Pumping 101
There are many reasons why you would decide to pump your breastmilk. Regardless of your reasons there are some things you should know about pumping.
When should I start pumping?
When you start will depend on your goals, your situation, and your baby. Many people begin pumping when they return to work or school. I recommend starting approximately a month before your return to establish a routine, troubleshoot any issues, and build a freezer stash. However, it is important to remember that we are feeding the baby, not the freezer! At home, prioritize direct breastfeeding. If your goal is to maintain your breastfeeding relationship after returning to work or school, exclusively breastfeed while at home and pump during work or school hours.
Pumping at work or school may seem daunting but “The Fair Labor Standards Act (FLSA) requires employers to provide reasonable break time for an employee to express breast milk for their nursing child for one year after the child's birth each time such employee has need to express the milk.” (FLSA Protections to Pump at Work | U.S. Department of Labor (dol.gov). Work closely with an Internationally Board Certified Lactation Consultant (IBCLC) to help you develop a pumping schedule and to give some tips and tricks on milk storage and transportation.
If your goal is to exclusively pump, it’s best to start from birth. However, colostrum, your nutrient-dense first milk, is easier to hand express than pump. Learning hand expression is a valuable skill, and you can find a helpful video guide here: How to hand express breast milk | Infant Feeding Team. Once your milk has transitioned into mature milk (typically around days 3-5), you can begin pumping.
If you face unique circumstances, such as having a baby in the NICU or a baby struggling to latch, reach out to an Internationally Board Certified Lactation Consultant (IBCLC) to develop a plan that suits your current situation and your future goals.
How often do I need to pump?
The frequency of pumping depends on your specific goals. If you are exclusively pumping,it's crucial to pump every 3-4 hours. During the initial 2-3 weeks postpartum, it becomes particularly vital to consistently remove milk. This period is when your body is regulating its milk supply and figuring out the right amount to nourish your baby. It's always easier to reduce milk supply than to attempt to increase it later. Once your supply is stable, you might consider omitting a nighttime pumping session, but I recommend consulting with an International Board Certified Lactation Consultant (IBCLC) before making that decision.
For those pumping upon returning to work or school, maintaining a 3-4 hour pumping schedule is important. It's worth noting that some individuals may experience a decrease in milk supply when resuming work or school. If this occurs, you might need to introduce an additional pumping or nursing session, or even consider power pumping to help maintain your supply. Your specific circumstances can influence the approach, so consulting with an IBCLC is advisable to tailor a solution to your needs.
How do I clean my pump parts?
The CDC provides an excellent article on maintaining the cleanliness of your breast pump: How to Keep Your Breast Pump Clean | CDC
Your breast pump typically includes instructions on how to correctly clean and sanitize its components. Following these guidelines is essential for maintaining hygiene.
While you might come across the viral "fridge/freezer" hack, which involves storing pump parts in the fridge or freezer between sessions, it's not a recommended practice. Although it's intended to slow the growth of bacteria, it doesn't completely prevent it. For parents who exclusively pump, I strongly advise having extra parts on hand. Before purchasing these parts independently, it's a good idea to check with your insurance provider and durable medical equipment supplier, as you may qualify for coverage of these parts.
Where do I get a breast pump?
When it comes to insurance and durable medical equipment (DME) providers, it's essential to be aware of the benefits available to you. Thanks to the Affordable Care Act (ACA), health insurance is required to cover the cost of a breast pump. However, it's worth noting that some insurance plans may have coverage limits. Most DME providers can guide you on what's covered by your insurance and what might involve out-of-pocket expenses, so it's a good idea to explore your options. Additionally, some insurances may also cover the cost of breast milk storage bags.. Be sure to check with your specific insurance and DME provider to take full advantage of these benefits.
How do I choose a breast pump?
Choosing a breast pump is so hard with so many on the market! For first time parents I always recommend getting a reliable double electric breast pump such as the Spectra or Medela. These brands have a proven track record and consistently deliver excellent results. What's more, they are widely used, meaning there's an abundance of resources and support available to assist you in using them effectively.
On the other hand, if you're a second-time parent, the hands-free option might become a necessity. I vividly recall how invaluable a hands-free pump was for me when juggling the demands of pumping for my twins while caring for my active 2-year-old. However, it's essential to remember that the hands-free pump should complement, not replace, your primary pump. Hands-free pumps are best suited for occasional use. If your goal is to build a milk supply or if you're pumping for a baby in the NICU, it's imperative to invest in a high-quality, standard breast pump. Your choice of pump should align with your specific needs and goals, and getting expert advice can be invaluable in making the right decision.
How do I store breastmilk?
I have a simple and easy-to-recall rule I like to call the "4, 5, 6 Rule." Freshly pumped milk can stay at room temperature for up to 4 hours, remain in the fridge for 5 days, and last in the freezer for a period of 6 months or more. When it comes to thawed breastmilk, it's considered suitable for consumption for just 24 hours after thawing and when no crystals are present. It's important to adhere to current recommendations, which advise against using breastmilk that has been heated or directly consumed from after 2 hours to prevent the introduction of bacteria. These guidelines help ensure the safety and quality of the breastmilk you provide for your little one.
How do I increase my supply?
One of the most commonly asked questions about breastfeeding and pumping is related to milk volume. The key to milk production lies in the principle of supply and demand: the more frequently you empty the breast, the more milk your body will produce. While there are various foods and herbs in the market claiming to boost supply, I'm often cautious about recommending them without knowing the underlying cause of low milk supply. One specific ingredient to be aware of is fenugreek, commonly found in many products on store shelves. It's not recommended for diabetics, and some individuals have reported a decrease in supply when using it. Ultimately, maintaining proper hydration and a balanced diet is the most effective way to support your milk supply because it's not only beneficial for milk production but also for your overall health.
When this doesn’t work there are next steps. As an IBCLC I will recommend a set of labs to be done by your primary care provider based off signs and symptoms and your health history. Together, with your primary care provider, we can find the underlying cause of your low milk supply and address it through supplements, medication, or lifestyle changes. Lactation is a vital sign and if something is not working how it should, it is worth investigating! Lactation aside, there are other health reasons to explore the cause of low milk supply and address the issue. For example, hypothyrodism can cause low milk supply and it can also cause fatigue, weight gain or difficulty losing weight, constipation, hair loss, and more. And, you deserve to feel good in your body!
It's important to note that the field of lactation requires further research, and recommendations may evolve as we gain more insights. When in doubt, reaching out to an International Board Certified Lactation Consultant (IBCLC) is a wise choice, as they stay updated on the latest developments and can provide the most current information and guidance to address your questions and concerns. Your IBCLC is your go-to resource for reliable support in your breastfeeding journey.
