How To Breast Pump Milk
Learning how to breast pump is pretty straightforward, but sure seems daunting when you’ve never done it before.
I remember the first time I pumped. I was in the hospital, the day after giving birth.
The nurse brought the pump in to me. Then she handed me a bag of parts.
And then she left.
My head was on a swivel while I looked wide-eyed from the pump to the parts and wondered what to do. After a little puzzle-piecing, I figured it out!
I sure would have liked a little instruction, so that’s what I’m here to give you!
Breast Pump Flange Size
This is one of the most important considerations of learning how to breast pump. The flange is the plastic funnel that sits on your breast and connects to the pump.
There are all sorts of different sizes of flanges, and there are all different sizes of breasts and nipples!
Often, the flanges that come in the breast pump supply parts are too small. That may mean that you need to order a larger size or check out a nearby store. Most pumps come with a few options though, so in the meantime choose the one that’s the best fit.
How To Tell If It Fits
If your nipple rubs against the sides of the flange, it’s too small. Too small of a breast flange can cause breast and nipple damage, not to mention it’s painful!
It can also result in your breasts not expressing an adequate amount of milk which can cause your milk supply to drop. So, pay close attention to where your nipple is within the breast flange. When the pump is on, be sure to note if your nipple touches the sides of the flange or rubs along it during each pump.
Your nipple should move freely in the tunnel of the flange. It should also stay in the center, and not touch any of the sides of the flange.
Another sign that the flange is too small is blanching. What blanching looks like is your nipple or areola turning white. This means that the circulation is getting cut off to your nipple and something isn’t right. It may feel numb, or be painful.
Speaking of pain, that’s another way to tell the flange isn’t fitting right. You shouldn’t feel any pain while pumping. Make sure that the suction isn’t on too high because that can cause some pain also.
And finally, when pumping your areola should have minimal tissue within the tunnel. If there is too much of your areola in the tunnel, the flange may actually be too big. There needs to be a happy medium here. Your nipple shouldn’t rub against the side, but you also shouldn’t have large amounts of areola or tissue being sucked into the flange.
Different Breast Pumps
There are all sorts of different pumps out there. Hand pumps, vacuum pumps, mechanical pumps, single or double pumps, the list is long! It can be overwhelming trying to figure out what pump you need.
If you don’t plan to pump a lot, you may be able to just hand express for the time you breastfeed when needed. If you need to express milk, hand expression is a great option! It’s fairly simple:
- Wash your hands. This is especially important in the first 6 weeks of baby’s life when their immune system is fragile.
- Massage your breasts. Massage helps loosen things up, and get your breasts prepared to express milk.
- Place your thumb and forefinger on opposite sides of your nipple, about an inch away.
- Press fingers towards chest wall and apply pressure.
- Roll your fingers towards your nipple. Be sure not to rub you fingers against your skin, causing irritation.
The first few times hand expressing can be difficult. In the first days of life, your body produces colostrum. It’s a thick yellow liquid with a consistency similar to honey. Colostrum is packed with nutrients and immunity, so it only takes a little to feed your baby. Therefore, you might only see a few drops when hand expressing in the first few days.
A hand pump is a good option if you think you’ll need to express milk every once in a while. It’s very tiring to use and takes about twice as long as a mechanical pump, so isn’t recommended for moms that need to pump more frequently.
A hand pump has an attachment and flange that connect to a container. When you press on the attachment, with the flange against your breast, there’s suction. It might take a few minutes before milk starts coming out, and you will have to continually squeeze on the pump in order to express milk.
Another option for a non-mechanical pump is a passive pump. A popular passive pump is the Haakaa. This is a silicone pump that you squeeze and then place on your breast. It uses continuous suction to pull milk out. You’ll need more than a Haakaa if you plan to pump frequently because it doesn’t give your breasts the same stimulation as a pump or your baby.
