What do open system and closed system mean?

These terms generally refer to whether or not there’s a barrier (sometimes called a ‘media separation’) between the breast pump and your expressed breast milk.

A breast pump with a milk barrier is known as a closed system as it’s ‘closed off’ from the milk. The barrier prevents the milk overflowing and leaking into the pump mechanism, and helps ensure your expressed milk travels through a hygienic route.

An open-system breast pump doesn’t have a milk barrier – but bear in mind that the risks of contamination are extremely small even if you do have this type of breast pump.

What is ‘overflow protection’?

It’s worth knowing that ‘closed system’ and ‘open system’ are not clinical or medical definitions, and different breast pump manufacturers may use them differently.

For this reason, we at Medela prefer the term ‘overflow protection’, as that’s the milk barrier’s main purpose: to stop milk from overflowing and entering the pump.

In addition, there’s actually no such thing as a completely ‘closed-system’ breast pump – all breast pumps need some air to flow in and out of them so the vacuum can work.

Where can I find the milk barrier?

It varies between breast pumps, but usually between the tubing and the motor, or between the breast shield connector and the tubing.

The latter option is increasingly common in the latest next-generation breast pumps. This is because it protects the tubing as well as preventing milk overflow.  

What are the benefits of Medela’s next-generation breast pump connectors?

Having the overflow protection within the breast shield connector means you can pump in a more reclined, comfortable position, because you can be confident your expressed breast milk won’t get into the tubing. This is a big bonus, as being comfortable and relaxed while pumping helps your milk to flow – for more on how to make the most of your pumping sessions, see our article on breast pumping tips.

Another plus for busy mums is that this type of breast pump is easier to keep clean and maintain. Because the overflow protection minimises the chance of moisture entering the tubing, you’re less likely to need to clean and sanitise it. 

Assembling Medela’s next-generation breast pump connectors is also uncomplicated and intuitive. The milk barrier is an easy-to-handle flexible membrane that can only be placed in one position inside the connector.

In addition, the connectors themselves are simple to clean, with as few parts as possible to wash and sanitise. And, as you’d expect from Medela, all plastic components are made without the chemical BPA and comply with international safety regulations.

What if I see moisture in my breast pump’s tubing?

If moisture does appear in the tubing of your closed-system breast pump, condensation is likely to be the culprit. This can happen if any parts are not completely dry when you start pumping.

If you spot water droplets in your breast pump tubing, you’ll need to clean and sanitise it or replace it according to the product instructions.

Are all closed-system breast pumps the same?

While many breast pump makers claim their products have closed systems, they’re not all created equally. If they are poorly designed, a closed-system breast pump can actually reduce the amount of milk you can collect, or even increase the risk of contamination.

A closed-system breast pump isn’t necessarily more hygienic either. Bacteria and mould growth are generally linked to poor cleaning, so if a closed-system pump isn’t cleaned properly it can still harbour germs. Every breast pump is designed a little differently, so you’ll need to follow the cleaning instructions from your pump’s manufacturer.

A closed system doesn’t necessarily mean better performance either. Some manufacturers have compromised their breast pumps’ effectiveness to have a closed system.

What makes Medela breast pumps different?

When you use a Medela breast pump, you’re using a medical device that’s been developed and refined through decades of scientific research to meet strict quality and safety standards.

And at Medela we go above and beyond the regulations, by clinically testing all our products with mums to make sure they’re effective and meet the needs of parents and babies.

Plus all our next-generation breast pumps have a milk barrier for overflow protection, so you can feel happy, relaxed and comfortable when pumping. And remember, a happy mum equals more breast milk and a happy baby!

The post What’s the difference between open- and closed-system breast pumps? appeared first on Medela South Africa.

The right breast shield size is an essential part of optimal milk flow during pumping. To help you obtain maximum comfort and pumping efficiency, Medela offers five breast shield sizes.

Choosing your Medela breast shield size (PDF, 346 KB)

The post Choosing your Medela breast shield size appeared first on Medela South Africa.

The benefits of hands-free expression

Using a hands-free pumping bra means you can collect milk for your baby while you’re on your phone or laptop, reading, having a snack, or playing with an older child. It also makes it much easier to operate the breast pump controls and deal with your bottles or bags of expressed milk.

“A hands-free pumping bra and easy-access clothes save me time and allow me to multitask at work. I book a mums’ room and find I’m able to work and pump at the same time,” says Natalie, mum of one, US.

The Medela Easy Expression bustier has the added benefit of a strap-free design, which means you can pop it on quickly and easily when you need to pump and remove it without fuss when you’ve finished.

