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Hi, I'm Julie, and I'm a lactation consultant. Today I'm working with Lexis, and we'll be talking about different types of breast pumps and the best ways to use them.
Before pumping, there are a few steps you need to take to prepare. First, wash your hands so you don't contaminate any of the parts. Read the instructions for proper assembly, cleaning, and operation of your pump.
Use pillows to support you back.
HOW TO USE AN ELECTRIC PUMP
Step 1: To start using the electric pump, the first step is to place the flange over your breast and line up the flange with your nipples centered within the tunnel. Be sure that the flange is a good fit – it's common for moms to need to move up a size. Be sure to hold the flange gently but securely against your breast in order to maintain a good seal.
Step 2: Hold one flange in place with your arm and use your other hand to place a flange on the second breast.
Step 3: Hold the bottles in place with one arm and hand, and use your other hand to turn on the machine. Start with a fast speed and low suction to initiate the letdown or the flow of your milk. This mimics the way your baby breastfeeds.
Step 4: Once your milk starts flowing, turn the speed down and then very gradually increase the suction. Consider a hands-free pumping bra so that you can read, talk on the phone, or work while you're pumping. While you're pumping, watch the flow of your milk. If you're noticing that it's slowing down, you can try increasing the speed again to see if that triggers the letdown or flow of more milk. And many moms have multiple letdowns during a single pumping session.
Continue pumping for two to five more minutes once you notice the milk stops, to be sure that you have good full drainage. Expect the amount of milk that you collect from each pumping session to vary and to change as your baby grows.
If you're returning to work, you want to pump about every three hours while you're away from your baby.
HOW TO USE A MANUAL PUMP
Manual pumps require that you pump a piston or squeeze a lever to create suction. These pumps typically empty one breast at a time but might require both hands to operate.
Step 1: The first step is to apply the flange to the breast.
Step 2: And then begin pumping. It may take a few minutes before your milk starts flowing.
Start with fast light squeezes to initiate the letdown or flow of your milk. Then use a stronger, slower motion to keep the milk flowing. This two-speed action mimics your baby feeding at the breast and may help you pump more milk faster. If you're having trouble getting the milk out, use your other hand to massage-compress the breast.
Step 3: Switch breasts about every five minutes, and make sure both breasts receive about 15 minutes of stimulation. Don't worry if one breast produces more than the other. This is normal. If you're concerned about your baby's feedings, contact your lactation consultant or your doctor.
Video production by Corduroy Media
Why would I need to pump my breast milk?
The most common reasons to pump are to collect your milk so your baby can have it when you're not around and to maintain your milk supply for when you're together. This is important if you're going back to work but want to continue nursing.
To get the hang of it, it's a good idea to practice pumping for a few weeks before you need to rely on expressed breast milk for your baby. Just make sure that breastfeeding is well established before you give your baby the bottle.
Pumping also means you don't have to be on call for every feeding when you're at home. Your partner (or another helper) can feed your baby your milk from a bottle, allowing you to get more uninterrupted sleep or take a break from baby care. (Letting Dad take over some of the feedings also helps him bond with the baby!)
You can also use a breast pump for these reasons:
- To stimulate your milk production and increase your milk supply
- To collect milk to feed a premature baby or one who can't latch on to your breast
- To relieve the pain and pressure of engorged breasts – though too much pumping when you're engorged can make matters worse
- To keep your milk supply up if your healthcare provider advises you to stop nursing temporarily because you're taking medication that might be harmful to your baby (this is rarely necessary) or if you're hospitalized for a short time and can't breastfeed throughout the day.
Most women express their milk using an electric or manual pump. Some women prefer to express their milk by hand, but most feel that using a pump is faster and easier.
Although it may feel strange at first to use a machine to get milk from your breasts, it usually doesn't take long for the process to become quick and easy.
To use an electric pump, you put a breast phalange (or shield) over your nipple, turn the machine on, and let it do the work of suctioning your milk into an attached container. (Phalanges are supplied with the pump.) Manual pumps also use a phalange, but you extract the milk by operating a squeeze mechanism or pulling a plunger with your hand rather than relying on a motor.
It usually takes ten to 15 minutes to pump both breasts with a good electric pump and up to 45 minutes with a hand pump.
Good breast pumps mimic the sucking action of a baby and won't cause you pain. Be sure to use the right size phalanges for your nipples and position them just right so you don't pinch or irritate yourself.
Consider buying a hands-free pumping bra so you don't have to hold the phalanges on your breasts. (That way, your hands are free to hold a book or magazine, type, or dial a phone, so you can read or work while you're pumping.) Some moms make their own pumping bras by attaching rubber bands to the clasps of a regular nursing bra or cutting holes in an old jogging bra.
Remember that for best letdown and milk production, you'll need to be calm and relaxed.
Initially you'll feel quite a tug from a fully automatic pump. Start with the lowest level of suction, then turn it up as needed once you get going. It shouldn't hurt, but it may feel a bit odd. Remember to clean the pump parts carefully after each session.
What kind of breast pump should I use?
Choosing the breast pump that's right for you depends on how often you plan to use it and how much time you can devote to pumping. If you work full time and have to find time to pump during a busy workday, you'll want to use a fully automatic pump so you can pump both breasts quickly at the same time. But if you only need to pump a few ounces occasionally, an inexpensive manual pump may do just fine.
When would I express milk by hand and how do I do it?
If you only need to express milk every once in a while – say, for a rare bottle-feeding – you may be able to get by with expressing by hand, although it might take a bit of practice to get it down.
Hand expressing a little breast milk can help soothe engorgement and plugged ducts. And if you have sore, cracked nipples, you might want to express a bit of breast milk by hand after each nursing session to rub over them and soothe them.
