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PUMPING BREAST MILK – ALL YOU NEED TO KNOW
When I was a fresh-faced new nurse the hospital where I worked had exactly one pump.
That was for 150 moms who gave birth there each month.
It was not in use most of the time.
Now, some hospitals have a breast pump in every room.
Top 3 Motivations for Pumping Breast Milk
- Lots of partners enjoy the fun of feeding. I want to take this opportunity to say that there are other ways to bond with a baby besides feeding. The co-parent is the first person who teaches a baby that love and food are not always connected. (I didn’t come up with that, but I heard it so long ago that I can’t remember where I did hear it.)
- I encourage co-parents to consider infant massage as a special way to connect with their baby. It has many benefits and can be their special thing that they do with the baby.
Whether you are planning to breastfeed, or already are a breastfeeding mom, I can almost guarantee you have thought about pumping.
- When should I pump?
- What kind of pump should I get?
- How much milk should I expect to get when I pump?
- When is the best time to pump?
- Can I borrow someone else’s pump?
Why Should I Pump?
- Babies who go skin-to-skin right after birth will usually start breastfeeding in the first hour.
- For a whole variety of reasons, some babies won’t.
- If your baby hasn’t breastfed by 12-24 hours after birth you should start pumping. This will help your milk come in.
- If your baby is too premature or too sick to breastfeed you should start pumping by 3-6 hours, as recommended by Baby-Friendly USA.
- Pump every 2-3 hours until your baby is breastfeeding well.
- History of low supply with a previous baby
- Baby who was under 6# 8 oz
- Baby is born 3 or more weeks early
- Large blood loss
- Significant tongue-tie that is not going to be revised right away
- History of any kind of breast surgery
- PCOS (Polycystic Ovary Syndrome)
- The goal is not to collect a lot of milk, it is just to provide extra stimulation.
- Pump 4-6x/24-hrs.
- Pump within 20 minutes after the baby feeds.
- Don’t worry about insurance pumping during those times when your baby is cluster-feeding.
- “Insurance pumping” is temporary. How long you need to do it is determined by the reason for doing it.
- Talk to a Lactation Consultant for guidance about when you can stop.
- There is the possibility that this will cause an oversupply issue. That is easier to deal with than an undersupply issue.
- You are establishing your milk supply in the first 4-6 weeks. Missing a feeding during this time can have a negative effect on your milk supply.
- After 4-6 weeks if you miss an occasional feeding it may be uncomfortable, but shouldn’t affect your milk supply.
- That plan you had of your partner giving a bottle in the middle of the night so you can sleep through a feeding? That’s not going to work, especially in the early weeks. This is not to say you can never miss a feeding, but it’s just not a good idea in the early weeks.
- Babies fed formula will go longer between feeds.
- If you supplement with formula and don’t pump you can slide down that slippery slope. This is how moms end up formula feeding because they don’t have an inadequate supply. They just didn’t get enough stimulation.
- Pumping will allow them to use their milk to supplement and it will keep up their milk supply.
- This will only work if it is milk making your breast firm.
- Pumping is not going to help if your breasts are firm because they are swollen. This is often what happens when your milk first comes in.
- Reverse Pressure Softening will be more effective in softening swollen breasts.
- When your milk first comes in you may make more than your baby wants to eat. If your breasts don’t soften with feeding this can destroy your milk-producing cells. Pumping can remove enough milk to soften your breasts.
- It’s important to have a freezer stash if you are going back to work or school.
- It’s also good to have a stash for emergencies
- Pumping is also important during regular separations to keep up your milk supply
- It provides the milk for your baby to eat during the separation.
- Most women’s supply will adjust to the longer stretches.
- However, if your supply decreases then you should pump at least once during the long stretch.
- Many moms are told to pump and dump when it is not actually necessary. I always recommend getting the second opinion from a knowlegeable source.
- Don’t discard any milk until you’ve talked to an LC or The Infant Risk Center.
What Kind of Breast Pump Should I Choose?
- A mom who is exclusively pumping for a preemie
- A mom who has an established milk supply and wants to pump an occasional relief bottle.
- A mom who has a full-time job, and is pumping at work
When choosing a pump the primary questions you should ask are:
- Why am I pumping?
- How often will I be pumping?
- How much time will I have to pump
- What is my budget for a pump?
