Pumping 411 - Getting the Most Milk

So what if you need to go back to work after your baby is born? What if you are needing to pump more than you already are because you can't keep up with baby's needs while s/he is away from you? What if you want to donate milk to a deserving family but don't want to risk decreasing your current supply? What if you have trouble emptying your breast while pumping?

Well, I just learned some new things in training that may be helpful to you.

Here's what I knew...I knew that you can pump just a few times a day after nursing your baby to increase demand and after a few days, you'll get a little more, a little more, and a little more. Usually. Obviously this is different for all women, and it can vary depending on how old your baby is and how effective a pumper you are. I also knew that mother's milk teas can help support this process. The few times I've tried this I've had a couple cups of the tea during the day whenever I thought of it, and pumped using a double pump maybe twice a day after nursing Chase. I found this very effective.

What I didn't know was that combining hand expression and hands on pumping can, on average, DOUBLE the yield from a single session. Now...this is more important that just having more milk...and empty breast makes milk faster than a full breast, so the emptier the breast, the faster it fills...the more milk it thinks it needs to make! So how do you do it?

Here is a great handout sheet from LLL about hand expression. This is a good guideline to start with, but pay attention to what works for you and modify how it works best. The research showed that if a mother starts her letdown with hand expression then begins using the pump, she will have more success, especially if she generally has a problem letting down to the pump. If you have 7.5 minutes and are interested in a video about it, this is very informative: http://newborns.stanford.edu/Breastfeeding/HandExpression.html

Pump until the milk slows to a drip or stops flowing, remove your pump flanges, massage and stroke the breasts, begin using the pump again in single mode, and do some massage and compressions WHILE pumping at your most efficient settings with your pump. Then massage and stroke the other breast, begin pumping and doing the massage and compressions to drain the breast a little more.

Now...hand express until you can't get anymore! Combine the milk, chill...done! Now...this sounds like a lot of work, and it can be, but you can pick and choose what works well enough for you. The mother's in the study who used this method took about 25 minutes total to express both breasts. Many moms don't have this kind of time to commit, so what should you do?

Get your breasts warmed up before putting your pump on a fast cycle and starting to pump. Once your milk begins to spray, slow the cycles down and turn the pump to your most efficient suction setting (where it is comfortable but removing milk). Your milk flow will slow, turn your pump back to the faster cycle and shake the girls around! Try turning it back to the slower cycle speed again to see if you get more, do compressions until you just can't get anymore and call it a day!

Some moms just do better, get more milk, and faster through straight hand expression, so maybe that's your ticket! Some moms also find a single hand pump just as effective for this situation, it's way less to set up, and you can control it easily by changing the speed of the suck and the pressure to your comfort. This can be very effective for achieving multiple letdowns...as the milk flow slows, increase the speed until another letdown comes through. A hand pump would also be easy to use while nursing baby on the other breast...what better way to get an excellent letdown that JUST KEEPS GIVING?! It's also easier and quieter to use while snuggling your baby (another excellent way to encourage a great letdown). So if you are pumping to build up a stash, slow and steady, to donate to a mom...this may just be the technique for you. In testing the pressure of the suction in many good manual pumps, it's equal to that in double electric pumps like Hygiea, Medela, and Ameda.

In order to ensure your highest comfort and your most efficient milk removal, make sure you are using the right size flange. A poor-fitting flange can cause endless problems, nipple trauma, pain, and decreased milk. Ameda has good images here of a good fitting flange and a too-tight one. On a too tight flange you will also notice blanching around the base of the nipple. A too-large fitting flange will result in too much areola getting pulled in and create quite a bit of discomfort. Both situations result in inefficient milk removal.

Not every woman needs a big, expensive, double electric pump. These pumps are best for moms who have to pump to return to work and thus must pump efficiently when they are away from their babies for an extended period of time. They are also a good fit for moms who are choosing to or NEED to pump exclusively for their babies whether they are home or not. Moms with babies in the NICU are better off using a hospital grade pump than a consumer grade double electric, but most moms do not need such a hearty pump. The rest of us can pretty much get away with a single electric or a manual pump.

