need (or make sure it can be returned if not used). A manual pump is much cheaper, and can be quite effective in those early days.
However, an electric pump is great for the following:
- If you have to exclusively pump for a preterm babe or a baby in the NICU, you need an effective tool that saves time and removes milk effectively. Many double electric pumps will “empty” your breasts in 10-20 min (sometimes less if the pump is hospital grade).
- Increasing milk supply. Moms who are struggling with low supply, babies with ineffective latches, tongue-ties, twins or triplets, etc, greatly benefit from these pumps. They can do an at-breast feed, and follow it with a 10 min pumping session to ensure full milk removal. Effective milk removal is what signals your body to produce more milk!
- If you are returning to work or school and want to continue to provide your baby with breastmilk, a double electric pump will save you so much time. You can pump milk during your lunch break (advocate for your workplace to provide you with a space to pump- that isn’t a public bathroom!).
- The drawbacks to these pumps include: cost, complicated instructions and assembly (for some, not all), and sometimes inconvenience. You will need to purchase storage containers (bags, Tupperware, small glass jars), and if you are pumping at work, you will need to bring the pump and a cooler bag to store your milk in for the day.
SINGLE OR DOUBLE PUMPS
Single or double? Both are available on the market. This may leave you wondering: if you have the option to pump both, why wouldn’t you? Well, there are some reasons for pumping only one side sometimes.
- You may want to use the pump for one side only if your baby is favoring one side (as they sometimes do when experiencing torticollis or tethered oral tissues (i.e. tongue-tie). If baby’s latch is less-than-stellar on one side, they won’t remove milk as efficiently, and your milk supply on that side may start to dwindle.
- You have a clogged duct on one side that requires some extra oomph to removes (truthfully, a baby with an effective latch will remove a clogged duct way more effectively than any pump, but it is totally fair to try the pump as well!)
- If you are pumping only occasionally (i.e. for your partner to be able to feed the baby, or if you are going for a night out), a single manual pump will take some extra time, but will definitely do the trick.
I will go into more detail on ALL the pump parts later on. For now, I want to discuss the most important part- the flange. This is the funnel-shaped part that comes into direct contact with your breast. During pumping, you will see your nipple get pulled into the flange opening, and stretched further than you ever though possible.
Nipple comfort and safety are the most important factor in selecting your breast pump. The proper flange size will facilitate effective milk removal while keeping your nipples free from damage. Any skin breakage, irritation, or discoloration (purple, red, white) is not normal and you should reassess your pump parts and settings.
How to find your correct flange size:
- This is tricky because it must be snug enough to prevent excess areola from being “sucked” up into the flange tunnel, but it must be loose enough to allow the nipple to move back and forth quite freely.
- You need to measure your nipple diameter (just the nipple, not the areola). It is a good idea to pre-pump a little before measuring, as your nipple will swell a bit while pumping.
- Select a size that is 2-3mm larger than your nipple diameter
Most pumps come with some common flange sizes (usually 21 and/or 24). They are made in “standard” sizes…but nipples most definitely are NOT one size fits all! If you fall outside of these “common” sizes (and most people do), it is important to order a few other sizes to try. Be aware that your size can change throughout your pumping journey, even months later.
Visuals from @pumpingessentials and @pumpmamapump Instagram accounts
All pumps will be a bit different. Some have more parts than others. This is a list of some of the common breast pump parts you may see (and may have to replace) and their functions!
Breast shields or flanges
This is the piece that goes on your breast and is shaped like a funnel.
These are the pieces that connect to the flanges. They have holes in them that allow milk to pass through into the milk collection bottle.
Small, circular pieces that fit onto the valves. The suction of the pump causes them to open and close from the valve.
This connects the flange to the breast pump itself. It is important to keep this tubing dry. If you see condensation after your pumping session, you can keep the pump turned on and the force from the motor may dry it out.
Milk collection bottles
These connect either directly to your flange or a connecting piece, depending on your pump. Many of these are standard sizes so you can interchange them and pump directly into the bottle you will use to feed your baby! Tip: these bottles are quite large, and, if you are struggling with supply, can create a very disheartening visual. When you are pumping very small amounts into these 5oz bottles, it can be incredibly discouraging. This impacts that mind-body connection that is so necessary for milk production and expression. I recommend covering the bottles with a towel while you are pumping. Focus on more positive things, like your baby!
