Do you need to pump? 

Breastfeeding directly is the most convenient way to breastfeed a baby. When you direct feed you are able to save time and manage your supply easily. However there are a few mothers that for a number of different reasons may need to use a breast pump to express their milk. By using a breast pump a mother can effectively express her milk and help to maintain her milk supply.   

Some reasons why you might want to express your milk: 

• To have a supply of milk for when you are away from your baby.
• The baby is not able to latch or feed directly from the breast. 
• The mother wants to give her baby breast milk but does not want to breast feed directly. 
• To donate breast milk to a Milk Bank for premature babies.
• To increase your milk supply.
• When weaning and you need to alleviate pressure, or you are suffering from mastitis and need to drain your breasts to help healing.

What you need to know before you start pumping:

Firstly you need to know why you want to start pumping. If you have a healthy full term baby you can wait a few weeks before you start pumping and storing your breast milk. Allow some time for you and your baby to learn how to breast feed directly. If your baby was born prematurely or ill and is not able to breastfeed directly yet or if you have chosen to exclusively pump you should try to start expressing within one to six hours after your baby was delivered. 

In order to get the most out of your breast pump you need to understand how it works and to be comfortable with your pump. Make sure that you do research about the different pumps that are available, check to see if the pump has different flange sizes so that the flange will your breasts well. Does the pump allow easy control of the settings to help you manage your let-downs. Also, consider how hygienic the pump is. A closed system pump prevents bacteria, mould and viruses from entering the pump and tubing which can grow and contaminate your breast milk at a later stage.  

Tips if you are primarily direct feeding:

• A great time to pump is in the morning. You are more likely to express more milk in the morning
• Try to pump between breastfeeding. Wait for about 30-60 minutes after a feed, and avoid pumping one hour before a feed. 
• If you your baby shows signs of needing to feed just after you have expressed, let your baby drink.

Tips if you are exclusively/predominately breast pumping:

• Plan to pump 8-10 times in a 24 hour period. You would have reached full milk production once you are able to pump 750 to 1035ml in a 24hour period. 
• It is best to maintain a schedule of expression once you have reached your full milk production. 
• Learn how your body works, plan your expressing schedule to work best around you and your baby.

Tips on how to pump 

Learning to pump can be a daunting process. Here are some tips to get you ready to express. 

1. Before you start, read the instructions of your breast pump.
2. Find a space that you are comfortable in. This is very important if you need to pump at work. 
3. Have a snack and a beverage handy. 
4. Hygiene is important, wash your hands with soap and water.
5. Assemble the pump kit. Make sure all the parts are in the correct position. 
6. Place your flanges over your nipples so that they are in the centre. Make sure you’re flange size is the correct size for you. If the flange is too small it can damage your nipples. If the flange is too big the pump will not be able to seal correctly and you will express less milk.
7. Hold your flanges so that they sit tightly onto your breast, so that they seal well.
8. Turn your pump on.
9. Try to imitate how your baby drinks from your breast. Most baby’s start with a high speed and low suction. This will help you to have a let-down where you can see your milk flowing. Once you have a let-down, adjust speed to medium and increase suction based on comfort level.
10. Never place the pump on a setting that is painful. Rather decrease the suction to where you are comfortable this will increase the amount of milk you are able to express.
11. Once milk flow decreases, increase speed to high until the next let-down, then decrease to medium speed.

The more that you use a breast pump the more comfortable you will be. 

How Much Will You Pump: 

Not all pumping sessions will result in the same about of milk expressed. It is all dependant on a few factors: your baby’s age, time since last feeding or pumping, time of day, pump type, how much practice you’ve had with your pump, and whether you’re relaxed or stressed.

What volumes to expect when pumping:

• You produce more milk in the early mornings so you can expect higher volumes.
• As the day progresses you will produce less milk. This is normal
• Your breast may produce different amounts of milk at the same time. It’s normal to have a “lazy breast”.

Aim for full milk production and then maintain your feeding or expressing schedule to maintain your milk supply.  

How to Reach and Maintain Full Milk Production

If you need to reach your full milk production because you have a premature baby, your baby is not able to latch or if you have chosen to exclusively breast feed see the tips below: 

Golden tip: Pump often to drain the breast completely as this activates your hormones and helps your body to produce more milk. This is where supply and demand is so critical, the more often you drain your breasts the more milk they will make.

Initially: Birth to Day 4

• Start as soon as you are able. It is ideal to start with in the first 1 to 6 hours after birth. 
• A hospital grade pump/ multi-user pump can be used to initiate and maintain your milk supply.
• In the beginning you will have colostrum. Only expect a few drops at first. This is normal. 
• As soon as you are able, start to pump 8-10 times a in a 24hour period. This is so that you are copying what a new born baby would do. With most mothers, the more you pump the more milk you can expect to make. Just remember that if you only pump a few times in 24 hours you can expect less milk. 
• In order to save time and help to boost your milk production, express both breasts at the same time. 
• Aim at pumping for about 10 to 20 minutes until your milk has “come in” around about on day 3 or 4. Then, hand express any remaining milk, this may help to drain your breast well after a pumping session. 
• By pumping at least once between 1 and 6 am you can help to establish your milk supply as you will have more milk during this time.

Later:  Day 4 to Full Production

You will see that your milk starts to become more around day 4 (sometimes sooner sometimes a bit later. Now is the time to change how you express:

• Start to pump for longer. Continue to pump for about 2 minutes after you no longer see any milk or until your breasts feel soft and are no longer full. 
• Aim to pump between 8 – 10 times a day rather than to wait 2-3 hours between pumping between pumping (every 2-3 hours).
• Never wait longer than 5 hours between pumping session if your baby is less than 2 weeks old 

Focus on how much milk you produce over a 24 hour time period rather than per each session. This will give you an idea of how close you are to full production. 

Maintaining Full Milk Production

Once you have reached between 750-1,050 mL per baby per 24 hour period, you’ve met your goal. Well done! You might even be able to reduce the number of times you pump in a day while maintaining your total output. You can now:

• Maintain your schedule that continues producing approximately 750-1050ml of breastmilk in a 24 hour period.
• You can drop your night time pump and sleep more. Pump just before you go to bed and as soon as you wake up. Test and see how comfortable you are. 
• You can start to reduce how long you pump for. You might see that you pump milk faster, 10-15 minutes of pumping can be sufficient.
• Track your production. Pick a day of the week and see how much milk you have produced over the 24 hour period and compare that to a day last week. This way you will be able to see how your milk production is tracking.