It's important to spend. the. money. I'm sorry, I know it hurts, a good electric pump (again, Hygiea, Ameda, Medela) is going to cost a good solid chunk of change...but believe me when I say it will be worth it. The crappy box store pumps are just that: CRAPPY. It is unusual to find a mom who has success with these. Also, not all manual pumps are created equally. The Medela Harmony is probably the best bet for a manual pump. it's easy to use, simple, effective, and well designed. Not to mention, it allows you to get the correct flange size for you!

Milk collection and your health can be at risk if you don't properly care for your pump. This means inspecting and cleaning it regularly. When you are away from your baby AT LEAST rinse the pieces thoroughly so there is no milk build up in the nooks and crannies, and be sure to TAKE IT APART and wash the pieces every day at the end of your pumping day. When you take it apart inspect the tubing for moisture, mold, and milk. Inspect the membranes and valves for wear...the membranes and valves are soooo important to the function of the pump that even the smallest flaw can impact it's effectiveness...so replace worn bits and pieces regularly. Read your manual, learn the lingo, learn how it works, use it properly, and your pump will last a long time.

I hope something here helps you to pump more effectively. Ask more questions, I just finished an extensive training on breast pumps...I got more to give...you just gotta ask. ;)

Guest Blog: Kirsty's Story

Sophia's first feed

Sophia had a tongue tie when she was born which caused some problems latching. For the first two days we expressed colostrum with a syringe and syringe fed her. When my milk came in I used a pump and finger fed her with a feeding tube taped to my finger.

When she was three days old, we took her to the doctor to get the tongue tie cut. After that I called the lactation consultant to come and help with getting her latched correctly. I was able to feed (uncomfortably, and with difficulty) while she was there, but when she was gone I couldn’t do it properly. The same thing happened when my midwife helped me, and even my aunty. Whenever someone was there to help, I was sort of able to do it, but when I tried on my own, it just didn’t work. Sophia woke up at 3am, so I tried putting her to the breast again to feed her. She wouldn’t latch: I was full, leaking, and stressed; she was hungry and stressed. I called the midwife (yes, at 3am) in tears, with Sophia screaming in the background, and told her, “I can’t do it, she won’t latch”.

Sophia being finger fed EBM

“You need to both calm down, have a shower” (she knows Sophia loves the shower).

“Can you still express?”

“Yes”

“OK then, just express, and finger feed her.” I was so intent on being able to breastfeed, that I had totally ignored the breast pump.

I pumped, fed her, then we all slept happily.

After speaking to my midwife, and Plunket, seeing lactation consultants, and discussing it with my husband, I decided to just ‘give up’ on breastfeeding. Obviously it isn’t going to work for us, so there is not point stressing us both out trying. I went and purchased my own pump (until then I had been using one borrowed from my midwife).

Sophia having a bottle of my EBM

I was still finger feeding Sophia, so at about three weeks old we tried Tommee Tippee Closer to Nature bottles. She didn’t like them, so we went back to finger feeding. When she was six weeks old, we finally found a teat she liked, so were able to transition her to a bottle.

I managed to build up a good supply of milk in the fridge, so that when we went out for dinner on our anniversary I had a drink (two standard drinks). The next two pumpings I had to throw out because of the alcohol in my milk, and after that I noticed my volume had decreased.

For a while my supply struggled to keep up with demand, so I kept trying her at the breast to stimulate production. I also while cluster pumped for a day, and soon my supply was back.

I enjoy pumping, as it is a nice chance for a wee time-out – I usually use the time to read. If I have to, I am able to pump while feeding Sophia, or giving her a cuddle. It gets easier to do other things while pumping once you’re used to it.

In the first few weeks I felt like a terrible mother because I couldn’t breastfeed. I don’t have any photos of Sophia being finger fed, because I didn’t want there to be evidence of it in later years. Looking back on it now, it was crazy thinking. I have come to realise that I am the opposite of a bad mother. My baby is better off on expressed breast milk than she would be on formula, and full time pumping takes a good dose of love and commitment on my part.