Breast pump back flow protectors
These attach to the flanges and tubing. They prevent milk from backing up into the tubing (which we want to keep dry)
If you are using your pump daily, you WILL find yourself needing to replace certain items.
You want your pump working optimally at all times. If any parts are worn, they are going to affect your pump’s function. If the suction ability of your pump is compromised in any way (even if you don’t “feel” it), your milk supply could also become compromised.
For replacement parts, check out the website of your pump manufacturer. You can often find replacement pump parts on Amazon (but ensure they are from a verified seller).
Visual from @milkymamallc Instagram account
Why do some electric pumps have one or two buttons, while others have like a million?
At first glance, some pumps look super intimidating (hello Spectra!). However, the buttons have very basic functions. Give yourself 30min to go through the instruction manual, and play around with it, and you will see it is actually pretty easy.
There will be a power button, and there may be buttons for let-down mode, expression mode, and/or buttons to increase or decrease the suction power and frequency. Some pumps have lights (so useful when pumping at night). Pumps with a screen will indicate which pump mode you are in, the vacuum level, the cycle speed, battery power, and possibly a timer or clock.
Again, all pumps are a bit different. One thing they do have in common is the 2 “modes”: let-down/stimulation and expression.
– this mode will use low pressure but quick cycles or “sucks”. This type of breast stimulation will facilitate that let-down. (Other ways to get your milk flowing: look at a photo of your baby, hold a blanket or toy that belongs to them, make sure you are comfortable and relaxed).
- Some pumps automatically start in “let-down” or “stimulation” mode. Some don’t. A typical let-down mode usually lasts about 2 min before switching to expression mode. Some pumps switch automatically and others don’t. Definitely read your instruction manual!
- The second mode will be your
milk expression mode
. This slows the suction cycles (i.e. the individual “sucks”) to emulate your baby’s suck-swallow-breathe pattern. The vacuum is also increased during this phase. Electric pumps will have an increase/decrease option so that you can find your comfort zone. I usually suggest going just to the point of discomfort and then decreasing one by one to find that comfort zone.
The goal is to maximize milk expression while remaining comfortable. Every individual is different, as is every pump. It takes a bit of experimentation and trial and error to find your ideal setting
WHAT ABOUT A HOSPITAL-GRADE PUMP?
It depends on how you plan on using your pump, how long you plan on using it, and your reasons for using a breast pump.
Perhaps you had a difficult time establishing a milk supply with your previous baby and you want to start off on the most powerful foot this time. Perhaps you plan on returning to work right away and will be very pump-dependent for the long term. Perhaps you plan on using it for your next baby (or babies) and need it to LAST.
There is actually no scientific data regarding the use of multi-user pumps vs. single-user pumps and their correlation to milk supply. Yes, multi-user pumps often have a more powerful motor and SOME people report an increase in milk supply. Ultimately, your milk supply is ruled by frequency and effectiveness of milk removal.
A multi-user, hospital-grade pump is VERY expensive to purchase. Unlike single-user pumps, they are safe to resell. However, with a cost of upwards of $2000, many people opt to rent such pumps (yes, this is an option!).
No matter your location, check you local pharmacy- most of them provide pumps to rent.
If you do choose to purchase, always remember to clean and care for all of the parts, replacing them when necessary.
YOU HAVE YOUR PUMP….NOW WHAT?
You now know about the types of pumps, sizing, the parts involved, and how to clean and replace them. So…now what? Just attach and go? Well, ya, kind of.
Remember, babies under 6 months old usually feed 10-12 times a day. If your baby is not at the breast that many times a day, but you want to exclusively breastfeed, you must provide breast stimulation (meaning: breastfeed or pump)10-12 times per day to maintain an adequate milk supply.
Some pumping tips for when you need to boost that supply:
Start in let-down/stimulation mode
which has low suction, fast cycles to get the milk flowing. Switch to expression phase, which uses higher suction power and slower cycles to mimic your baby’s suck swallow pattern. Continue until no more milk is coming out, then switch back to let-down mode. This gives your body the signal that it needs to produce more. You may not get any more milk during this session but it’s all about sending proper signals to your body.
Replace one pumping session per day with a “power pumping” session. This method mimics cluster feeding, which is nature’s way of signaling your body to produce more milk. Use this one with caution, as some people’s bodies will be more receptive to it than others. An oversupply is just as bad as an undersupply, believe it or not.
In order to Power Pump, you need to:
Pump for 20 min, Rest for 10 min, Pump for 10 min, Rest for 10 min, Pump for 10 min
Breast massage and heat application.
