Breast Pumping Basics: the Answers to All your Pumping Questions

 

When you are expecting a new baby, it’s normal to have lots of questions about pumping.  It can feel like getting a breast pump for your milk is a top priority! Whether you plan to breastfeed/bodyfeed, exclusively pump and bottle feed or are not sure what your feeding plan will look like yet, having a pump available after your baby is born can be really helpful. In fact, most insurance companies will cover the cost of a double-electric pump and for those who end up needing a stronger hospital-grade pump—you can usually obtain one from a local hospital, pharmacy or lactation consultant’s office. In addition to having access to an electric pump, many nursing parents also like to have a hand pump like the Hakkaa or Elvie Curve. Finally, it is important to note that often the most effective and comfortable way to express milk is with your own hands. Hand expression is the best method for early milk (colostrum) removal, and lots of lactating parents continue to use manual milk expression throughout their nursing journeys! 

Once you have your pump or have learned hand expression, you will undoubtedly have questions about why, how, and when to express or pump your milk.

Why use a pump in the first place?

Not all parents use a pump. If your baby is nursing well, gaining weight, peeing and pooping and generally thriving, there is no need to pump at all. If you enjoy nursing and you are never apart from your baby when they need to nurse, you will not need to pump. Pumping is used primarily to replace a feeding at the breast or chest and to keep milk supply up. If you are not feeding your baby directly, you will want to express your milk when your baby would have fed in order to signal to the body to make more milk by emptying the breast/chest and to have that milk out of your body so it is available to nourish your baby. Pumping can also be used to increase your supply if the baby’s suckling is not driving enough milk supply. 

How do I use my pump?

Great question! Along with your pump’s instruction manual and YouTube videos, your lactation consultant can help you not only learn how to use your pump but also help you find the settings and flange sizes to maximize your pumping experience while finding the most comfort (just like nursing shouldn’t hurt—neither should pumping). Lactation Consultants are also experts at teaching hand expression. Don’t be discouraged if pumping or hand expressing seems complicated at first—most people fall into a rhythm that works for them pretty quickly. 

When should I start pumping?

When you start using your pump really depends on your individual situation and goals. If you plan on primarily nursing and your baby is nursing well, you may not use your pump at all in the early days, weeks or months. You’ll possibly turn to your pump when you are ready to introduce a bottle to your baby, but won’t need to pump before then. 

If you have early nursing challenges, you will want to hand express or pump early on at a similar frequency that your baby is eating. For example, if pumping for a baby in the neonatal intensive care unit (NICU), plan to pump every 2-3 hours. If you are pumping in addition to nursing to help build your supply, you may pump right after nursing to increase stimulation and encourage your body to make more milk. Some nursing parents also find their pump helpful in the first week after birth when they are dealing with some initial engorgement. You might pump a bit to soften your breast/chest before latching your baby or after nursing if you are experiencing continued fullness or discomfort. 

How often should I pump and for how long?

In general, many lactating people find that they need to nurse and/or pump at least 8 times a day to stay comfortable and make enough milk. Everyone is different but plan to be pumping between 10-30 minutes each time. Usually pumping both sides at the same time is most effective and efficient! 

How can I maximize how much I milk I am pumping?

There is much that can be done to maximize milk production but the most important factor is usually frequency. The more milk that is removed from your body, the more your body will make. Additionally, skin-to-skin contact with your baby prior to pumping (when possible) will hormonally help boost your production. Using your hands to massage and compress your breast or chest before and during pumping and utilizing hand expression at the end of your pumping session (collectively often referred to as “hands on pumping”) will increase your output. If you are exclusively pumping, you may want to try this pumping bra which massages and stimulates your breasts/chest while you pump, increasing output. 

How much milk should I be expecting in the early days? The early weeks? When I return to work?

When pumping and expressing in place of nursing, ideally you will pump the amount your baby needs. In the early days, your baby will need small amounts of colostrum frequently. You might find you are expressing about 5-10 ml for each session on the first day increasing to 20-30 ml on your third day postpartum. Usually between day 2-5 postpartum, your milk will transition from colostrum to mature milk and it will increase in volume.  Often by the end of your baby’s first week, they will be taking 45-60 ml (1.5-2 ozs) per feeding. Over the course of the first month, your baby will slowly increase their intake and you will increase your production. On average, babies eat about 25 ounces a day between 1-6 months. When you are pumping and nursing, perhaps when you are back at work, you may find your baby nurses more frequently when you are together and takes less by bottle when you are apart. Many working parents plan to leave about an ounce per hour they are apart from their baby and will pump every 3-4 hours while at work. You may find taking a back to work and pumping class helpful to more deeply understanding this process. Many families find booking a back to work session with a lactation consultant helps prepare to go back to work and keep milk supply up. 

How long is expressed milk good for?

The most basic answer is generally longer than we expect. Human milk is incredibly resilient and has antibacterial properties that keep it fresh after you express it. Washing your hands and equipment well, especially when pumping outside of your home, can help keep your milk usable longer.

According to the CDC, at room temperature, newly expressed milk is good for ideally 4 hours. Once in your refrigerator, it is ideal to use within 4 days. As new research emerges on human milk, these guidelines are often updated. The most recent guidelines by the Academy of Breastfeeding Medicine allows more time for human milk to be used and your lactation consultant or pediatrician may share more specific information for your baby. If you know you do not plan to use your milk for a while, it is best to freeze it. Frozen milk is good for at least 6 months and up to 12 months in a deep freezer. 

Is it normal that one side produces more milk than the other?

Yes! This is really common. Many lactating people find that one side produces more milk than the other. 

The experience of breast pumping and expressing human milk for your baby varies widely for each family. You may ultimately pump once a day, exclusively or just when you are apart from your baby. Working with a lactation consultant can help you find what works best for you and your baby!