I had many people offering to help me get my baby breastfeeding, but after two months I got to the point where I knew it wasn’t going to happen, no point stressing about it.

Sometimes when I am giving Sophia a bottle in public I feel like I have to justify myself to strangers and explain that it is EBM, not formula in the bottle.

Sophia - 7 Months

Because my pump is battery operated, I am able to pump when I’m out and about. I always take my power cord with me just in case, so I have been able to plug myself into the Mall Parents’ room, University Parents room, and at friends’ homes. I have pumped in a park, in a cafe, in the car on a long trip, on an intercity bus in broad daylight, and even on a full intercity bus at night time (they guy next to me didn’t say anything about it :s)

My greatest fear is that I’ll go on holiday out of town, and leave my pump, or part of it behind. I am thankful to say that never happened, although I did leave essential parts behind on two occasions when I went to Uni.

Sophia on her 1st Birthday

My supply started decreasing when Sophia was ten months old, and a couple of weeks before her first birthday it got so low I thought I wouldn’t be able to make it until her birthday. It made me sad, and I felt like a failure again. I started pumping just morning and night (12 hours apart), but I was getting a lot more milk, so was able to keep pumping for another couple of weeks. When I was only getting 50mls, I started pumping just in the mornings, which lasted about a another week. I was pleased I made it pumping exclusively until Sophia’s first birthday, and continued for a couple of weeks after. Because I got a few more weeks than I was expecting, when I stopped, there weren’t any sad feelings.

I am really proud of myself for pumping so long, and I’m quite surprised my supply managed to hold up for a year without a baby’s mouth to keep it going.

I am due with a little brother for Sophia in November and I am filling myself with as much information as possible and surrounding myself with supportive people in real life and online so I can feed him at the breast instead of from a bottle.

I made the most of my pumping experience, but it was hard. I would much rather be able to feed my baby whenever, wherever than need to have a bottle and somewhere to warm it, and have to remember to take my pump with me everywhere I go. Come November I hope to become a total NIPing pro!

I know with a little bit of help, support, and perseverance I CAN breastfeed. I have learnt from my past and will make sure I succeed at this. I keep telling myself “I WILL BREASTFEED”, and I really do mean it.

I’m taking the lazy way out this time and breastfeeding. No bottles or pumps for me (except for pumping milk to donate via HM4HB NZ).

Kirsty's story originally was posted on Anything Baby minus the exciting update! Good luck to you Kirsty and please keep us posted!

Toddlers, Breastmilk, and Why I Won't Tandem

So all three of the TGL toddlers are receiving breastmilk. Mother Hen is tandem nursing, Mama Christa is giving Olivia pumped milk and HOPING she'll go back to the tap when Ella gets home, and I am giving Aiden pumped milk daily. But why do our toddlers get breastmilk? Why are Mama Christa and I going to the trouble to give our big kids breastmilk when they don't take it from the tap? Well, breastmilk is awesome...why else?! 2 year olds still benefit from the perfect human milk proteins, the over 200 amazing substances that have been identified in human milk, the purity, and most of all THE ANTIBODIES! It is, afterall, cold and flu season...now all three of our households have been ransacked by stomach flus and head colds over the last two weeks or so.

As a mommy I feel the need to protect my child from severe illness in any way possible...did you know that if you are breastfeeding and someone in your house gets sick, within ONE HOUR your body has developed antibodies to the virus/bacteria and those antibodies are already in your milk? This protects your nursling(s) from getting the illness. It doesn't mean your child will never get sick, but it does mean your child will get sick less often and the illnesses will be less severe. In humans, one of the top ways that viruses and bacteria get into our bodies is through the digestive tract. This is why exclusive breastfeeding protects infants from serious illness, it coats their virgin gut with the good stuff, antibodies, good bacteria, healthy mucous. What is the Virgin Gut?


