Pumping Guidelines (includes VIDEO)

• how much time you will spend away from your baby
• how easily your body produces a milk supply. You might tend to be an under-producer, a just-enough- producer, or an over-producer.
• your baby's ability to remove milk from the breast

Reasons to pump (or hand express)

• Remove colostrum if your baby doesn’t latch in the first 24 hours of life. Hand expression may work better than a pump before your actual milk comes in. 
• Pump to pull out flat or inverted nipples.
• Hand express enough milk to soften a breast that is too firm for your baby to latch on to.
  • Click here to watch a video on Reverse Pressure Softening.
• Pump after 5 hours at night if your baby sleeps through, to maintain your milk supply.
• Remove just enough milk to be comfortable, if you’re too full and your baby won’t nurse any more. Perhaps use a Haakaa to collect a bit of leakage or hand express into the Haakaa.
• Whenever your baby is bottle fed breastmilk or formula, drain your breasts with a pump or by hand expression.
  • when you are away from your baby at work, at school, when ill, on vacation, etc.
  • when he gets a practice bottle
  • when you triple feed (nurse – supplement – pump) to manage low milk supply or poor milk removal.
    • Click here to read about when triple feeding might be helpful.
  • Remove extra milk to stock-pile frozen milk for back-up. Not everyone can make enough extra milk to stash in the freezer. Try these things to get extra: 
    • Pump to empty after your first morning nursing session, when your breasts are at their fullest.
    • Let milk leak into the Haakaa while your baby nurses the opposite breast. Make sure your baby gets filled up before taking this milk for storage. 

Tips to optimize pumping sessions

• Use a high quality double electric breast pump.
• A pumping bra should fit loose enough, so it doesn’t constrict milk flow.
• Gently massage your breasts before pumping, perhaps with oil on your fingers. 
• Adjust the suction strength to be strong but comfortable.
• Adjust the suckling speed so it pumps quickly for a couple minutes. This is the let-down feature.
• When milk starts flowing, adjust it to a slower suction cycle, to mimic a nursing baby. Your pump might do this automatically.
• When milk flow slows, adjust the pump to cycle faster again, to prompt another let down. Some moms have several let downs.
• Finish up with hands-on pumping, perhaps one breast at a time. 
• NOTE:  If watching the milk flow causes you stress, put socks over the bottles so you can't see it! Set a timer and just let the pump do the work. More on this below!! 

Which pump to use

• A double electric pump will most effectively remove milk and thus stimulate milk supply. Our local hospitals use the Medela Symphony hospital grade pump. There are several options of double electric personal use pumps. Your insurance will likely cover the purchase price or rental cost, so check with them. 
• A hands-free, battery operated wearable pump is an option for moms who know they produce milk well. This type of pump is placed inside your bra to discretely pump as you move about. Because it may not remove milk as well as a double electric pump, use it only if you can't sit down to pump, and would otherwise have to skip a pumping session. 

Fitting the flange for comfortable pumping

• Click here to view a video that shows how to choose a proper flange size.
• If the tunnel is too small, the sides of your nipple will rub on the inside wall of the tunnel, which may cause friction. Try a lubricant to lessen the friction.
• If the tunnel is too big, excess breast tissue might pull into the tunnel and cause discomfort. In this situation, avoid lubrication, as the friction keeps the tissue from sliding in.
• If you're in between, alternate sizes at each pumping session, or try an insert.

How many minutes to pump

• Before your milk comes in, over the first 2-4 days, pump for about 15 minutes ,  even if very little milk comes out. This stimulates the hormones and milk cells to establish milk production.
• Once your supply is clearly coming in, you can stop pumping when you’re empty. Empty milk cells will make more milk.
• If you end up being an "over-producer," you may need to stop your pumping session when you reach a certain volume instead of pumping for a certain amount of time. The volume to pump depends on how much your baby is nursing each day versus exclusively pumping for all of your baby's intake. 

What can you do to help get the most milk out faster?

You can 1) massage while pumping (hands-on active pumping) or 2) just set the timer and GO (passive pumping).

1. Active pumping

• The video below shows active, hands on pumping. By using your hands, you can get empty faster. You'll spend less time pumping, but you'll need to pay attention the whole time. 
• This is stressful for some moms. Thus, the milk doesn't let down easily, so it doesn't help much.

2. Passive pumping

•   You might prefer to multi-task while pumping. Set a timer for 15-20 minutes. A pumping bra can hold the flanges in place. As the pump does the work, you might bottle feed your baby or accomplish other tasks like reading, or even cooking, if a wearable pump works for you. 
• If watching the milk flow causes you stress, put socks over the bottles so you can't see it!

Exclusive Pumping

A feeding plan for which you express milk regularly, and then bottle feed it.

• Why do this?
  • Your baby won’t latch.
  • Latching hurts too much.
  • Your baby nurses too slowly or is ineffective.
  • You want to measure how much your baby drinks.
  • You prefer this plan.
• Note: A baby who nurses well stimulates milk production better than a pump. But not all babies nurse well. Skin-to-skin time helps milk let down during pumping.    
• Note: If your baby doesn't nurse well, you may find the pump drains your breasts better. If you are an "over-producer," be careful not to ramp up your milk supply too much. 

VIDEO
This 10 minute video from Stanford shows effective pumping strategies. 
Click the words Watch on You Tube below.