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The International Breastfeeding Symbol » Pumping

Pumping


For many women, pumping is the only way they can nourish their babies with breast milk. Some women are able to both breastfeed and pump. Some women can breastfeed but can’t get enough out of pumping to make it worth their while. Other women wouldn’t be able to feed their babies breast milk at all if it weren’t for breast pumps. This section is devoted to the subject of pumping because, though it is often overlooked, pumping is a big part of breastfeeding in today’s world. Here you will find:

This is for informational purposes only; nothing here or anywhere on this website is meant to replace the recommendations of your doctor or primary health care provider.


A few reasons why women pump

Some women breastfeed without ever having to touch a pump. Many women, however, choose to pump as part of their breastfeeding experience. Some of the reasons for this may include:

  • Work. Since lactation depends on the constant action of emptying the breast in order to sustain itself (learn about the supply-and-demand principle of breastfeeding), many women pump at work while away from their babies. It usually provides enough stimulation to the breasts to keep lactation going while also providing expressed milk to store for later.
  • To help establish milk supply. Sometimes nature needs an extra push to get started. Depending on a woman’s situation and her baby’s condition at birth, her baby may not be able to provide the stimulation needed to establish a milk supply. Rather than risk losing her ability to lactate, she may opt to use a hospital-grade pump to stimulate the breasts enough to start producing milk.
  • Baby refuses to latch. This is an unfortunate situation for the mothers who experience it. It can be attributed to a multitude of factors ranging from bad hospital policies at birth to sickness/deformity in the infant to atypical shape of the mother’s nipples and many others. The long and the short of it is that the baby, for whatever reason, cannot or does not want to suckle from the breast. Usually this means that he/she prefers a bottle, but not always — some babies need to be fed through a nasogastric tube, or NG tube, and never really learn to suckle from the breast or a bottle. This is sometimes the case for micropreemies or babies born with a cleft palate or other facial deformity. In any case, when a baby refuses to latch for a mother who desires to breastfeed, it can be a heartbreaking and emotional experience. In this situation, the only recourse she has if she wants to feed her baby her breast milk is to pump.
  • Mother feels uncomfortable with breastfeeding. This could be purely physical, due, for example, to sore nipples caused by a bad latch. Sometimes pumping can provide relief from engorgement (when the breasts are full with milk) and make it easier for the baby to latch on. A mother’s discomfort with breastfeeding could also be emotional and psychological, however, because of trauma experienced in the past. Pumping may make it possible for a woman in this situation to still provide her baby with breast milk. Whatever the reason, a mother need not explain her reasons for pumping unless she wants to.

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How to pump

Pumping, like breastfeeding, is a learned skill. Though it seems straightforward, it requires a thorough knowledge of how breastfeeding works and practice to get it right.

Note: always begin with clean hands and equipment. Pump parts should be washed in hot soapy water or in a dishwasher prior to use. To sterilize, they can be boiled or sterilized in a special microwave bag or microwave sterilizing container.

The parts of a breast pump usually consist of: a flange that fits over the nipple (a.k.a. “horn,” “cone,” or breast shield), a membrane of some sort that allows the suction and release necessary to stimulate milk flow, a container for the milk to be collected in, and tubing to connect the flange-membrane-container parts to the pump which provides the suction. If using a hand-pump, all the parts stay the same except for the tubing. Instead of having to connect to an electric pump for suction, the pumping action is manually provided.

To pump with an electric breast pump, one needs to put together the parts and then center the nipple inside the flange. Set the suction on the lowest setting possible and the speed on the fastest that you feel comfortable with, and turn the pump on. You may need to experiment. The trick is to try and get the let-down reflex going, the same way a baby would by suckling. Once the milk starts to flow, slow down the speed to mimic the sort of stimulation a baby would provide once the milk-ejection reflex has occurred. Some women increase the suction a little at this point, though others prefer to leave it the same. Always pump using the lowest suction level that will accomplish getting the milk out. High suction levels could damage the breast. If anything hurts at anytime, stop and find a lactation consultant for help as soon as possible.

Some women appreciate the ingenuity of a hands-free pump bra because it allows them to do other things while they pump. A lot of moms use a sports bra with holes where the breast shields go to hold up the pump parts (mark where the cuts will be made while wearing the bra, but remember to take the bra off before cutting the holes!), while others with a little sewing savvy can whip up their own homemade pump bras. This can be an inexpensive and effective alternative to costly hands-free bras. Another way to make a pumping session hands-free is explained on this page.

Pumping time will vary from woman-to-woman, but it is important to make each pumping session at least ten minutes long on each side (double-pumping can help make this easier). If one is pumping to establish a milk supply, it’s important to pump every two hours, with a minimum of eight pumping sessions per day, preferably more. Ten to fifteen minutes per pumping session is what most women pump for, though some women pump for twenty and sometimes even thirty minutes per session. It depends on each individual’s woman’s needs and whether or not she’s already established a good milk supply.

If you are pumping to establish or increase your milk supply, it’s a good idea to pump for 1-2 minutes after the milk has stopped flowing. This tells the breasts that more milk needs to be made. Sometimes gentle breast massage can help get the milk flowing, as well as relaxing and thinking of things other than pumping.

Sometimes the best way to learn is by asking women who pump on a daily basis. This can also be a good source of support. Please see the links page for pumping support links.

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How to store pumped milk

After a pumping session is over, it’s important to store the milk right away to try to retain its nutrients at their peak. There are many storage containers made specifically for pumped milk: plastic bottles with lids, glass bottles with lids, and pre-sterilized bags. It doesn’t matter much which is chosen, as long as the container used is clean, preferably sterile. Generally glass storage containers are not recommended for freezing as they could crack or break with the expansion and contraction of the liquid inside.