"When babies are born, they have sterile gastrointestinal tracts. If babies are exclusively breastfed, they develop a natural healthy gut flora. (When I speak of the gut, I mean Baby's insides where the food goes until it hits the diaper.) This means that the major flora in breastfed babies has reduced numbers of bad types of bacteria and increased numbers of good bacteria. Formula-fed babies have increased numbers of bad bacteria, leaving them at more risk for illness"


Additionally, it's interesting to know that the introduction of formula, even just one little 2oz bottle not only interferes with the establishment of a good, solid milk supply (we'll talk about this delicate balance later on) it can change the pH levels of the baby's gut, and it takes 6 weeks for those levels to return to normal! This pH and Virgin Gut theory are the primary reasons behind why formula fed babies are at a higher risk for illness, especially severe illnesses. This is why breastmilk saves lives.

But that's BABIES right? Well, sure it is, but doesn't it stand to reason that an older child would benefit from the antibodies and the more than 200 substances found in that liquid gold? Not to mention, it's even being used to treat and CURE cancer in adults...won't our toddlers benefit from whatever it is that is killing cancer cells? This isn't in cow's milk, or goat's milk, or soy, rice, almond milks. It's in HUMAN milk...substances in HUMAN milk protect human infants and children from illness. Amazing.

Olivia receives almost exclusively pumped milk every day. For one thing, Mama Christa has an abundance of milk to give Olivia...for another, she's a petite child, was premature herself, and needs to stay healthy and strong when Ella comes home. Additionally, have you ever thought about how EXPENSIVE milk is these days?! I know our DHA fortified, organic milk costs more than a gallon of gas...so why not save some cash and give the kids some breast milk?

Aiden gets breast milk daily as well, but it is about half  and half compared to cow's milk, but he's getting it. Today he's ONLY getting breast milk because he had a nasty stomach flu yesterday and I'm trying to give him the easiest to digest stuff and take good care of his tummy.

Are you into organic? What's more organic that unprocessed BREAST milk ladies?! Nothing. That's what.

NOW, on to why I prefer that Aiden NOT get his breast milk from the tap. I fully support Mother Hen and Mama Christa in their tandem nursing, not just because they are my friends and I support them no matter what (yes, I would support them even if they were bottle feeding or formula feeding) but because I think that it's good for young children to continue to receive breast milk for the reasons listed above. Personally, however, I get overstimulated and "touched out" as it is by dealing with both boys...especially when Chase is nursing. I do great if Chase is nursing and that's all that's going on, but more often than not, Aiden is also climbing all over me and it would blow your mind the level of anxiety all this clamoring and touching causes me. If I had two children breastfeeding, I'm pretty sure I would LOSE MY MIND. Is this weird? To some, probably, but I'm an abuse survivor...I get touched out, and overcooked in  A LOT of different situations. Part of me, the emotional, I know tandem nursing is a good thing part, would really like Aiden to take up a liking for nursing so I could nurse them both...BUT...1: Aiden is a BIG kid, 30lbs and 3 feet tall, he doesn't need to be on me ok? and 2: that's too much touch for me...my breast would constantly be in SOMEONE's mouth and I"m not cool with that.


Many people wonder why you would nurse a toddler, and why you would tandem. I think the reasons are plain as day when you look at all the wonderful things in and about breastmilk, it really is easier to get it from the tap, so just do it that way. Many people say "I think it's great you tandem nurse/nurse an older child but I would never do it" but what's their reason...usually it's because it actually skeeves them out. Seriously, let's be honest, if you aren't an extended/tandem nurser...deep down, is it because it skeeves you out?! that's usually what's behind that statement, and often people only say the "I think it's great" part because they don't want to make the mom feel bad. Guess what, I'm on to this...it skeeves you out, and you know what...THAT'S OK TOO!! The fact is, around infant feeding/toddler feeding, we need to be supportive of other moms, even when they are not supportive or are skeeved out by what we do. The fact is, you don't know most people's motivations, even if you think you do! Part of the reason Aiden and I ended our nursing relationship early was because I didn't know how to/couldn't handle feeling exposed, used, and WAY overtouched when he started getting screwy at the breast...I couldn't handle it with a toddler for sure. :)