Like any skill worth having, it might take you a bit of time to get the hang of using a breast pump. The key is to be patient, even if you’re not able to express as much as you’d like right away. After all, a breast pump won’t stimulate the same feelings in you as your baby does. But, withtime, your body will usually learn to trigger your let-down reflex when you pump, and the quantity of milk you express should increase.

1: There’s no need to rush to start pumping…

In the first four weeks, you and your baby work together to initiate and build your milk supply. If your baby is healthy and breastfeeding is going well, you won’t need a pump to help with this. Pumping is, however, really helpful if you need to be apart from your baby any time (see tip below). If not, enjoy this time with your baby and be reassured that even if you plan to pump regularly in future, there’s no need to ‘train’ your body to express milk in the first few weeks.

2: …unless your baby is unable to breastfeed

If your baby can’t feed directly from the breast, perhaps because she’s premature or has special needs, or you are separated for any reason, start double pumping breast milk as soon as you can after the birth.

Research shows that starting to express within the first few hours (when a healthy newborn would usually have her first breastfeed) helps mums produce a higher volume of milk in the early days and weeks,^1,2 giving their babies the best chance of being fed exclusively on mother’s milk.

If you’re expecting your baby (or babies) to be born pre-term, in need of intensive care, or to have a condition that might make breastfeeding difficult, prepare yourself. Learn about expressing, source equipment you might need, and ask a healthcare professional, lactation consultant or breastfeeding specialist for support.

There will probably be a hospital-grade double breast pump at your hospital or birth facility, so ask staff to show you how to use it. It’s important to remove milk from your breasts whenever your baby would normally drink – this means your breasts will still get the message to make milk. Aim for eight to 10 pumping sessions every 24 hours at first,³ and continue this frequency once your milk comes in.

3: Time it right

For your first breast-pumping session, express for at least 15 minutes. Don’t worry if you don’t collect much milk at first – regular extra suction should soon stimulate your breasts to produce more milk.

Some mums find pumping one hour after a feed gives the greatest milk yield, others prefer to pump straight after every second feed – try expressing at different times to see when best fits your lifestyle. When you find times that work for you, stick with them so your body gets used to your breast pump use and the extra demand on your milk supply. You may be tempted to extend the time between expressions in a bid to collect larger volumes of milk. However, if you wait until your breasts are full one pumping session won’t drain them very well,^3,4 so the key is to pump frequently and regularly.

4: Be hygienic

Always wash your hands before and after breast pumping, and clean any pump parts that have been in contact with your milk or your baby’s mouth. You will also need to sanitise them after cleaning at least once a day. Be sure to allow all the pieces to completely dry and you can then store the pump set in a clear bag or container until next use.

5: Be prepared

To avoid interrupting your breast-pumping session, have everything you need close by before you start. You might want a drink and snack, your phone or TV remote, bottles or milk storage bags for your expressed milk, and a muslin cloth to soak up any drips.

A specially designed breast pumping bra allows you to keep your hands free, making it much easier to operate the controls and do other things while you express.

6: Make yourself comfortable

The best position for pumping is one in which you feel at ease. Being relaxed is essential for the release of the hormone oxytocin, which stimulates your let-down reflex. Discomfort and distractions can hamper this process,⁵ so choose somewhere private and comfortable, and make sure your arms and back are well supported as you pump.

If you’re not using a pumping bra, hold your breast shield between your thumb and index finger, and use your palm and other fingers to support your breast. Hold the breast shield gently against the breast – pressing too hard could compress your breast tissue and obstruct milk flow.

Some mums find deep breathing, soothing music, visualisation techniques, or having their partner massage their back and shoulders, can help them express more milk.

7: Kick-start your let down

Most Medela electric and battery-operated breast pumps have 2-Phase Expression technology, which mimics the way your baby feeds (with fast, light sucking followed by slower and stronger sucks), to help trigger your let down. Massaging your breasts before and during pumping,⁶ as well as warming your breasts⁷ by applying a warm compress (such as a flannel) on them before expressing has been shown to help stimulate your milk flow and increase the amount you collect.

