Pumping 101 Please

I would always pump in the morning during my son's first feeding, when I was really engorged. I had a hand pump as well. I would put my son on one breast and while he was nursing I would pump the other one. This worked out really well. When the baby first goes on your breast, it initiates the let down in both and makes pumping the opposite one a lot easier. And mornings were great for me because my breasts were very full at that point. Don't worry about short changing your daughter. Let her nurse a little longer on the first breast and then you can still switch her to the one you were pumping from for a little extra. She's more efficient than the pump and will be able to get more out of it, even if it has stoppped giving milk to the pump. Again just give her a little extra time on feeding if she needs it. This will also greatly increase your milk supply. I never had a problem with my son wanting for more when I did this, although if you are really worried you can always offer a little of the pumped stuff if she does get fussy.

I have always let down more easily nursing than pumping so it works better for me to pump first. The worst case is that she is still really hungry after you nurse her and you will need to give some of what you pumped. If you need to do so, I'd offer small amounts at a time so you don't contaminated it and end up with left overs that need to be tossed. Bacteria can go from their mouth into the milk so you want to toss anything left after about an hour.

The other thing that you might try is pumping from one side and nursing from the other. You can try taking advantage of the let down as you nurse and pump at the same time or let it build up and try when you are finished. One way to build your supply is to pump between feedings. You don't want to go too crazy with that or you will be overflowing. Try during one of her longer feeding gaps but maybe 30-45 minutes before you expect her to need to eat again. That way your body has had some time to prepare for nursing again, but it will give you time to replenish before needing to nurse again.

Hi R.,

I am in the process of writing an article on pumping and working. It has lots of good tips. I pumped with my son until he was 15 months old and I had all kinds of supply issues - so I think I have experienced just about everything that can come up. Feel free to send more questions my way if you have them. My first advice would be to get a good electric pump. The manual ones are much more difficult to use. They are good to have for emergencies - but if you are going to pump on a regular basis you should have an electric pump. Here is a link to where you can find one: <http://www.mothersboutique.com/peelbrpu.html&gt;. I have copied and pasted my article in its current format below. Even though it is designed for working mothers, even if you aren't working, the pumping tips will be good for you. I apologize if items are missing, but I am still working on it:
Working and Breastfeeding – Tips for Success

Going back to work after having a baby can be very challenging. You can be very emotional and you are worried about how your baby will do without you by his/her side. If you are breastfeeding, you also need to find time to pump so that your baby can have your milk for his next day of childcare.

It is never too early to start pumping. I pumped for the first time when I was still in the hospital. I also started pumping prior to going back to work so that I could build up a frozen supply for my baby to have when I was away. I recommend starting to pump as soon as possible so that you can build up your supply for when the baby is with the sitter. Every mother is different, so you will need to figure out what works best for you and your baby.

Below are some tips that I put together to help you before you go back to work:
- Add in an extra pumping. You have the most milk in the AM, so if you can do it then, great - if not - just try some other time. For me it was 10 PM - do whatever works for you. The important thing is to try to be consistent. You won't get much milk the first few times you pump, because the pump isn't as efficient as your baby and because your body isn't used to having this extra feeding time. But do it consistently and your body will adjust.
- Try pumping one side while your baby nurses on the other. Having your baby nursing on one breast will actually stimulate the other breast to make more milk.
- Try pumping right after you nurse your baby. You won't have much milk left, buy every little bit helps and the added stimulation is good for helping to increase your milk supply.

