This amazing mom pumped with hand pump while hiking in Maine for 3 days to keep up her supply. Thank you so much @straightfromthetap_milklady (Instagram) for your adventurous spirit and for sharing this fantastic and beautiful photo!
photo from the CDC Media Center
Table of Contents for all blog posts
Pumping is incredibly helpful
for any breastfeeding family
Exclusive pumping
For when the lactating parent is away from the baby
If there are latch difficulties
To relieve overly fully breasts
To boost supply
And so many more reasons.
Many types of pumps are available through insurance - this is wonderful, because pumps can be free or more affordable. But, not all pumps are made alike! In fact, too many are poorly made. And most pumps come with flanges that are too large for the vast majority of users (more on this below)
Also, because pumps are so easily available, people commonly think that they should pump right after having a baby. This is not necessarily true - if breastfeeding is comfortable and effective, it is completely fine to wait. In fact pumping on top of effective breastfeeding can lead to an oversupply if it’s not carefully planned out. However, for exclusive pumping, or if someone needs to pump because of breastfeeding problems - then it is very important to start pumping or hand expressing right away (and of course make a plan with your IBCLC) to keep your breasts healthy and support your milk supply.
How often you need to pump (or hand express)
depends on your situation
For exclusive pumping, start with double pumping 8x/day to bring in a full supply. I recommend short sessions (~15 min). This signals to your body that the baby is drinking milk frequently. Based on how things are going, you can adjust things up or down.
If a baby is nursing part-time, or nursing full time but ineffectively (not taking in full feedings) - then there’s a bit of “lactation math” that needs to be done to figure out the right amount of pumping for your situation - enough to keep you within your lactation goals, but not so much to overwork you. Work with your IBCLC to assess your supply, baby’s latch, and how to utilize pumping for your scenario!
Pump effectively and comfortably
Correct flange fit is essential to get the most milk (and get it comfortably). We used to tell people that there should be space around the nipple, but new research has shown that a flange that matches the diameter of your nipple is usually best. The pump companies have not caught up with this, and are still providing 24 mm (and larger) flanges. Having a flange fitting with a knowledgeable IBCLC is crucial - not only to customize your size, but also for pump settings, type of flange to use, and more. In the meanwhile - here are helpful online resources:
Flange “FITS” guide by Babies in Common
Flange fit video from Katy Linda at The Breastfeeding Den
Hands-on pumping - using your hands to massage your breasts is very helpful while pumping (although with proper flange fit it’s often less (or not) needed. Hand Expression is shown as part of that video from Stanford Medical, but for much more information see my hand expression resource page.
Lubrication of the nipple sometimes helps with flange fit and comfort. Non-lanolin nipple balms are a good option (lanolin is too sticky for this purpose!). Other options include organic olive oil or coconut oil. All are generally regarded as safe for babies but always check ingredients and consider your own family history of allergy. And, try pumping with and without lubrication - sometimes it’s not needed and sometimes it actually makes things worse.
Power Pumping sometimes helps boost milk output - but in my experience is not needed as often (or ever) once flange fit is customized.
Vacuum milk collectors
Soft Silicone Milk Extractors (most common brand is Haaka, but there are many other brands) are helpful but sometimes cause too much swelling of the nipple/areola, or overstimulate supply. Use with caution and talk to your IBCLC to customize their use for your situation (or determine if they should be avoided).
Video from Katy Linda at The Breastfeeding Den
Instagram post showing how to place them for better comfort and milk removal
Pumping (or “Haaka”-ing) on one side while nursing on the other
There are also passive milk collectors - that can be placed in your bra and collect leaking milk with no vacuum - I prefer these if milk is leaking anyway (you may as well catch it!) because they don’t cause swelling of the nipple/areola.
Hands-free pumping
It’s very helpful to have something hold the flanges for you - this could be:
A nursing/pumping bra that you wear all the time (definitely my preference so you don’t have to change every time!)
A dedicated pumping bra that you change into for each pumping session.
A sports bra, or any bra, that has enough flexibility to pull the cup to the side to hold the flanges.
Hacks for pumping bras:
Try a stretchy bra or camisole - pull the cup to the side to hold the flanges.
Ponytail holder trick for holding flanges - works with most bras or camisoles
Items like these bra extenders
Homemade - cut a small hole in a bra you like, use a pad to cover the hole
Portable pumps are convenient but not always strong enough for full-time use. They also need to be fitted with silicone inserts for best fit (see flange fitting info above). If you are not able to support your supply with only a portable pump, it may be important to have a portable pump for when you need portability, and a stand-alone/stronger pump for other times.
There are also very light/portable pumps that are very strong - they don’t fit in your bra like a wearable pump, but you can wear then on a lanyard - an example is the Baby Buddha (here’s a 10% coupon - LACTATIONPRINCETON10).
There are flange cups that are like the portable pump shape, and work with any stand-alone pump - such as Freemies, Cara Cups or Legendairy milk cups (as with wearable pumps, you need proper inserts for best fit)
Milk Storage
CDC guidelines (updated Jan 2020)
Articles written before the CDC updated their guidelines - included here because the overall info is helpful, but defer to the CDC info for timing of storage.
Nancy Mohrbacher “Why Milk Storage Guidelines Differ”
The Milk Meg “Keep on Pumpin’, Breastmilk Storage Guidelines”
The main difference between these article and the newer guidelines is that we used to say milk was good in the fridge or room temperature a bit longer. So, use these articles for their great info, but also keep in mind that if you go beyond the CDC guidelines it’s wise to smell/taste the milk to judge if it’s still good. And, if you think the milk is not suitable for drinking, it’s still great for the baby’s skin in a milk bath!
“Refrigerator hack” - not endorsed by the CDC because there are too many steps where contamination could occur - but very commonly used since the basic rules indicate milk is safe a cooler with ice-packs for 24 hours or a refrigerator for up to 4 days. The basic method (more info in the link) after pumping is to store the milk in a cooler with ice-packs, or in the refrigerator. Put the other parts (flanges, valves, etc) in a clean storage bag with a good seal. Keep the parts in a cooler with ice-packs, or refrigerator between pumps. Then use them for your next pump. Repeat and then wash everything thoroughly when you get home. Again - not formally endorsed, so always evaluate your situation for cleanliness, and smell/taste the milk to check!
Sterilization of bottles and pump parts is not necessary for a full term healthy baby as long as parts are thoroughly clean. However feel free to sterilize if needed/desired - boiling water bath, commercial sterilizer, commercial microwave sterilizer bags, etc.
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