Often, moms will use a passive pump when they want to catch milk on the breast their baby isn’t feeding from. When your baby breastfeeds, it can stimulate the other breast to release milk. It’s sad to see that milk go to waste, so using a passive pump on the opposite breast is a good option.
These are the best for moms that will pump frequently. They are either battery-powered or plug into a wall.
There are different types of mechanical pumps:
Single breast pumps only have one flange, and pump only one breast at a time. This will work, especially if you don’t plan to pump very often. It’s easier than using a hand pump but it doesn’t work as well as a double breast pump.
Double breast pumps allow you to pump both breasts at the same time. Double breast pumps are better than single breast pumps for two reasons:
- They take half the time to complete a pumping session, for the simple fact that both breasts are being expressed at the same time.
- Double breast pumps stimulate both breasts at once. They stimulate a let down (which is when your breast relaxes and starts squeezing out milk) on both sides at the same time, which allows more milk to be expressed in a session.
The third type of mechanical breast pump is a hospital grade breast pump. These are typically double breast pumps, and are SIGNIFICANTLY stronger than other mechanical pumps. A hospital-grade breast pump can cut a pumping session time in half, just because of how efficient it is!
Most insurance companies will cover the cost of a mechanical breast pump, and it’s definitely worth looking into! They can really come in handy if you end up pumping.
There are many rental options for a hospital-grade breast pump that would be worth looking into if you primarily pump. They make things much easier for the exclusively pumping mom.
How To Use Let-Down Function
This was probably the hardest part for me to understand when I was learning how to breast pump. I didn’t really understand what a let down was, how it was triggered, or what any of the buttons on the pump were supposed to do.
What is a let down?
A let down is a reflex. It’s a natural response your body has to a breastfeeding baby. When your baby feeds (or when you pump), your nipples are stimulated which tells your body it’s time to release milk. This is the let down. Some women feel a let down as a tingling or may feel thirsty. Others don’t feel anything at all.
The way to recognize a letdown is when milk starts flowing. This is easy to see when pumping… milk will start shooting out of your nipple.
This is how a letdown is triggered:
- Your baby latches on to your breast and starts to suckle. In the first few minutes, your baby makes rapid movements with their tongue and sucks very quickly. Their jaw moves fast and they don’t swallow with every jaw thrust.
- Then, your breasts respond. The letdown happens and milk starts being expressed rapidly. You will recognize this when your baby makes slower, longer jaw thrusts. They will make big gulps and swallow the milk that’s expressed.
How To Trigger A Let-Down With A Breast Pump
To trigger a let-down with a breast pump, you want to mimic what happens when a baby breastfeeds.
Just like when a baby breastfeeds, there should be a function with your breast pump that simulates the quick movements baby makes. For example, most Medela breast pumps start out this way. They generally have a 2-minute timer and recreate the small, quick sucks just like a baby. At 2 minutes, the pump changes to the second phase.
The second function occurs when the pump takes longer, stronger sucks. On most medela pumps, the second phase is automatic after 2 minutes, but there is a button that looks like milk droplets that can be pressed to switch between the 2 stages.
Once you see milk start to come from your breasts, switch to the second function (basically, make sure your breast pump is taking long, strong sucks just like your baby).
While you’re pumping, you may see that milk stops flowing.
This is normal, and doesn’t mean that you got all the milk out.
If you notice your milk stop flowing, turn the pump back to the first phase that has quicker, more shallow sucks. This can trigger a second let-down. After a few minutes on the first function, your breasts will likely start to release milk again. Once you notice this, switch it again to the second function.
Learning how to stimulate a let-down with a pump can be extremely helpful! It also allows you to express more milk during a pumping session if you can stimulate more than one let-down per session.
How To Pump Enough To Maintain Milk Supply
Establishing your milk supply is extremely important in the first 6 weeks of your baby’s life. When learning how to breast pump, keep in mind the number of times you should be pumping per day.
