Breast Pumps and Expressing

10 situations you might express for?

Stimulate milk supply

To increase supply

To give your milk to your baby who isn’t latching

To give as a ‘top up’ after a breastfeed

Manage engorgement or oversupply

To provide your milk to your baby in NNU/NICU

To share feeding with your partner

Induce lactation

Relactation

Returning to work and want baby to have your milk

Due to the nature and consistency of your colostrum it’s often recommended to hand express your colostrum into a cup or syringe until your milk ‘comes in’. Once your milk comes in, about day 3 or 4, there is often a larger volume and that’s where a pump can be handy if you need/want to pump.

There are a number of options for breast pumps, they are not all the same. Some are made for frequent use and multiple users, whereas other are for one person more infrequent use. It’s important to have the right pump for the job.

Hospital Grade/Multi user Electric Pump:

These pumps are best to encourage a milk supply. For those needing to pump in hospital, NICU/NNU, induce lactation, really establish a supply. The strength and durability of these pumps means they can be used from the very early days all the way through a journey.

They use a closed system which means there is a barrier between the milk being expressed and the machine which prevents milk leaking into the pump which causes contamination.

Benefits of Hospital Grade/multi user pumps -

·      These are the strongest of pumps

·      You can double pump, saving time

·      Can be hired so as not needing to buy them

·      Often readily available in hospital for use and potentially hire for home too

·      Various flange sizes can be used (may need to be bought separately)

Drawbacks –

·      Need to be plugged into an electricity supply

·      Can be bulky and noisy though the newest ones are less so

·      If you want to buy one they are expensive. Buying second hand is cheaper and since they are a closed system this is safer.

Electric Pump:

·      These pumps tend to be smaller and as such more portable.

·      They can be double or single pumps

·      They are cheaper, not as cheap as a hand held pumps but certainly not the cost of buying a hospital grade pump.

·      They are an open system where there isn’t a membrane between the milk and the mechanism and so it’s recommended they are not shared, for hygiene reasons.

These pumps are good for when you have a supply that you want to maintain. They are portable and will generally last a breastfeeding/pumping journey.

Wearable pumps:

·      These are new-ish to the market and as such we are all learning.

·      They can be very expensive, and more so if you want to double pump.

·      The success of these pumps often relates to many things, shape of breast, position of pump, movement (which is ironic since you are meant to be able to move, but sometimes it’s at the expense of the milk expressed), whether you have a milk supply already or not.

In my experience they are not great at establishing a supply, due to the small motor compared to the multi-use hospital grade pumps, but can be better if you need to pump occasionally on the go, maybe once you have returned to work.

Many families spend a lot of money on something only to find it isn’t the right piece of kit for the job.

Hand pumps or manual pumps:

·      There are a couple of options and these can be helpful in the early days and to reduce engorgement.

·      You control the amount of suction by the amount of pressure you squeeze the device with

·      They are cheap

·      Easily portable

·      Often get good results but are also often overlooked for the electric variety.

As well as the hand pump with the handle you squeeze there are silicone ‘pumps’. It’s more of a suctioned silicone catcher rather than a pump. These are often used while breastfeeding to catch the extra milk from the breast not been used but they do pull milk out and can create an oversupply.

Hand Expressing:

·      A skill sometimes learnt in pregnancy, or early postnatal
Totally FREE

·      Very little kit needed apart from something to catch the milk in/on. Could be a glass, spoon, mug or a bottle

·      Great at stimulating milk supply

·      Best used in the first 3 days but a tool for your whole journey

·      Perfect for reducing fullness just before a feed in the early days.

Flange fitting:

The flange is the part of the pump that sits against your breast. Depending on what make and design of pump you have they sometimes call them different things from cups to shields. For the purpose of this I’m going to call them flanges.

Pumps often come with a 24mm and 21mm flange size (irrespective of electric or manual pump). From my experience, most women find these too big.

The key here is to measure the diameter of your nipple and have the flange fit that diameter, or as close to it. Only the nipple should be brought into the flange when the pump is working.  

There are smaller flanges available as well as silicone inserts that can reduce the diameter.

It can be very beneficial to work through this process with an IBCLC to help choose the right type of pump with the right flange size to optimize the milk expressed and the time it takes to do so.

Tips for travelling with a baby

Many people are starting to go away for summer holidays, and I thought I’d share my travelling tips with babies. Having done this a lot with my family when we lived overseas, I’m hoping some of my wins and fails can help out you out.

Things always take longer with babies/small children, more kit, more to check in, more passports to check etc etc. Go with plenty of time because if you’re early you can always enjoy a coffee and cake!