“Double pumping using a bustier saved my shoulders from aching and allowed me to get stuff done (or at least eat and have a cup of tea!) while expressing – something I was doing constantly as mum to a premature baby in NICU for six weeks,” says Suzanne, mum of one, UK.

4 simple steps to using a hands-free pumping bra

The Medela Easy Expression Bustier holds the two breast shields of your double breast pump gently in place while you express, and is easy to wear and use – just follow these instructions:

Step 1

Put the Medela Easy Expression Bustier on and fasten the hook at the top – this is designed to make it easier to zip up from the bottom.

Step 2

Zip up the bustier.

Step 3

Insert a breast shield on each breast under the bustier. The bustier material is very stretchy, allowing space for you to do this, but you can also unfasten the zip temporarily if this helps. Your nipple should be centred in the breast shield tunnel, which fits through the hole in each side.

Step 4

Attach a connector to each breast shield, and you’re ready to pump hands-free.

10 top tips for hands-free expression

Like all aspects of breastfeeding, it can take a little time to become proficient at hands-free expressing. Follow these tips to keep yourself comfortable and maximise your milk flow:

1. Make sure you have the right size breast shield. The tunnel should be around 4 mm (0.16 in) larger than your nipple’s diameter. If it’s too narrow your nipple may rub against the sides; if it’s too loose too much breast tissue can be pulled inside. The good news is Medela makes breast shields in five different sizes so you can find one that suits you.
2. Check that each of your nipples is positioned centrally within each breast shield tunnel before you start pumping.
3. Make sure the pumping bra holds both breast shields securely against your breasts without being too tight. If necessary, adjust or loosen it to ensure milk flow isn’t restricted.
4. Pump at your maximum comfort vacuum, which is the highest vacuum you can tolerate comfortably, as this has been proven to release more milk in less time.² To find the right level for you, increase the vacuum gradually until it feels slightly uncomfortable (not painful), then turn it down a notch.
5. Avoid leaning on a breast shield or pressing it too hard against the skin, as this could compress your milk ducts and restrict milk flow.³
6. Massage your breasts occasionally during pumping to help the milk flow freely from all your ducts.⁴
7. Feel your breasts all over after pumping to check for complete breast drainage – they should be soft.
8. Although it’s normal for nipples to appear larger, longer or redder immediately after pumping, they and your breasts should feel comfortable, with no pressure marks or sore spots. Chafing could be a sign that you need a different size of breast shield, or you need to reduce your vacuum. Any indentations on the skin may indicate your pumping bra is too tight or that you’ve been leaning or pressing too hard against the breast shield. Make adjustments next time you express to keep yourself comfortable and avoid problems in the future.
9. If you experience ongoing soreness or pain when pumping hands-free, stop using this method and get advice from a lactation consultant or breastfeeding specialist.
10. If you’re expressing exclusively and are concerned about any of the above issues, pump once or twice a day without the hands-free option, so you can support your breasts while you pump and ensure they’re well drained.

The post Tips and instructions for hands-free pumping appeared first on Medela South Africa.

Reasons for low milk supply

A small number of new mums have difficulty producing enough breast milk due to medical reasons, which include:

• Excessive blood loss (more than 500 ml/17.6 fl oz) during the birth or retained fragments of the placenta can delay your milk coming in (which usually happens around three days after the birth).¹
• A history of polycystic ovarian syndrome, diabetes, thyroid or other hormonal disorders. Mums with these conditions sometimes experience a low milk supply.²
• The rare medical condition mammary hypoplasia, in which there isn’t enough milk-producing glandular tissue within the breast.³
• Previous breast surgeries or breast trauma – although many mums who have had surgery go on to breastfeed successfully.⁴

If any of these conditions applies to you, see a lactation consultant or breastfeeding specialist.

How breast milk supply works

Once your breast milk has come in, your breasts start to make milk through a process of ‘supply and demand’. Each time milk is removed, either by your baby feeding or by expressing, your breasts make more.

That’s why giving bottles of formula can reduce your milk supply – your body isn’t getting the message to produce more breast milk, because none is being removed.

The way your baby nurses also affects your supply. The more frequently and effectively she breastfeeds, the more milk you’ll make. If your baby doesn’t take enough milk during a feed, it’s essential to express regularly to protect your milk supply – see below for more advice.

Signs your baby isn’t getting enough milk

Even though low milk supply is rare, your baby may still struggle to get enough for other reasons during her first few weeks. She may not be breastfeeding frequently enough, or for long enough, particularly if you’re trying to stick to a breastfeeding schedule rather than feeding on demand. She may not be latching well, or might have a condition that makes it harder to take in milk.

The following are signs your baby isn’t getting enough milk:

• Poor weight gain. It’s normal for newborns to lose 5% to 7% of their birth weight in the first few days – some lose up to 10%. However, after that they should gain at least 20 to 30 g (0.7 to 1 oz) per day and be back to their birth weight by day 10 to 14.^5,6,7 If your baby has lost 10% or more of her birth weight, or she hasn’t started gaining weight by days five to six, you should seek medical advice immediately.
• Insufficient wet or dirty nappies. The number of poos and wees your baby has per day is a good indicator of whether or not she is getting enough milk – see our article explaining the pattern your baby should be following in Breastfeeding your newborn: What to expect in the first week. Seek medical advice if you’re concerned or if you have noticed her dirty nappies decreasing in wetness and heaviness.
• Dehydration. If your baby has dark-coloured urine, a dry mouth or jaundice (yellowing of the skin or eyes), or if she is lethargic and reluctant to feed, she could be dehydrated.⁶ Fever, diarrhoea and vomiting, or overheating, can cause dehydration in infants. If you notice any of these symptoms, seek medical advice quickly.

Misconceptions about low milk supply

Newborns typically feed very often – around 10 to 12 times a day, or every two hours – and this is not a sign that you don’t have enough milk. Don’t forget that your baby also nurses for comfort, and it’s difficult to tell how much milk your baby takes during each feed – amounts can vary.

The following are all perfectly normal and are not signs of a poor milk supply:

• your baby wants to feed frequently
• your baby doesn’t want to be put down
• your baby is waking in the night
• short feeds
• long feeds
• your baby will take a bottle after a feed
• your breasts feel softer than they did in the early weeks
• your breasts don’t leak milk, or they used to leak and have stopped
• you can’t pump much milk
• you have small breasts

What to do if you have low milk supply

If you suspect your baby is not getting enough milk, see a lactation consultant or breastfeeding specialist. They will assess whether you have low milk supply and observe a breastfeed to see if your baby is latched on well and taking in enough milk. They may suggest adjusting your feeding position or your baby’s latch so she can feed more efficiently.

You could also try having more skin-to-skin contact with your baby before and during feeds to stimulate the hormone oxytocin, which gets your milk flowing. Or use relaxation techniques, such as listening to your favourite calming music, to reduce any anxiety that could be affecting your supply.⁸

With support, most mums with low milk supply are able to partially breastfeed their babies, and some will manage to develop a full milk supply.

If your baby is not yet taking enough milk directly from the breast, perhaps because she was premature or has special needs, you may need to express to protect your milk supply, and your healthcare professional may prescribe galactogogues (medication to increase milk production).

If you’re not yet able to express enough breast milk for your baby, you’ll need to supplement her with donor milk or formula, under the guidance of a medical professional. A supplemental nursing system (SNS) can be a satisfying way for her to get all the milk she needs at the breast.

How to increase milk supply with a breast pump

If you need to encourage your milk supply in the first five days after birth, you can use a double electric breast pump with initiation technology, such as the Medela Symphony. This type of pump is designed to mimic the way a baby stimulates the breasts while feeding, and has been found to increase longer-term milk production.⁹

Once your milk has come in, double pumping means you can express more milk in less time.¹⁰ This method also drains the breasts better, which also helps with milk supply.

Although every mum is different, it’s often a good idea to express milk straight after, or an hour after, a feed. This may seem counterintuitive, because it’s usually easier to pump from a full breast. But you should think of your pumping session as ‘putting in a milk order’ for the next day.

At first you may only collect small amounts, but don’t be discouraged – with regular pumping, this will increase. Aim to be removing milk (by breastfeeding as well as pumping) eight to 12 times a day, including one session at night when your levels of the milk-producing hormone prolactin are highest. The more frequently milk is removed, the better. After two or three days of regular pumping you should see a significant increase in supply. For advice on getting more milk from each pumping session, read breast pumping tips.

Hands-on pumping to increase expressed milk

If your baby is not breastfeeding directly at all, or you can’t yet pump enough milk for her, a technique called ‘hands-on pumping’ can be useful. It has been shown to increase the amount of milk mums can express in a session.^11,12 The whole process takes around 25 to 30 minutes. Remember, the emptier your breasts, the more quickly they’ll make milk.

Follow these simple steps:

• Massage your breasts.
• Double pump using an expressing bra to keep your hands free.
• While pumping, use your fingers and thumb to compress your breast for a few seconds. Release and repeat. Use compressions on both breasts until your milk flow slows to a trickle.
• Massage your breasts again.
• Finish by hand expressing or single pumping, using breast compressions and switching between breasts to drain them as fully as possible.

Once your baby is gaining weight and you’ve increased your supply, then you can move on to feeding her exclusively at the breast.

The post Too little breast milk? How to increase low milk supply appeared first on Medela South Africa.