- Will my insurance provide a pump for me?
- This may limit your choices
- They may not give you a choice
- What is my milk supply like?
- You have a premature baby
- Your baby is too ill to breastfeed
- Your baby is not breastfeeding well before your milk has come in
- You are not breastfeeding at least 8x/day
- Your baby is not breastfeeding effectively due to a weak or dysfunctional suck
- This can result in your baby not getting enough milk out to grow properly
- You might not get enough stimulation to create and maintain a good milk supply
- Your baby is not directly breastfeeding for any reason
- You are planning to exclusively pump
Double electric personal pumps are intended for the mother with the established milk supply (source).
Breast Pump Recommendations
When I had my babies you could rent an electric breast pump, you could use a manual breast pump, and they just came out with a single battery operated pump. I was thrilled to have that last option because the manual pumps were awkward to use and rentals were expensive.
Today there are a dizzying number of choices.
Ever since breast pumps are provided by insurance companies (more on that below) there has been a flood of new breast pumps on the market. They are not all created equal.
The Medela Pump in Style has been around for a very long time. It is tried and true.
The Spectra has gotten great reviews by the moms I work with as well as on Amazon.
Manual pumps that perform really well are the Medela Harmony
And moms love the Haaka. Gotta love a low tech, easy to clean option.
A lot of moms will keep a manual pump on hand as well as having an electric pump.
Breast Pumps and Insurance
The Affordable Care Act mandates that insurance companies cover the cost of a breast pump.
It does not specify what kind of breast pump. Typically they have provided double electric personal pumps.
They may give you a choice of pump or they may just have one pump available.
You may be sent the pump directly. You may be sent to a website or told to call a durable medical equipment company. I had one mom tell me she was told to go to Target and get one. The insurance company paid for it so she didn’t have to get reimbursed.
Each insurance company has their own way of doing things so it is best to call them and find out what yours will do.
Medicaid coverage varies from state to state. If you have Medicaid you may be told to contact WIC for a breast pump.
Second Hand and Used Breast pumps
1. Closed vs Open System
Breast pumps are one of two types of systems.
A closed system means that milk cannot get into the motor because there is a barrier preventing this. An open system does not have that barrier.
2. There is another reason you shouldn’t use a pump that has been used before.
When Is the Best Time Pump My Breast Milk?
The best time to pump will depend on why you are pumping. You can probably understand now why that was such an important question to answer first.
Building a freezer stash
How to Pump
Each Pump has different parts, so read the instructions or have a Lactation Consultant show you.
Breast massage and hands-on pumping help you pump more milk.
Troubleshooting for poor or no suction
- Make sure all parts are intact and connected tightly.
- Replace parts. Start with the smallest piece. See if it makes a difference and progressively work your way up to the tubing. For Medela pumps the membranes wear out and can result in poor suction. I recommend replacing them every month or two.
- Have extra pieces of parts that can wear out.
- How old is the pump? Could the motor be wearing out?
- Call the pump company’s customer service number. Most companies are really good about replacing your pump if it is not working properly.
- Consider renting a pump for a week if you are not sure if your pump needs to be replaced.
How Much Milk Should I Get When I Pump?
It can be a little intimidating if you are barely covering the bottom of a bottle.
Things that will affect how much you pump:
- Whether you pump after a feeding or instead of a feeding
- How long it has been since the last feeding or pumping
- How often you pump
- Some moms pump really frequently. They have fooled their body into thinking they have twins.
- How much milk you produce
- Some moms produce just enough
- Some moms produce way more than they need for their baby
- What kind of pump you have
- How old that pump is
All you need is enough. If you don’t get enough, it can help to talk to a Lactation Consultant to see if you can do anything to get more milk.
Breast Pump Hygiene
Proper cleaning of your breast pump is very important. The CDC came out with a new guideline to properly clean pumps in 2017.
Products That Will Make Pumping Easier and More Comfortable
- Hands-Free Pumping Bra. Some moms like Pumpin’ Pals.
- Lanolin to put on the pump flange can make pumping so much more comfortable.
- If you pump more than once a day, having an extra pump kit allows you to wash parts less often.
- A Wet/Dry Bag and Mat for Your pump Parts.
Get a free printable so you can Pack the Perfect Pumping Bag
Now You Know
EVERYTHING ABOUT PUMPING BREAST MILK
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.