Use a sling or carrier through the airport/on the ferry allowing you to be hands free! If you're flying you can take your pram or stroller all the way to the aircraft door if you want or check it in to oversized luggage (free of charge). It can be helpful to have a bag to pop it in. Firstly, for insurance purposes and mainly to protect it from damage.

Ask for help at any stage, most people will be kind and hold things for you, even the baby! I have done this many times at an airport when travelling solo with my daughter. Everyone from airport security to the lady behind me in the security queue. Only once did a young security officer decline, at which point his much older colleague was delighted to take over!

Keep hydrated, it's easy to forget to eat or drink enough when travelling.

Breastfeed as you want. Travelling could be unsettling for them but breastfeeding will be a source of comfort and security, baby will come to the breast for more than milk.

Breastfeeding on a plane for take-off and landing can be really soothing for their ears. You will be given an extra seatbelt so baby is strapped to you, but it’s still possible to breastfeed – promise!

If you have travelled somewhere sunny here are my top tips for ensuring everyone stays safe in the sun.

• Try and keep everyone in the shade, using wide brimmed hats for everyone. Consider using an umbrella or a tent. Often these can be rented, save you carrying too much, there will be enough kit already.

• Suncream all round! Even on a cloudy day, as the sun can burn through.

• Water for the breastfeeding parent, drink to thirst but do keep hydrated.

• Milk for baby (under 6 months). You may find they have a combination of longer feeds and quicker feeds, this is them managing a thirst vs hunger.

• Babies over 6 months may be having sips of water with food, but when it's hot they may come for more milk too.

• If everyone is very sweaty, wearing cotton clothing or popping a muslin between you and baby can help absorb the sweat.

• Wear thin loose layers of clothing, during the day and at night.

• If you are using a fan, don’t have it directly at baby as they can get too cold, but moving air around the room is helpful

• Please Please don’t cover your pram with anything to keep out the sun as it will increase the temperature inside at put your baby at risk. If needs be use a parasol that clips to the buggy.

• When you need to breastfeed on the beach and there isn’t a chair, use a rucksack behind you to lean on. The other option is your partner sits behind you, so you are back to back and that way you support one another.

• Take the sling to the beach as pulling a pram along sand is HARD. If you do take the pram pulling it backwards along sand is much easier!

Sleeping spaces while away from home

Making sure the sleeping environment is safe for your baby while you are away from home is really important. Babies need a cot with a firm flat surface and a waterproof mattress. The mattress should fit the space well with no gaps. The cot should be free from cot bumpers and cuddly toys. If your accommodation can’t provide that you may think of taking a travel cot with you. If you are visiting family or friends it’s worth asking if they can get things like the travel cot ready for you to save you bringing it with you.

If you co-sleep, the safe sleep guidance for co-sleeping are the same too.

Using a pram while out and about for naps is fine, just as it would be at home but I will repeat this again as it’s so important Please Please don’t cover your pram with anything to keep out the sun as it will increase the temperature inside at put your baby at risk. If needs be use a parasol that clips to the buggy.

The lullaby trust has a great website with all the up to date guidance to keep baby safe while sleeping.

https://www.lullabytrust.org.uk/safer-sleep-advice/travel-and-weather/baby-sleep-away-from-home/

Myth Busting

It is normal for breastfeeding to be painful – When people tell you their stories about their breastfeeding journey they often say it was painful. It is common for breastfeeding to be painful but it is not normal. Breastfeeding should not be a painful process. Most breast pain stems from the latch. If the baby has a deep latch the nipple is in the baby’s throat, therefore not being squashed between their gums. In short, if breastfeeding is painful, reach out for support as there could be many reasons the latch isn’t quite right.

You won’t know if the baby is getting enough milk – Oh yes you will! If the baby is feeding a minimum of 8-10 feeds a day with regular sucking and swallowing, they are pooing regularly, gaining weight and are growing well, you can be reassured the baby is getting what they need.

No one can help you with the baby if you breastfeed – This is such a bug bear of mine, of course they can help you. I’ll give you just a few ideas of what help people can give you.

Nappy changing, cuddling, rocking, burping, soothing, going for a walk in the sling/pram, making breakfast/lunch/dinner, laundry, cleaning, shopping, making a hot drink, sitting with you while you feed, entertaining older children, picking up/dropping off older children from school. The list is endless and I could go on.

Breastfeeding will make you have saggy breasts – It is your pregnancy hormones that do that, not breastfeeding. A well-fitting bra (nursing or otherwise) will restore a great shape and your confidence!

You can’t take medication while breastfeeding – There is an ever-growing list of medications that are safe for breastfeeding, and few that you can’t take. For those few, there is almost always a safer alternative. A free resource suitable for everyone to use is The Breastfeeding Network which has lots of information on breastfeeding and medicines.