Many women find that expressing milk by hand is time-consuming, though, so it isn't usually feasible if you need to express a larger amount of milk regularly.
It helps to have someone demonstrate this for you, but here's a step-by-step:
- Wash your hands before you start.
- You may find it helpful to massage your breasts a bit or apply a warm towel before expressing.
- Sit up and lean forward – gravity helps!
- Place your thumb and index finger on each side of the breast, about an inch or so behind the areola, forming a C with your hand.
- Press your fingers back toward your chest wall and then gently together. (You want to compress the area under the areola, not the nipple itself.) Use a rolling motion rather than pulling or yanking. You may need to experiment a bit to find the right spot – when you do, you'll squirt milk.
- Rotate your fingers around the areola (starting on top and bottom and moving to the sides, for example) as you continue to milk each breast. At first you may only get a few drops. That's okay – you'll get more with practice.
- Collect milk in any clean container with a wide mouth.
What about storing breast milk?
You can store breast milk in a feeding or storage bottle that's made of plastic or glass. A secure cap will keep it fresh. (Many pumps come with storage containers.)
You can also use a plastic bag made especially for storing milk. Fill the container three-quarters full if it's going in the freezer, to allow for expansion.
For convenience, store the milk in the amounts that you normally use at a feeding. (If your baby typically takes 3 ounces, then store in 3-ounce portions.)
Remember to write the date on the bottle or bag before putting it in the refrigerator or freezerso you'll know when you pumped it. (You'll want to use the oldest milk first.) Don't combine fresh milk and frozen milk (by topping off a frozen container with some fresh milk, for example).
You may be surprised to see what breast milk looks like. It's normal for the fat to separate and float to the top, and sometimes the milk has a bluish hue, especially early on. (Your milk color may also be affected by your diet or medications.) Don't shake the milk. Instead, gently swirl it to mix the fat back in.
Your milk shouldn't smell or taste sour, but after thawing milk sometimes has a slightly soapy smell from the change in the fats. This is perfectly fine.
The process of freezing destroys some of the antibodies in the milk, so don't freeze it unless you have to. But frozen breast milk is still healthier and offers more protection from disease than formula does.
How long can I store breast milk?
There are different opinions on how long breast milk stays fresh once it's left your body.
- Fresh breast milk. The Centers for Disease Control and Prevention (CDC) says milk can be kept at room temperature for six to eight hours, though it's best to refrigerate it immediately. Use fresh, refrigerated milk within five days. (Store it in the back of the main part of the refrigerator.)
- Frozen breast milk. In the freezer compartment of a refrigerator (5 degrees F), milk can be frozen for two weeks. If there's a freezer compartment with separate doors (0 degrees F), it can be stored for three to six months. And in a chest or upright deep freezer (-4 degrees F), it will be good for six to 12 months.
(Use the lower numbers – three months and six months – for best quality. At the higher end, the milk is still safe, but the quality will be a bit lower.)
Once you've thawed frozen milk, you can keep it in the refrigerator for up to 24 hours. If it's at room temperature, use it within one hour. (If you haven't used it in that time, you'll have to throw it away, since you can't refreeze it.) If you need to transport milk, keep it cold until just before using.
Some health professionals recommend throwing out any milk that's left in your baby's bottle after a feeding, though others may tell you it's okay to save a bottle of partially consumed breast milk as long as you refrigerate it right away and use it within four hours.
How do I thaw frozen breast milk?
To thaw frozen milk, hold the bag or bottle under warm water until it's a comfortable temperature or let it defrost in the refrigerator overnight. Don't use the microwave for defrosting or warming, because it kills the nutrients in breast milk and hot spots can develop.
What can I do if I'm having trouble pumping?
For many women, the most difficult thing about pumping is finding the time to fit it into their schedule during the workday or finding a comfortable, private space to do it in. But pumping doesn't come easily for everyone. Here are some reasons you may be having trouble getting much milk out and some tips for what to do about it:
- You may be pumping too soon. You won't get much milk out of your breasts if you or your baby has recently done a good job of draining them. Don't stress about exactly when is the optimum time to pump, but take note if you're having trouble.
- You may need to change the settings on your pump. It can be hard to get enough milk if the suction pressure is too low or the cycling speed is too fast. In some cases, your pump may not provide the right pumping pattern for you no matter how you adjust it. The most advanced pumps now come with a reprogrammable setting card that you can send back to the manufacturer for adjustment.
- You may not be using a very good breast pump. Some women have trouble getting enough milk out if they're using a manual pump or an electric one that doesn't work very well (after about a year of use the battery may be worn out). You'll get the best results from a high-quality, electric double pump.
- You may be using shields (phalanges) that are too small for your nipples. This is a common problem because most pumps come with phalanges that are designed for women with small nipples. If your phalange is too small and your nipples swell up once you start to pump, you won't be able to get as much milk out of your breasts.
Many breast pump companies now make breast phalanges in larger sizes. Make sure you're using the size that's right for you.
- You may not be producing very much milk. There are many reasons for this, including not nursing often enough and not staying hydrated by drinking plenty of fluids. Some medications, like decongestants or estrogens, can also inhibit milk supply.
- You may be having trouble with the letdown of your milk. Try to relax and get yourself comfortable while pumping. (Some women like to look at a picture of their baby, close their eyes and think of their baby, or even listen to a recording of their baby's coos or gurgles.) You might also try gently massaging your breasts or using warm compresses on them before pumping.
If you're having trouble or feeling discouraged, call a lactation consultant. Or talk to pumping moms in our Community. They can help and be a great source of support.