Breastfeeding Part 3 – Pumping

Whether you plan on staying home with your infant or going back to work, most breastfeeding mothers end up pumping at some point during their breastfeeding journey. Pumps range from single, manual pumps to double electric ones. For mothers who are only going to pump a few times, a single, manual or electric pump will work. However, if you plan on working out of the home or pumping frequently, investing in a double electric pump will increase your success rate and decrease your frustration in the long run. You do not have to buy a pump, you can borrow one from a friend, buy a used one or rent one from your local hospital. Several medical insurance plans are now covering the cost of pumps – all you have to do is call the number on the back of your insurance card and ask about your breast pump benefits (you may need a prescription from your pediatrician or OB/GYN). Just make sure to get new tubing, nipple shields, and collection bottles when you start pumping, especially with a used pump.

The process of electric pumping can be daunting at first, ask a lactation consultant or nurse in the hospital to show you how to set it up and get started. First, hand off your infant because it is very difficult to pump holding your baby! Next, connect the tubing, set up the nipple shield and collection bottles. Finally, place the nipple shields to your breasts and turn on the suction, slowly. If you are going to be double pumping frequently, several manufacturers make hands-free pumps and bras for easier use. Pumping takes an average time of 10-20 minutes per breast. Continue to pump until the milk flow stops if you have adequate supply, or longer (5-10 minutes) if you are trying to build up your supply.

Some breastfeeding mothers start pumping in the hospital, within a few days of birth. Breastmilk supply is based on demand – so the more stimulation to the breast, the faster milk “comes in”, with increased supply. Sometimes, mothers pump because they want their milk to come in faster, which works, but is not necessary for most mothers. The mothers who do need to pump are the ones with infants who are being supplemented formula because of jaundice or weight loss, or those who have infants in the NICU.

There are several different strategies for pumping and you will hear different advice from everyone you ask. I make my recommendations based on whether or not you are going back to work and when. For mothers who are going back to work within 6-8 weeks, I recommend starting to pump during the “engorgement phase” – usually between days 3-7 after birth. You will make plenty of milk during that time and it will help make you feel more comfortable. Pump only a couple of times per day, after your infant feeds. Remember that when you pump after your baby feeds, your body will make more milk at that time… so you can take advantage of that and pick times when you will be able to pump when you go back to work. Continue to pump daily after that to store milk for when you go back to work. For mothers who are not working outside the home or have an extended maternity leave, I recommend starting to pump and introducing a bottle a couple of weeks before you need it or just doing it “as needed” for a night out.

Expressed breastmilk can be stored in hard plastic bottles or breastmilk bags. I recommend storing or freezing in 2-4 oz allotments, so you do not waste any milk when you thaw it for your baby. As your infant gets older and eats more, 4-6 oz bags work well.  Click here for a chart on safe breastmilk storage:

http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

While most breastfeeding mothers will admit that pumping is not the most exciting activity, it does give many mothers the opportunity to provide breastmilk for their infants whether they are working outside of the home or just out for a quiet dinner.

Heather Joyce, MD

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