How to Express Breast Milk

If breastfeeding is going well and you are not planning to go back to work, you may find that you never need to pump. But if your baby is in the NICU from birth, you may need to express milk every couple of hours, and the most efficient pump is your best bet. Options for expressing milk include:

•  Hand Expression: If your baby is having problems during the first couple of days after birth, you may be able to hand express drops of colostrum onto a spoon or into a syringe and feed this to your baby. If you are engorged when your milk first comes in, hand expressing some milk over the sink or a bowl may be just enough to relieve the pressure in your breasts. You can also use the Mumasil Breast Milk Saver to catch the milk you may want to store. Some women find that hand expression works much better for them than any pump – likely from a hormonal difference between the skin-to-skin contact of your hands compared to the plastic of the breast pump. Hand expression is convenient, easy and free. You can learn the technique from this video as well as these written instructions.

• A Manual Breast Pump: Sometimes called a hand pump, this is a mechanism that allows you to express milk from one side using only your hands for power. The benefits of the manual breast pump include portability, nearly noiseless operation and no electricity needed. You can also have a little more control on the suction level as well as the rhythm of the pumping. Drawbacks include fatigue in the hand doing the pumping!

• An Electric Breast Pump: Electric breast pumps come in two general categories - hospital grade pumps and single user personal pumps. A hospital grade breastpump is a multi-user, closed system device. You use your own pumping kit, but more than one person can share the motor. These are typically the most efficient pumps. A single user pump is for your own personal use, and isn’t meant to be shared or sold after use. These pumps come in wide spectrum of efficiency. The most expensive pump on the market isn’t necessarily the best, but the less-expensive pumps may not have the strength needed to maintain your milk production. Do your homework before buying a pump. Read reviews, ask friends and family, talk to coworkers who have pumped in the past. All of this will help you make a well-informed decision on which brand of pump to buy. You private health insurer may give rebates for the purchase of a breast pump. Check with your member services to see if you qualify.

So, which pump do you need? Start by thinking about why you might need to pump, and then choose the best pump you can afford to meet your needs. Reasons you might need to express breastmilk include:

• Maternal or Infant Illness at Birth: If your baby has any complications at birth that require special care, you may need to begin pumping as soon as possible after the birth. Aim for frequency – every 2-3 hours. This stimulation will help your milk to come in and will set your body up for good milk production once you are with your baby again. Maternal illness is a more difficult situation. Depending on circumstances, you may be able to pump with the help of the medical staff. If not, you may be able to re-lactate after you have recovered. Discussing options with your care provider and including your desires for infant feeding in your birth plan would be beneficial.
• Your Baby Won’t Latch: If your baby is having difficulty learning to latch, you may need to pump to bring in and keep up your milk supply.
• Low Milk Supply: A baby is better than any pump at getting milk from the breast. So pumping isn’t a good indicator of how much milk you’re making. If you are concerned about low milk supply, though, adding pumping can give it a boost. You can pump a couple of times each day in between feedings, or you can pump for a short period after each feeding.
• You’re Going Back to Work: Pumping as often as your baby would be nursing when you are apart is the ideal, though it’s not always practical in all types of employment. So pumping as often as you can – so that you’ve got milk to leave for your baby and so that your body continues to produce plenty of breastmilk for when you’re together.

Pumping is fairly self-explanatory. Always start with clean hands and clean pump parts. Set the pump up according to the manufacturers instructions, centre your nipple in the flange, and turn the pump on. You may need to adjust the settings to make it more comfortable for you – it doesn’t need to be cranked to the maximum suction to do the work. Then try to relax and let the milk flow.

Don’t be alarmed if you don’t get much milk the first time that you pump. There’s a definite learning curve to pumping. The key is to maximise your letdowns. Make sure you have privacy for pumping, and that you’re warm enough. Use a warm compress on your breast or a sweater over your shoulders. Practice relaxing – even taking a few deep breaths at the beginning of each pumping session. Visualise your baby, look at pictures of your little one, or listen to a recording of your baby cooing (or crying!). Massage your breasts before turning the pump on. When you don’t see milk spaying out anymore, turn the pump off and massage your breasts again. Women say this hands-on-pumping technique helps to increase how much milk they can get at each pumping session.

If pumping hurts, play around with the pump’s settings to find one that is comfortable for you. Make sure that the flange fits your breast well. If too much of your areola is being pulled into the pump, or if your nipple is rubbing the sides of the flange, you can experience pain. You can order bigger or smaller flanges from most pump manufacturers.

Clean any pump parts that come in contact with your milk after each pumping session using soap and hot water. Allow the parts to air dry. Follow the manufacturers instructions regarding sterilisation or using a dishwasher to clean the pumping kit. The tubing doesn’t typically need to be washed. Occasionally the tubing will have a bit of condensation inside. Turning your pump on for a few minutes should dry this out. 

Sometimes when pumping has been going well for several months, your pumping output all of a sudden seems to decrease. Check all of your pump parts – especially tubing and membranes – to make sure they’re in working order. Consider temporarily trying a different type or brand of pump. Check with your manufacturer for instructions to test the pump’s suction and for troubleshooting what to do if it has become faulty. Make sure you are pumping often enough – sometimes just adding minutes to your pumping sessions or pumping sessions to your day is enough to boost your output.