If storing in a pre-sterilized bag, it’s important after pouring the milk in to bring the two sides of the bag together so that they become wet with milk. This makes it possible to remove all or most of the trapped air in the bag before sealing it. Removing the air before sealing the bag helps to keep the milk from becoming freezer burned. Label with the date and perhaps the time of day (like “morning”), if desired. If storing in a freezer, lay down flat so that once it’s frozen, it can be stacked easily. Some mothers like to stack these flat milk packs standing up in a rectangular storage container with the newer ones in the back, so they can easily grab the oldest milk first and not occupy too much freezer space. Other mothers like to store the bags inside zipper-style freezer bags for added insurance against freezer burn. This is a good idea in the event that the milk will be stored for a long time, or if it will be stored for an unknown time.

For refrigerator storage, rigid plastic or glass bottles are usually preferable to unstructured plastic bags. Plastic bottles are almost always preferable to glass for traveling with breast milk, though it’s important to choose the bottles carefully because in recent years some types of plastic have been found to be harmful, particularly those that contain Bisphenol-A. Some companies like Medela make pump parts and breast milk storage bottles that are free of Bisphenol-A, though it is not known if there are other dangerous substances in plastics in addition to Bisphenol-A.

Generally, it is recommended that freshly pumped breast milk be stored:

  • At room temperature (66-72 degrees Fahrenheit) for no more than ten hours;
  • In the refrigerator (32-39 degrees F) for no more than five days
  • In a side-by-side freezer for 3-4 months
  • In a stand-alone or chest style freezer for 6 months or longer.

The Centers for Disease Control has a page dedicated to the proper handling and storage of human milk. It includes a table with safe time ranges for a given temperature. Please see the links page for more breast milk storage guideline information.

It is important to use the oldest milk pumped first and to freeze any milk if it is known that it won’t be consumed before five days have elapsed. If the milk supply is plentiful and more milk is consistently produced than is consumed, it’s important to freeze the oversupply as soon as possible to retain the nutrients and freshness at their peak.

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How to thaw frozen milk

To thaw frozen milk, first place the bag of frozen milk inside a zipper-style plastic bag. Make sure both bags are clean and that the outer bag has no tears or holes in it. The outer bag will act as a backup in case there are any tears in the bag containing the frozen milk. After the outer bag is securely zipped shut, put it in a warm water bath until the milk thaws. It may help to put a timer on for about 15-20 minutes so that the milk isn’t forgotten. Once the milk has thawed, gently swirl it to thoroughly incorporate the fat that may have stuck to the sides of the plastic bag. The fat in the milk is very important for the developing infant’s brain, so it is especially important that as much of it is recovered as possible. After all the fat is thoroughly incorporated into the liquid, carefully pour the thawed milk into the bottle(s) it will be consumed from.

Never thaw breast milk in the microwave. The microwave may damage some of its components.

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What to do with extra milk

Sometimes a lot of extra breast milk ends up stored in a pumping mom’s freezer, way more than can be used by one baby before it will go bad. In a case like this, one person’s surplus can be another one’s treasure.

There are a few organizations called milk banks that will gladly take excess frozen breast milk and make sure that it goes to babies who need it. Before donating your solid gold (frozen breast milk) to such an organization, however, make sure that you know where your milk is going. There are non-profit milk banks and those that call themselves non-profit but are actually working with for-profit companies. True non-profit milk banks will provide the milk to a needy infant whether or not the infant’s family can pay. Those working with for-profit companies do not have this obligation. The National Milk Bank at one time falsely claimed “non-profit” milk bank status, but in truth it never was non-profit. The National Milk Bank sells, and has always sold, all of its donated breast milk to Prolacta Bioscience, a for-profit company. Prolacta Bioscience processes this milk and sells it for a profit to hospitals all over the country. Truly non-profit milk banks, those that are members of HMBANA, provide breast milk directly to sick babies at prices equal to or below what it costs to process it.

HMBANA milk banks provide an invaluable service to sick infants, many of them clinging to life in Neonatal Intensive Care Units (NICUs) across North America. A lot of these babies are preemies and could use the nourishing and healing power of human milk.

One study suggests that preemies fed formula are six times more likely to develop necrotizing enterocolitis than those exclusively fed breast milk. Necrotizing enterocolitis is a serious condition which causes inflammation of the bowels that in many cases leads to death. When fed breast milk, not only do preemies and other sick babies have reduced risk of this disease and others, but they have a lower incidence of rehospitalization compared to formula-fed preemies. Milk banks provide breast milk to these sick infants when their mothers cannot, provided that there is enough milk available.

In order to donate breast milk to a milk bank, the donor must have a blood test (or show documentation for having had one recently) which shows negative HIV 1 and 2, HTLV 1, and Hepatitis B and C tests. Additionally, donors must answer questions about their lifestyle and any medications they are taking. Sometimes milk banks are in need of milk from mothers that don’t consume dairy (for dairy-sensitive babies), so they might ask potential donors about their diet as well.

All milk banks pasteurize the donated milk to make sure the critically ill babies who receive it won’t inadvertently be passed on milk-borne diseases which could make them sicker. The easy digestibility and species-specific nature of the milk helps them get better sooner even when it is pasteurized.

Informal milk donation is another option for mothers who have an abundance of stored milk and cannot, for whatever reason, donate to a milk bank. This carries some risks for the recipient if the donor has a communicable, incurable disease (which she may not even be aware of) like HIV/Aids, Hepatitis, and other diseases transmissable through bodily fluids. If a (recipient) mother wishes to go this route, it may be advisable to purchase a home pasteurizer so that the risk to her baby of contracting one of these diseases decreases.

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