Pumping your breast milk: An overview
Why would I need to pump my breast milk?
The most common reason to pump is 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 essential if you're going back to work but want to continue nursing.
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 your baby!)
You may also use a breast pump to stimulate your milk production and increase your supply, to collect milk to feed a premature baby or one who can't latch on to your breast, or to relieve the pain and pressure of engorged breasts.
Finally, pumping allows you to keep your milk supply up if your practitioner advises you to stop nursing temporarily because you're taking medication that might be harmful to your baby, for example, 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.
How do I use a breast pump?
To use an electric pump, you put a breast cup or shield over your breast, turn the machine on, and let it do the work of suctioning your milk into an attached container. Manual pumps also use a breast cup or shield, 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 plastic cups for your breasts and position them just right so you don't pinch or irritate yourself. Initially you'll feel quite a tug from a fully automatic pump. It shouldn't hurt, but it may feel a bit odd. Consider buying a pumping bra so you don't have to hold the cups on your breasts. (That way, your hands are free to hold a book or magazine, so you can read or work while you're pumping.) Remember to clean the pump parts carefully after each session to prevent bacteria from getting into them.
What kind of pump should I use?
Choosing the breast pump that's right for you depends on how often you plan to use one 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 at the same time. But if you only need to pump a few ounces occasionally so your partner can feed the baby while you're out for a short while, 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, to relieve engorgement or 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. (Also, if you have sore, cracked nipples, you might want to express a little breast milk by hand after each nursing session to rub over them and soothe them.) Expressing milk by hand is time-consuming, though, so it isn't usually feasible if you need to express milk regularly.
Wash your hands before you start. Then, place your thumb and your fingers across from each other at the edge of the areola, and squeeze, pushing your fingers back against the chest wall, to express the milk. If your areolas are large, position your fingers so they're at least an inch behind the nipple. Use any wide-mouth container to collect the milk.
How do I store breast milk?
It's best to put breast milk in plastic or glass feeding bottles with secure caps to seal in freshness. You can also use plastic bags made especially for storing milk or disposable baby bottle liners (although they may break more easily because the plastic is thin). Remember to write the date on the bottle or bag before putting it in the refrigerator or freezer so you'll know when you pumped it. 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.
Use fresh, refrigerated milk within 72 hours. Milk can last at least three months in the freezer of a double door fridge. or three to six months if you have it in a stand-alone freezer set no higher than zero degrees Fahrenheit. Once you've thawed frozen milk, you can keep it in the refrigerator for up to 24 hours. (If you haven't used it in that time, you'll have to throw it away, since you can't refreeze it.) 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.
To thaw frozen milk, place the bottle or bag in a bowl of warm water and run it under warm tap water, or defrost it in the refrigerator overnight. Don't use the microwave for defrosting or warming because it kills the nutrients in breast milk. Most health professionals recommend throwing out any milk that's left in your baby's bottle after a feeding, though some may tell you it's okay to save a bottle of partially drunk breast milk as long as you refrigerate it right away and use it within four hours.
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 after your last session of nursing or pumping. You won't get much milk out of your breasts if you or your baby has just recently done a good job of draining them.
• 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. You'll get the best results from a high-quality, fully automatic pump.
• You may be using shields that are too small for your nipples. This is a common problem because most pumps come with shields that are designed for women with small nipples. If this is the case for you, your nipples may swell up once you start to pump, and that can reduce the amount of milk you'll be able to get out of your breasts. Many breast pump companies now make breast shields in larger sizes. Make sure you're using the size that's right for you.
• You may just not be producing very much milk. There are many reasons for this, including not nursing often enough.
If you're having trouble or feeling discouraged, call a lactation consultant. Or talk to the women on our Pumping Moms bulletin board. They can often help with problem-solving and be a great source of support.
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