An easy way to make sure you’re pumping enough is to make sure you’re expressing as much milk as baby is eating. For example, if you give your baby a bottle and they drink 4 ounces, then make sure that you pump 4 ounces if possible.
It’s not always possible to do this, so don’t worry if it doesn’t happen. A breast pump isn’t nearly as efficient as a baby removing milk from your breasts. It doesn’t necessarily mean that you are having an issue with your supply.
BUT you want to make sure that your supply doesn’t become negatively affected.
When you pump, your breasts might stop producing milk. When this happens, you might be thinking that’s all you’re going to produce.
The BEST thing to do is to keep pumping! Even when you don’t see any milk come out.
There are two reasons for this. The first reason is that continuing to pump may stimulate a second let-down. In other words, if you continue pumping your breasts might start to release milk again in a few minutes.
The second reason is because breast stimulation tells your body to increase milk supply. So even when there isn’t milk coming out, the pump stimulating your breasts is telling your body to produce more milk. It keeps your supply up by sending signals to your breasts.
It’s just like if your baby was sucking and not getting any milk. Your body intuitively knows that sucking is happening, and there isn’t milk released. It senses that baby is hungry and responds by producing more supply in the next few days. This is the same thing your breast pump can mimic, so continue to pump after milk flow stops.
How To Sanitize A Breast Pump
Babies have fragile immune systems, especially in the first 6 weeks after birth. That means they’re susceptible to infections or illnesses, and cleaning your pump parts it VERY important. In the first 6 weeks, be sure to clean your pump parts after each use with warm water and soap. After the first 6 weeks, it’s acceptable to put your pump parts in a ziploc bag or a dish in the refrigerator between uses.
The caveat to storing your pump parts in the refrigerator is that you HAVE to sanitize them once per day. Additionally, replace the bag or sanitize the dish you store them in daily. This ensures that your baby won’t get sick from microorganisms on the breast pump.
The best way to sanitize pump parts is to boil them in water every 24 hours.
Once per day, fill a pot with the breast pump parts so water completely covers them. Then, boil the pot for 5-10 minutes. This will ensure that any microorganisms die and the pump is ready to use for the next 24 hours.
You don’t need to sanitize the breast pump itself or the tubing, just the things that contact your breast milk. The CDC has a fantastic step-by-step guide to cleaning and disinfecting breast pump parts- for more information just click here.
How To Store Breast Milk
Storing your expressed breast milk properly is extremely important for your baby. Each time your store breast milk, be sure the container is sealed. If you store your breast milk in a bag, label the bag and zip it completely closed. If storing it in a container, make sure the container is air tight and follow guidelines for how long to store it.
Your milk is good for 4 hours after being expressed without refrigeration. If you refrigerate your milk, you can store it for up to 4 days. Frozen, the CDC states it is best used by 6 months but is acceptable for storing for 12 months. Once you thaw milk, use it within 1-2 hours, or it will be good in the refrigerator for 1 day.
Don’t refreeze milk after it’s been thawed. When your baby drinks milk, they introduce bacteria into the milk and bottle. For this reason, make sure to give the baby any unfinished milk within 2 hours or discard it.
Thawing milk should never be done in the microwave because it destroys many nutrients and proteins found in the milk. It can also cause tiny spots in the milk to super-heat which can give your baby burns in their mouth and throat. The best way to thaw milk is to place it in the refrigerator overnight or place it in a warm bowl of water.
I hope this guide about how to breast pump will help you along during your breastfeeding journey! It’s not always easy but it’s worth it to give your baby the liquid gold of your breast milk!
Kealy Hawk, BSN, RN, CLC
Kealy is a Registered Nurse, Lactation Counselor, and most importantly a mommy! Her own baby feeding struggles gave her a passion to help moms throughout their feeding journey. She specializes in breastfeeding support and evidence-based formula recommendations. To talk with Kealy or take one of her breastfeeding or formula classes, visit https://littlebearcare.com.
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