Scientists have discovered that having skin-to-skin contact with your baby before and during pumping can help you express more milk too.⁸ This is because the warmth and touch of your baby’s skin against yours releases oxytocin in your body.⁹ In fact, some mums find expressing works best if they feed their baby from the other breast while they pump because of the extra stimulation.

If your baby isn’t with you, try looking at a photo or video of her, or smelling an item of her clothing, while you express.¹⁰ Being able to connect with your baby at the same time as pumping is another way to raise your oxytocin level and help get your milk flowing.

8: Take advantage of your milk flow

Many mothers don’t sense their let down, so watch out for it as you pump. When you start to see jets of breast milk squirting into the collection bottle or bag, you’ll know it’s happening.¹¹

If you’re using a breast pump with 2-Phase Expression technology, it will have a stimulation mode and an expression mode. The stimulation mode normally lasts about two minutes, but once you see milk flowing as described, it’s important to switch to the expression phase. This is because that first let down typically provides around 36% of the milk volume, so you’ll be taking advantage of your flow to collect more milk.¹²

9: Find your comfort zone

During the expression phase, pump at your maximum comfort vacuum, which is the highest breast pump setting you can use while remaining comfortable. In research, this was found to remove a similar amount of milk as a baby does during breastfeeding.^13,14

To find the right level for you, increase the breast pump suction gradually until it becomes slightly uncomfortable, and then turn it down a notch.

10: Tailor the length of your pumping sessions

Once your supply is established (after about four to six weeks), you can start tailoring how many minutes you need to pump for, which can save you valuable time. Some mothers need to pump longer than others due to their number of let downs, which determine how often and how long milk flows.^4,15 What’s really amazing is that while every mum has a unique flow pattern, yours will be the same each time you pump as well as when you breastfeed.¹⁶

So how can you tell what your pattern is? Pick a time when you normally pump your highest volume of milk and watch while you pump, noting when jets of milk start coming from your nipple, or when milk drips into the container over the course of the session.

A mum who only has let downs early in a session will have removed most of her milk within eight to 10 minutes, and pumping any longer won’t reward her with more milk. Conversely, a mum who has many or late let downs may need to pump for 15 minutes or longer to drain her breast thoroughly.¹⁵

11: Double up

If you’re planning to pump regularly, it’s well worth investing in a double breast pump. Double pumping raises the level of prolactin, the milk-producing hormone, in your body.¹⁷ Amazingly, research has shown that women who double pump have an additional let down in each pumping session. This means they typically express almost a fifth more milk, and milk with a higher fat content too, as opposed to pumping from each breast in turn.¹⁸ This can really add up, in addition to saving time, after just a few pumping sessions you could have an extra bottle.

12: Don’t ignore discomfort

Pumping breast milk shouldn’t hurt. If you feel discomfort while expressing, or notice blisters or chafing on your nipple or breast, try reducing the breast pump suction.

Also make sure you’re using the right size of breast shield (the funnel-shaped part that fits over your breast). The breast shield tunnel should surround your nipple closely, but leave enough space for it to move back and forth freely without rubbing. It shouldn’t chafe or pull too much of your areola (the dark area around the nipple), or the breast skin around it, into the tunnel as you pump. A badly fitting breast shield can reduce the amount of milk you express, which is why Medela makes breast shields in several different sizes.

If the discomfort continues after you’ve tried these tips, stop pumping and ask a lactation consultant or breastfeeding specialist for advice.

The post How to use a breast pump: 12 top tips appeared first on Medela South Africa.

Before you pump

All the parts of your breast pump that come into contact with your breasts or breast milk must be completely clean and dry (see below). But it’s not just your equipment that needs to be clean when expressing milk – so do you! Before every pumping session, remember to wash your hands thoroughly with soap for at least 20 seconds, then rinse them and dry with a clean towel. There’s no need to wash your breasts, unless they have cream or cosmetics on them that aren’t compatible with breastfeeding¹ – if in doubt, check the packaging. Many lanolin-based nipple creams are fine to leave on while you express.

Tips for cleaning your breast pump equipment after use

After you’ve expressed, always wash any pumping equipment, such as bottles, valves and breast shields, that have touched your breasts or milk and then dry thoroughly so they’re ready for your next session.

• First, rinse off your pumping equipment with drinking-quality water (at around 20 °C/68 °F), to remove any milk proteins left behind.
• Then wash all parts with warm water (approximately 30 °C/86 °F) and washing-up liquid.
• Rinse the parts again with drinking-quality water for 15 to 20 seconds.
• Alternatively, you can wash the pump parts in the top rack of your dishwasher using your usual detergent. Smaller parts can be placed in the cutlery section. Make sure breast milk bottles, breast shields and teats are facing downwards.
• Dry the equipment with a clean cloth or leave to air-dry on a clean tea towel.
• Don’t forget to check your breast pump instruction manual for specific cleaning guidelines.

How to sanitise your breast pump equipment

At least once a day, you’ll need to sanitise your pumping parts after washing them. You’ll also need to do this if your breast pump equipment is brand new or hasn’t been used for a while.

Sanitising means that the equipment has been thoroughly cleaned of germs and bacteria. You may often hear people talking about ‘sterilising’ baby equipment or see products advertised as ‘sterilisers’, but sanitising is a more accurate term. It is impossible to completely sterilise equipment at home, even if you boil it, as our homes are not totally sterile environments. But sanitising ensures equipment is perfectly safe for you and your baby.

Every product is different, so make sure you follow the sanitising method recommended by your pump manufacturer, but generally you’ll probably use one of these methods:

• Boil. Place your pump parts in a large pan and cover with water. Bring to the boil, then keep boiling for at least five minutes, making sure all the parts stay submerged.
• Microwave. Put the pump parts in a microwaveable sanitising bag or microwave steriliser and follow the manufacturer’s instructions for use.
• Steam. Use an electric steam steriliser, making sure bottles, breast shields and teats face downwards inside it.
• Sterilising fluid or tablets. Some people choose to use a cold-water sterilising solution. If you do, make sure all parts are submerged, with no trapped air bubbles, for at least 30 minutes (and discard the solution after 24 hours). Alternatively, you could use a sanitising spray.

After sanitising

Once you’ve sanitised your breast pump equipment, allow to dry off thoroughly before use:

• Remove the pump parts from the pan, sanitising bag or steriliser using clean hands or clean tongs. Be careful not to scald yourself!
• Shake off any excess water, then dry with a clean cloth or allow to air-dry.
• Place the parts on a sanitised surface or in a sanitised storage container.

Washing your pumping equipment after use, and sanitising it thoroughly at least once a day, will ensure your breast milk is safe to store for your baby.  

The post Cleaning your breast pump equipment appeared first on Medela South Africa.

Which breast milk storage method is best?

Breast milk is better for your baby than formula – but freshly expressed breast milk is preferable to refrigerated, and refrigerated is better than frozen. That’s because freshly expressed milk has the best bacteria-fighting properties and is higher in antioxidants, vitamins and fat than milk that has been refrigerated or frozen.⁴

Storage guidelines for freshly expressed breast milk (for healthy term babies)^2,3:

If you have expressed breast milk cleanly and safely, you can store it at room temperature, in the fridge, or in the freezer, depending on how soon you want to use it. Follow this storage location and temperatures guidelines for freshly expressed breast milk (for healthy term babies)^2,3:

* Very clean conditions means rigorously following the guidance in our article on cleaning and sanitising your breast pump.These guidelines for storing and defrosting breast milk are a recommendation – contact your lactation consultant or breastfeeding specialist for further information.

If your baby is in a neonatal intensive care unit (NICU) or special care ward, your hospital may have stricter recommendations for cleaning and storage.

If you’re refrigerating or freezing expressed milk, always label the bottles or bags with the amount and the date it was pumped, so you can track and manage your stored milk.

Guidelines for using expressed breast milk

Stored breast milk tends to separate into layers, with the fat (cream) rising to the top. Gently swirl the bottle to mix the layers before feeding your baby. Vigorous stirring or shaking can damage some of the milk’s nutritional and protective components.⁵

When your baby feeds on expressed breast milk from a cup or bottle, bacteria from his mouth can naturally end up in the milk. For this reason, it’s best to throw away any leftover, partly drunk milk within one to two hours of his initial feed. To avoid wasting expressed milk, it’s always a good idea to store it in small amounts, and only use what you need.²

How to store breast milk in the refrigerator^2,3

Follow these guidelines to store expressed milk safely in the fridge:

• Refrigerate your breast milk as soon as possible after expressing.
• Store your milk in clean breast milk bottles or storage bags  made from BPA-free materials. BPA is a chemical that was previously widely used in plastic containers and coatings, which many manufacturers are phasing out due to its uncertain long-term effects.
• Small amounts of expressed milk may be added to the same refrigerated container, provided the milk you want to add is cooled in the fridge beforehand. Don’t add body-temperature milk to already cooled milk.
• Store breast milk in the coldest part of the fridge – at the back, on the shelf above the vegetable compartment. Don’t keep it in the fridge door where the temperature is less consistent.

How to store breast milk in the freezer^2,3

Read on for how to freeze breast milk safely:

• Freeze your breast milk as soon as possible after expressing.
• Expressed milk may be added to already frozen breast milk, provided the milk you want to add is cooled in the fridge beforehand. Don’t add body-temperature milk to frozen milk.
• For easier thawing and minimal wastage, store your milk in small portions (less than 60 ml). These can be combined after defrosting.
• Check that your breast milk storage containers can be used in the freezer – some products (such as glass bottles) may crack at very low temperatures. Medela breast milk storage bags are ideal for storing frozen breast milk as they’re freezer-proof, ready to be used and easy to label.
• Don’t fill bottles or bags more than three-quarters full, as breast milk expands during freezing.
• Store frozen breast milk at the back of the freezer where the temperature is most consistent. Keep it away from the walls of self-defrosting freezers.

How to defrost breast milk^2,3

Take care when defrosting breast milk to make sure it’s safe for your baby:

• Breast milk can be defrosted in the fridge, normally in around 12 hours. Alternatively, hold the bottle or bag of frozen milk under warm running water (a maximum of 37 °C or 99 °F). Don’t leave frozen breast milk to defrost at room temperature.
• Once fully thawed, previously frozen breast milk may be kept at room temperature for a maximum of two hours or in the refrigerator for up to 24 hours.
• Don’t thaw or heat frozen breast milk in a microwave or in boiling water. These can damage its nutritional and protective properties and create hot spots that could scald your baby.
• Thawed breast milk left at room temperature should be fed to your baby within two hours or thrown away.
• Never re-freeze breast milk once thawed.

How to warm your stored breast milk^2,3

Healthy, full-term babies can drink breast milk at room temperature or warmed to body temperature. Some have a preference, others don’t seem to mind.

• To warm your milk, place the breast milk bottle or bag into a cup, jug or bowl of lukewarm water for a few minutes to bring it to body temperature (37 °C or 99 °F). Alternatively, use a bottle warmer. Do not allow the temperature to go above 40 °C (104 °F), and do not use a microwave, as this can overheat your milk.
• Gently swirl the bottle or bag, without shaking or stirring, to mix any separated fat (see above).

Why does my stored breast milk smell odd?

You may notice that your refrigerated or defrosted breast milk can sometimes smell different. This is because an enzyme called lipase breaks down fats and releases fatty acids – a process that helps prevent the growth of harmful bacteria.

Some mums report that their stored milk has a soapy or rancid smell. But if you’ve followed all the safe-storage guidelines in this article, it will be perfectly fine to use.²

Breast milk storage on the go

If you have to transport your milk between work and home or daycare, use a cooler bag with ice packs.² For more on pumping and storing milk on the move, read our article on travelling and pumping.

The post How to store, freeze and thaw breast milk appeared first on Medela South Africa.