Now that you are pumping and starting to build up your milk supply, you will need to make sure you store the milk properly so that it can be used down the road when you need it. I strongly recommend storing your milk in bags, not bottles – especially anything that you want to freeze. If you are just going to keep it in the refrigerator for a few days, then bottles are OK, but you will want to freeze in bags to prevent freezer burn. Below are some tips for storing and using your breast milk.
When you first go back to work, don't worry if your baby drinks a lot more than you pump. You will both be going through a stressful time. For your baby, the milk may remind him/her of you and so he may drink more than usual. It is also easier to get milk from a bottle than from a breast - so he may just gulp down more because it comes out so easily. You are also going to be a little stressed with the new job and being away from your child - and stress tends to decrease milk supply. Don't worry - as you both settle into your new routines, this will even out and you will pump more and your baby will drink less. But it is a good thing to be prepared for. When I first went back to work my baby drank 17 ounces and I pumped 10 for the same time period! But over time, I ended up with a whole lot of left over milk in the freezer, so don't worry and it will all work out well.
My tips for pumping at work are:
- Make sure you have a good pump. Medela Pump-in-style or Ameda Purely Yours are the only personal pumps that use the same high quality components as the hospital grade pumps.
- Get a hands-free pumping devise. There are several different kinds. This will allow you to type e-mail or do other things while pumping and you won't feel like you are "wasting time" while you are pumping.
- Bring in a photo of your child and maybe even one of their outfits or a recording of their voice - this will help your milk to let-down and will give you more milk per pumping session.
- Pump both breasts at the same time - they help each other to let-down.
- Make sure you pump for a FULL 15 minutes - even if you have stopped getting anything. The added stimulation will be good for your milk production and it may even stimulate another let down.
- One thing that I did when I was pumping was to pump for 10 minutes, then turn my pump off for 2-3 minutes and pump again for another 5-10 minutes. This ALWAYS gave me a 2nd let-down.
- Buy extra breast flanges so that you don't have to wash them after each pumping. You can also put the bottles and the flanges in the refrigerator - that way you don't have to wash them between each pumping and can just continue to pump with the same bottle and base each time. I recommend several breast flanges because you don't want to put the cold shield from the refrigerator against your breast.
- If you can, buy your own "dorm-style" refrigerator to have in your office - this way you can store all of your milk and nursing supplies without having to put them in a shared refrigerator
- Drink LOTS of water. I kept a case in my office at all times. My husband and I would refresh it every weekend.
- If needed, you can try taking a supplement to increase your milk supply. Fenugreek is supposed to be good and I know people who swear by it. You need to take much more than the dose that is written on the bottle. Ask a lactation consultant how much to take. Other things that help to increase milk supply are oatmeal and some of the “mother’s milk” style teas.
Pumping and working can be stressful, so try to find something that helps you to make it a less stressful time. Play some music or use your hands-free devise so that you feel “productive” while pumping. Take pride in what you are doing – you are taking good care of your baby! Both you and your baby will benefit from your efforts to pump at work!

Written by:
J. P. Masucci, Ph.D.
A Mother’s Boutique, LLC
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Personally, I would keep pumping after she is done feeding. This can also help to increase your milk supply. However, for more expert advice on the matter I would suggest contacting the La Leche League. I found specific info on pumping on their site at http://www.llli.org/NB/NBpumping.html.

Good luck and I hope this is helpful.

It worked for me to set aside a specific time each day just for pumping. After a few days my body got used to producing more milk at that particular time and I was able to pump more effectively. Also, keeping yourself adequately hydrated prior to pumping is also helpful. Hand held pumps did not work for me. I had to purchase an electric pump to get the most suction. You can also rent pumps from the hospital or Leleche league.
Setting aside a specific "pump time" is also good because I found that if I fed my son then pumped, the pumped milk was full of the fatty milk. Milk is watery when it first comes out at each feeding and then gets thicker as you nurse. The same is true in the reverse, if you pump then nurse, the pumped milk is more watery and less fatty which stisfies the baby longer.
I have to also admit that pumping with my second child did not work as well as it did for the first child. What I ended up doing was nursing my son in the morning, at bed time, and throughout the night, and maybe once during the day. The other feedings I used formula. My son's nutrition was still primarily breast milk but maybe two feedings per day were formula.

Congratulations on your recent birth!

I "worked & pumped" for all 4 of my children, and I'm a childbirth educator so I've been sent samples of several types of pumps, so I'm intimately familiar with the task you are trying to do. But my youngest is 3.5 years, so I'm getting a bit less familiar with newer pumps on the market.

I mostly used a Medela Pump in Style since I was working full time. It is awesome...just to plug that in case you will be going back to work. On manual pumps, I *HATE* the Ameda pump that is given out free at many hospitals in the "breastfeeding diaper bag." It hurt my breast and my hand when I used it, and it was hard to get much milk. I am an "easy pump" so ultimately I would get milk, but I only reccommend it in an emergency.

I do like the Avent Isis and the Gerber Massaging Manual as far as use goes--both are comfortable for the breast and the hand (ergonomic design keeps wrist straight and has a large pumping handle to spread out force over your hand). I've heard that Dr's Browns has a pump out now that is similar to the Gerber, but I've never seen it yet. The Gerber pump is a pain in the neck to take apart to clean, which is its major drawback. The Avent is easier. But the Gerber is a great design for sore nipples as it puts less suction stress on the nipples.

When using a manual pump, you should pump only until milk starts to let down, then hold the suction at a comfortable level while the milk sprays until it stops. Then start pumping again until it sprays again...

