Pumping breast milk for the first time can be quite daunting. How does this pump work? Which settings should I use? How hard, how often and for how long should I pump? This post will answer all those questions.
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The first important thing you need to do is to choose the right breast pump for your needs. The best pump for you will depend on how often or how much you need to pump, your budget and your personal preferences. If you’re not sure which breast pump to get, check out this post – it explains exactly what types of pumps you get and what situations each pump should be used for.
It’s incredibly important to ensure that the flange of your breast pump is the correct size for your nipple. The diameter of the flange opening should be a bit larger than your nipple, allowing your nipple to move backwards and forwards freely when you apply suction. A flange that is too small will damage your nipple, and one that is too large will be ineffective. This picture should give you an idea of what a good fit looks like:
Positioning the breast pump is simple: simply put the opening dead centre over your nipple. Be sure to hold the pump flat on your breast, so that the “tube” part of the flange is in line with your nipple. If you tilt the pump downwards while you’re pumping (which can easily happen if your hand gets tired), it can damage your nipple.
When you switch on the pump (or, for a manual pump, start squeezing), you may be tempted to put the suction as high as you can stand, thinking that this will give you the most milk. Not true! The moment you set the suction so high that it hurts, you are inhibiting your let-down reflex – and no let-down means no (or very little) milk!
What is a let-down?No, we’re not talking about a disappointment! A let-down is more properly known as the milk ejection reflex. In simple terms, it means that your milk starts flowing freely.
During the let-down, your brain secretes a hormone called oxytocin. Oxytocin causes all the muscles inside the breast ducts to contract, which literally squeezes the milk out of the breast. You may feel a squeeze or tingle in your breast, or you may notice milk leaking from the other breast – or perhaps the only sign is that your baby suddenly starts to swallow with every suck. When pumping, you will notice the flow of milk suddenly increases.
The best way to get a good let-down is to mimic the way a baby feeds at the breast. Babies always start with quick, fluttery sucks, which stimulates a let-down. Then, the moment you milk lets down and the flow increases, they switch over to a slow-and-steady suck. To mimic this with your breast pump, you can do the following:
Before we go any further, you need to answer one question: why are you pumping? This will determine all the rest that is to follow. Some common reasons for pumping are:
In each of these situations, you will pump on a different schedule. So once you know what your situation is, we can answer the two other important questions: how often should I pump, and how long should each session be?
The basic guideline for pumping is to make up for every missed feed – in other words, you want to pump often enough that you are removing all the milk that baby would have been removing if you were breastfeeding. Based on research and experience, it seems that two things are necessary to maintain a steady milk supply:
Put in practical terms, it looks like this:
The short answer to this is: pump for as long as it takes to get enough milk out! There really isn’t a fixed number of minutes. The amount of time it takes will depend on how strong your let-down is, how easily you respond to a pump and how much milk your breasts contain at a given time.
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The follow-up question, of course, is this: how much milk do you need? Use this as a guideline:
It can be utterly depressing if you set everything up, start pumping… and get only a few drops. But I would say that is more often than not what happens, at least in the beginning. Here are a few common pitfalls that catch almost everyone at some time or another:
Let’s make one thing clear: it’s very, very unusual to get significant volumes when you first start pumping. Trust me on this: even I, who could at one stage pump 500 ml in a sitting, started out pumping 10 or 20 ml between feeds. Why? Well, there are several reasons. The biggest one is that your body needs to learn to respond to a pump. Our bodies and brains are hard-wired to respond to a baby suckling – the cold, hard plastic of a pump is a strange, foreign sensation. So it takes time for your body to learn to respond to the pump; and even with all the practice in the world, your body will never give as much milk to the pump as it would to the baby (I read that a study found that a pump can at best – at best – get about 2/3 of the milk out of the breast!).
Another factor that plays a big role is timing. If you are in the first few days after birth, your body is only producing colostrum. Colostrum is present in small volumes and it’s thick and sticky and extremely difficult to pump – you will almost certainly get better results with hand expressing. On the other hand, you may be pumping in-between feeds. In this case, you are pumping the “leftovers” – only after several days of regular pumping will you increase your production enough that you will start to get larger volumes.
Try not to stress about how much you’re pumping. I know, that’s the most annoying bit of advice ever! But if you are stressed and worried, it inhibits your let-down reflex. So the more you stress about how little you’re pumping, the less you’re able to pump, and the more you stress – that’s not a good situation to be in. So cover the pump or close your eyes, listen to some relaxing music and focus on deep breathing. It sounds corny, but it works.
If the flange of your breast pump is too small or too large, it won’t be effective. If your nipple can’t move freely and it’s rubbing against the sides of the flange’s “tube”, you need a bigger flange. If your nipple and most of the surrounding areola are being pulled into the flange tube, you probably need a smaller flange. If you are in doubt, a lactation consultant can help you check the fit. The tricky thing is that only certain breast pump manufacturers make pump flanges in a variety of different sizes, so getting a perfect fit can be a challenge.
You need to find the “sweet spot” in the amount of suction that you apply. Too little suction, and nothing will happen. Too much suction, and you will cause pain, which will inhibit your let-down reflex. I’ll repeat what I said earlier: you want to have the highest amount of suction that is still comfortable. So if you get to the point where it hurts, dial it down a notch; you’ll get more milk that way. I’ve never seen a case where using the maximum setting (or squeezing the handle of a manual pump all the way down) was a good idea; you always get more milk somewhere in the middle.
We often forget to check the pump itself. If there is a small opening letting in air anywhere on your pump, it won’t generate suction properly. How to check this: close off the opening of the flange tightly (you can press it against a fleshy part of your body or use something like a rubber ball). Apply suction, and then stop the pump, holding the suction. If you hear any hissing of air, or if the pump loses its “grip”, you have a leak somewhere. Check all the connections, and make sure the valve of the pump isn’t damaged.
It’s also important to note that electric breast pumps aren’t designed to be used for more than one baby. So if you have a breast pump that you inherited from a friend (bad, bad idea – don’t do it) or a pump that you used for a previous baby, there’s a good chance that the motor is simply worn out. I’ve found that the most “long-lived” pumps are manual pumps, because there are fewer parts that can wear out or break down.
If you’ve checked all of the above thigs and you’re still not getting enough milk out, you’ll need to try some more advanced tactics to increase our pumping output. I’ll be posting more on that later in this week, so watch this space!
So, in summary, let’s highlight the most important points for successful pumping:
Have you ever pumped? How easy or hard was it for you? Do you have any tips to make the process easier? Please share in the comments below!
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