Use some heating pads on your breast just prior to pumping. During your pumping session, use your hands to gently massage your breasts in a downward motion, towards the nipple.
Don’t watch the pump!
The pump is never going to be as effective at removing milk as a baby with an effective latch! Don’t get stressed or discouraged if you get minimal amounts sometimes. Regroup, relax, and try again in 1-2 hours.
Make sure you are comfortable, relaxed, and either looking at your baby or a photo of your baby…
Have a blanket or toy of theirs, have relaxing music, make sure you are set up with water and snacks for your session.
Milk storage and Reheating
There are many different ways to store breast milk. Breast milk bags, small BPA-free plastic containers, even small glass jars are all great methods.
The most important tip is to store in small quantities. Once you thaw or reheat breast milk, you should not re-freeze or re-store it.
Other than this, some simple rules of milk storage are as follows:
Room temperature: 4 hours
Cooler bag (insulated) with freezer block: 24 hours
Fridge: 4 days
Regular freezer: 6 months
Deep freezer: 12 months
To thaw breast milk: ideally, you should remove it from the freezer and let it thaw in the fridge for 24 hours. Then placing the container in a bowl of warm water and swirling it to distribute the heat is the best way to prepare it for baby. Once thawed, it must be used as soon as possible, and it cannot be re-frozen due to risk of bacteria growth.
Never put breastmilk in the microwave: it distributes the heat unevenly and there can be hot spots.
STRATEGIC PUMPING…aka so you want to drink wine?
Yes, this section is all about alcohol, and YES, you can have wine at dinner, or go out for a night with friends. Just remember: alcohol passes very easily into your breastmilk. The level of alcohol in your breastmilk will be roughly the same as your blood alcohol level. How is this still safe for breastfeeding? Well, with a little planning, it is totally safe!
Breastfeed (or pump) just before you plan to have that drink (or two). After your drink(s), there is rarely a need to “pump and dump” as the ONLY thing that reduces your blood alcohol level (and therefore milk alcohol level) is TIME.
Alcohol affects everyone a bit differently, but a simple rule of thumb is to wait 1-2 hours after EACH alcoholic beverage before breastfeeding or pumping again.
Now, if you REALLY want to let loose (no judgement here), you should be prepared to pump and dump at some point (my rule is to go no more than 4 hours between feeds or pumping sessions). Totally skipping even just one feed an put you at risk for engorgement, or even mastitis! And yes, if you have had several drinks within an hour or so of pumping, you should discard this milk (hence the term “pump and dump”).
When clients call me for lactation help, they are often at the stage where they are TRIPLE FEEDING in order to keep their infant nourished.
This means they are:
1. Feeding baby at the breast
2. Using a breast pump to pump extra milk (sometimes before AND after feeds)
3. Supplementing baby with bottles of breast milk or formula
*actually, if you’re using formula as well, you could also call this QUADRUPLE FEEDING (formula preparation adds a whole other level of work to this process- it’s not the easy way out, people!).
I don’t think you need me to tell you why this is not the ideal situation, but: THIS SUCKS! It is so much work, stress, and aggravation, and isn’t always necessary! It is a TEMPORARY feeding plan for when we are trying to boost or maintain milk supply and infant weight while assessing for and treating anatomical issues suck as tongue tie. Moms of premature babies will often do this while baby is growing and learning to breastfeed.
When I see my moms doing this, I first assess WHY. Is there a physical reason- in mom or baby- for low milk supply? or is there a low milk supply at all? Is this feeding plan sustainable? How is it affecting the parents mentally and emotionally (I say it all the time: the mind-body connection is HUGE when it comes to new-parent life!).
Breastfeeding is hard because we don’t have that immediate concrete visual of what baby has eaten. We like concrete visuals. We are also bombarded with images of freezers full of milk, and the expectations that we should be storing milk to last until college graduation. Um, no.
If you are finding yourself trapped in this triple feeding nightmare, do not hesitate to get IBCLC help!! This process requires assessment, a long-term plan, and SUPPORT!!
Using a breast pump is a very individual experience. Everyone has different reasons why they require a breast pump, and it fits into everyone’s lives and routines differently. If you feel stressed about pumping, or don’t even know if you HAVE to pump, call an IBCLC! We help determine which tools (if any) will be useful in achieving your infant feeding goals!!
For more amazing resources on all things breast pumps, check out the following social media accounts: