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.