Pumping Pointers: Clearing up Confusion about Milk Expression

Modern breast pumps are an excellent tool that breastfeeding mothers can use to boost milk production, maintain a milk supply when returning to work and protect their supply during times of illness or feeding difficulties. Some mothers also choose to exclusively pump and bottle feed their own milk to their babies. There is so much information available on pumping, that it can be confusing and overwhelming for a new mom.

The following information should help explain times when pumping is appropriate or necessary, expel some common pumping myths, explore methods for maximum milk expression and encourage proper pump use.

Pumping Pointers: Clearing Up Confusion About Milk Expression

Is Pumping Right For Me?

For mothers who are planning to exclusively breastfeed, pumping may not be necessary right away, if at all. The first two weeks after a baby is born are a very important time for establishing a good milk supply. During this time, babies nurse frequently, usually 8 or more times a day. By emptying the breasts frequently, the babies are programming mother’s body to produce the amount of milk they need. Breasts make milk on a supply and demand system, so in order to make more milk it needs to be removed more often. A good way to remember this is “8 or more in 24”. As long as babies are nursing frequently and effectively, pumping is usually not required.

When to Pump

During these early days, reasons a mom might need to pump or hand express milk would include:

•a sleepy baby who is not emptying mother’s breasts often enough or vigorously enough to stimulate her milk to come in well

•an early (premature) baby who doesn’t have the adequate muscle tone to transfer milk from the breast

•a baby who needs some extra milk for a medical reason such as low blood sugar or newborn jaundice

•for mom’s comfort if she is experiencing engorgement

•if a mother is exclusively pumping and bottle feeding she will need to start removing milk from her breasts as soon as possible after her baby is born and then at least 8 times a day

Later on, after a mother’s milk supply is established, pumping can be used to:

•Stockpile a supply for moms returning to work

•Boost milk production

•Maintain milk production if baby starts sleeping through the night and/or going longer stretches between feedings

•Prevent or relieve engorgement caused by infrequent emptying

Breast pumps are a useful tool, but just like any tool, they should only be used when required. For a mom who has an adequate milk supply and a baby who is nursing well without difficulties, routine pumping is not necessary, unless she is storing milk for times she will be away from her baby.

Pumping Myths

In the past moms were often advised to pump and dump milk at certain times, while taking prescription medicines, if they had a drink of alcohol, or if they were sick. This waste of milk can be distressing for a mother, and in most cases, is entirely unwarranted. Anyone who says “there’s no crying over spilled milk” has obviously never pumped!

You Can’t Take Any Meds

Very rarely, do medications pass into breast milk in large enough quantities to affect a baby. The most common medications that do get into milk include chemotherapy drugs and radioactive isotopes that are used in contrast studies. If a mother is ever unsure if a medicine is safe to take while nursing, she can contact the WMMC lactation consultants in the Stork’s Nest or call Dr. Thomas Hale’s Infant Risk Center Hotline at (806) 352-2519. The hotline is live Monday – Friday, 8 am – 5 pm.

You Have to “Pump & Dump” After You Drink Alcohol

Recent research also indicates that it is okay to have an occasional drink of alcohol. According to the Center for Disease Control “moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing.” More information can be found at www.cdc.gov/breastfeeding.

Pumping While You’re Sick Will Make the Baby Sick Too

Mothers who have mastitis or are sick should continue to breastfeed or pump to maintain their milk production. Breastfeeding is also the best way to protect your baby from catching the bug or to help decrease the severity and length of your child’s illness if they have already become infected.
As you can see, incidences, where the pumping and dumping of expressed breast milk are needed, are actually uncommon. Breast milk is considered “liquid gold,” and its waste should be avoided if possible.

How to Pump

Mentally Prepare: If a mother needs to pump for any reason, there are many ways to pump more efficiently and effectively. When pumping, it is important to remember that a mother’s brain is her most powerful milk making organ and it will respond better to her baby than to a machine. Because of this, some mothers find it helpful to have their baby close by when they pump, or if that is not possible, a picture, video, or item of baby’s clothing that smells like their infant can be helpful. It can also be useful to cover the pump with a blanket and focus on something else while pumping.

Be Gentle: Another thing to remember is that pumping should not hurt. Using lanolin or a food-grade oil such as coconut or olive oil while pumping may help the nipple to glide in the flange more easily and prevent discomfort. Moms should also avoid turning the suction up too high. If your pump’s suction is too high, it can cause the milk ducts to collapse and decrease your output. It’s like trying to suck a thick milkshake through a small straw, it just won’t work!

Learn Massage Techniques: Lastly, any time a mother can use her hands as well as the pump, she will be able to express more milk. Massage and breast compressions also help to increase the fat content of the milk expressed. For an awesome video that teaches hands-on pumping techniques, moms should check out this link.

Who Can Help

The internet, friends and family, and mother’s groups can all be great sources of breastfeeding tips and support. However, the most reliable source for up-to-date breastfeeding and pumping information is an international board-certified lactation consultant (IBCLC). Any time a mother has a question about whether or not to pump, how to pump, or whether or not she needs to pump and dump, she should contact a breastfeeding professional. In our area, there are many trustworthy breastfeeding resources:

•WMMC Lactation Consultants, Monday – Friday 9 am – 3 pm, (660)-262-7519
• Johnson County WIC Lactation Consultants, Monday – Friday 7:30 am – 6 pm, (660) 747-2012
• Mom to Mom: Breastfeeding Support Group: Third Thursday each month from 4pm-5pm. Facilitated by a WMMC IBCLC

Author: Ruthie Porter, RN, BSN, IBCLC