There are a wide variety of pumps available on the market: manual pumps, single and double electric, hospital grade electric pumps, hands-free pumps. The best model will depend on the individual’s requirements.
Most electric pumps on the market are ‘open systems’ and are not designed for use for multiple users as there is a possibility for germs and fungus to grow inside the pump. ‘Closed system’ pumps are also known as ‘hospital grade’, which can be, after thorough sterilisation, used by multiple users. The use of a second hand pump (unless it is a hospital grade model) is discouraged due to the contamination risk.
When using an electric breast pump, it is very important to follow the assembly instructions carefully, as leaving a part out or attaching it incorrectly could lead to malfunctioning or leakage from the pump. Most electric pumps are made up of a flange (or two flanges in the case of a double pump), valves (usually made from silicone), backflow protectors, tubing which connects the bottle with the pump, and the collection bottles.
It is crucial to ensure the flanges fit properly.
The nipple should fit snugly inside the flange funnel; there shouldn’t be any rubbing (as this would indicate the flange is too small) and the areola should not get sucked in (which would indicate that the flange is too large). Many companies supply a standard flange size of 24mm, and some companies produce size 21mm-36mm to cater for various nipple sizes. If you are unsure of the correct size for you, speak to a breastfeeding specialist.
Step by step: using a breast pump
Before using a pump, you should always wash your hands with soap and warm water. Be sure not to touch the parts that come into contact with milk in order to avoid contamination.
For good milk output, it is helpful to be sitting as comfortably as possible, and to have a drink and a snack ready. Being close to your baby, having a muslin that smells of of them, or even looking at a photo or video of your baby will help with the milk to flow.
It can be helpful to apply a warm compress to the breast for a few minutes before pumping as this enhances circulation, and then to massage your breasts to encourage the let-down reflex, massaging the whole breast in a circular motion, using your fingertips as well as stroking motions with your palm or the flat of your hand.
Place your nipple in the centre of the flange and turn the pump on. A lot of pumps have a 2-phase technology, whereby the pumping cycle starts with short, light sucks to trigger the let-down reflex, followed by slower and stronger sucks. If you want to control the settings manually, at the start of a session, the vacuum needs to be set on low, with the cycles set on high. Once the milk starts to flow, the cycle speed needs to be decreased and the suction strength should be increased to a comfortable level, which is strong enough to get the milk to flow, but not too strong as this can cause pain, which inhibits milk flow.
The volumes a mother can express vary considerably depending on the age of the baby, maternal milk supply, pumping frequency and the length of the pumping session, and whether she is exclusively pumping or pumping after a breastfeed. How long it takes for a mother to experience the let-down reflex can vary greatly between mothers and it is not a good idea to compare yourself with other mums as this can lead to unfounded feelings of inadequacy. Most of the available milk will be removed within 15-20 minutes, although it’s important to be aware that lactating breasts are never completely empty. If the aim is to increase supply, it is helpful to pump for a few minutes after the milk has stopped flowing.
After you have finished expressing, label the bottle with the date and time of the expressing session, and place it in the fridge (or freezer if it needs to be stored for longer) until you need the milk.
Recommended storage details:
Reasons for pumping:
It is not recommended to use a pump before birth, but it can be helpful to start hand expressing milk from 36 weeks pregnancy (more information: https://www.llli.org/the-benefits-of-antenatal-colostrum-harvesting/) in preparation for the baby’s arrival.
After the baby’s birth, there is no need to pump if they are feeding well from the breast and if the milk supply is sufficient. Pumping in the early weeks should only be done if there is a need, such as:
Once breastmilk supply has been established, which is around 4-6 weeks, some mums like to pump to build up a freezer stash, for when they go back to work, so they can introduce a bottle, or for example in case there is a medical reason which means they need to stop breastfeeding – although this is rare. (Please always double check with a lactation consultant).
What to do if pumping is painful?
Pumping should not be uncomfortable. Pain while pumping can be caused by an ill-fitting flange, which is either too small and chafing the skin of your nipples, or too big and pulling your areola into the funnel of the flange. Please ask a breastfeeding specialist to check the fit of the flange if you are experiencing pain. If the pain does not settle despite a correct flange size, it is advisable to seek help from a specialist.
How to increase the milk yield when pumping:
How often do I need to pump?
Breastmilk is produced on a supply and demand basis. Thorough and frequent emptying of the breast will help to increase your levels of prolactin, the hormone responsible for milk production.
How often a mother needs to pump depends a lot on the situation and the reason why pumping is necessary. If a baby is unable to breastfeed, it is recommended that the pumping frequency mimics a baby’s feeding pattern, which is at least every 3 hours, 8 times in 24 hours (ideally 2-hourly in the day and 4-hourly at night). It is crucial not to let the gaps between the pumping sessions get too long, in order to ensure plenty of breast stimulation, sufficient expressed milk to feed the baby, and to avoid breast engorgement or a drop in milk supply.
If the baby is also breastfeeding, some of the breastfeeds can be replaced by expressing.
If a baby is breastfed but not efficient at emptying the breast, the pump can be used after a feed in order to maintain milk supply and so the baby can be supplemented with expressed milk. In some cases (for example: excessive weight loss in the baby, tongue-tie, prematurity) a feeding regime might have to be put in place, whereby every breastfeed is followed by a pumping session and a top-up of expressed milk (or formula). This is called ‘triple feeding’ and is mostly a temporary measure to ensure good weight gain.