Pumping in the morning is usually the easiest as you have the highest milk supply then. Pump after your baby eats, not before to ensure the best supply for the baby. On days I was at home I would generally nurse my baby, then spend some time playing with baby, eating my breakfast, then nurse baby to sleep for a nap, then I'd pump while baby was sleeping. I wouldn't necessarily pump immediatelly after nursing the baby down to sleep, but I'd make sure to get it done while baby is sleeping. If you have to pick between pumping very soon after the end of a feeding, or very close to the beginning of the next, I'd go with the beginning, just because a healthy baby can ALWAYS pull out more milk than the pump, and you are constantly making milk, so you will not short the baby if you pump before, but as you mention, if you pump after and baby has eaten a lot, you might have trouble getting milk.

Pumping in the evening, unless you have an over supply, is likely an exercise in futility. You are already tired from the day anyway, and your milk supply is reduced (this reduced supply is why some babies "cluster feed" in the evening). I would nix evening pumping sessions unless you are separated from your baby at that time--like for a part time job, or because you are out for an extended date with your hubby (but babies at this age are so portable...I always brought mine along when hubby and I went out).

Good luck!

P.S. One other poster said "Milk is watery when it first comes out at each feeding and then gets thicker as you nurse. The same is true in the reverse, if you pump then nurse, the pumped milk is more watery and less fatty which stisfies the baby longer."

I'm sure this poster just accidentally left some words out here. The "watery" pumped milk in this scenario that is low in fat would satisfy the baby *less*. I think what the post meant to say is that since you have pumped out the foremilk, when the baby nurses and gets the hind milk--which is more fatty--the baby will be satisfied longer.

R.,

Pumping after she eats is good for emptying your breasts, but remember that your baby has already depleted your supply. Unfortunately, you need to pump when she is not eating. Late night, early morning, etc. I know one mom who got up at 3 a.m. to pump! It is going to suck for a couple of weeks, but it will really pay off in the long run.

Some moms feed their baby on one side and pump the other, but that never worked for me, even though my daughter only nurses on one side at a time.

Figure out how many times a day your baby eats and estimate 3 ounces per feeding. Start adding pumping sessions and build up a supply that will feed your baby for several days. Just having that supply will help you feel more confident moving forward.

Once you return to work, make sure you pump regularly to keep your supply up. I try to pump as many times as McKenna eats - usually 3 times a day, and I get a full day's milk for her.

Also, stressing about getting enough milk really impacts your supply, so when you pump, really try to relax. If you do it late at night, curl up with a good book/movie and a cup of something soothing (I like Hershey's Goodnight Kisses hot chocolate - 99% caffeine free).

Good luck!

Kali

I made the mistake of buying a cheaper pump at first, too. You need to go out and buy a good pump- you'll probably have about $250 in it, but it is so worth it!!! I bought the Ameda Purely Yours and it worked wonders. You can buy it online or in more upscale pharmacies. The lactation specialist at the hospital I delivered in also recommended the Medilia as well if you can't find the Ameda.
As far as when to pump, I would always pump the opposite side when my son nursed. When he finished the one side, I would switch and pump what was left from that side. He never once acted like he didn't have enough to eat, and pumping at the same time he nursed seemed to help the let-down process and produced more milk. Also, I would pump between feedings at night. When he slept through the night around 2-3 months, I would still wake up every few hours and pump. Hope this helps!!!!!

Hand pumps are convenient since they are easy to assemble but you may get more with an electric like Pump in Style. I used feed a bit longer than normal off the 1st breast, and pump the 2nd breast after the feed. In the morning you have more milk, so that's the best time. I used an advent hand pump for this, but as I mentioned, if you still aren't having luck, an electric is a good next step. Also try to relax. If you're getting anxiuos about not being able to pump much, this will affect your milk output.

Hello, oh the joys of pumping. You said this is your second child but I only have one and I am sure the time factor is a lot different.

I now have a 1 yr old and she has not had anything but breast milk. I work full time and pump all day it seem like but I Know it is the best thing for her. When I am with her she nurses but when I am at work I pump 3 times a day. When I get home I nurse her and then right before I go to bed I pump again. I have not had any problems with not having enough milk. If I keep on that schedule I have enough for the next day. I also saved milk before I went back to work just in case.

My advice is to pump on her schedule when you are away from her, that way your body is still following her schedule.

I also noticed you said you had a hand pump...I have an electic pump and if you are planning on pumping a lot that is the way to go. I tried to use a hand one and it is too time consuming! THe electric ones are expensive but so much quicker.

GOod luck

I have the electric pump in style and it works great!

i remember before i went back to work (about 2 weeks before) as soon as my son was done nursing, i would put him down and get on that pump, that way my body produced more...it worked out really well...i can remember feeling a great sense of confidence when i'd fill up a whole bag at work!! I highly recommend a electrical pump...they work great!!! i never did the hand pump thing, but i had a girl friend who did and it took her about 20 mins to pump...it took me 5 - 8 mins for a good bottle....
best of luck!!!!!