Feeding Information...

• Rental/Usage/Care of a Quality Electric Breast Pump
• Collecting and Storing Breast Milk
• Care of Your Nipples and Breasts

Rental/Usage/Care of a Quality Electric Breast Pump

Purpose:

1. To stimulate the production of colostrum/breast milk
2. To build and maintain an adequate supply of breast milk

Reason to Pump:

1. Premature baby or baby in NICU
2. Mother receiving medication that is contraindicated in breast feeding
3. Baby unable to breast feed due to an illness or required treatment
4. Baby unable to latch on breast and successfully breast feed

Types of Electric Breast Pumps:

Hollister/Egnell electric breast pumps

• Hollister/Egnell SMB (large, heavy hospital grade model)
• Hollister/Egnell Elite (portable mid weight model)
• Hollister/Egnell Purely Yours (light weight model with carry case) **

Medela Electric Breast Pumps

• Medela Classic (large, heavy hospital grade model)
• Medela Lactina Plus/ Medela Lactina Select (portable mid weight models)
• Medela Pump In Style (light weight model with carry case) **

** Light weight pump models are not recommended if your baby is in the NICU, while stimulating the production and building the full volume of your breast milk. *

Pumping Equipment Needed:

1. Hollister/Egnell or Medela electric breast pump with compatible pumping kit
2. Compatible double pumping kit for Hollister/ Egnell or Medela Pump: Hollister/Egnell Dual HygieniKit Collection System with Flexishields Areola Stimulator -or- Medela Universal Pumping System
3. Storage containers: (Sterile plastic syringes -or- sterile plastic volu-feed bottles & sterile caps -or- sterile nurser bags & self-locking freezer bags -or- Hollister/Egnell Mother’s Milk Freezer Bags -or- Medela CSF Bags)
4. Tape for labels

(Note: Follow manufacturer's directions for care of pumping equipment)

Rental of the Electric Breast Pump
Hollister/Egnell and Medela electric breast pumps are available for rental and purchase through your neighborhood rental depot. Call Hollister/Egnell for your local rental depots at 1 800 323 8750 or Medela at 1 800 435 8316. To rent or purchase a quality electric breast pump locally, call the Lactation Center at 610 645 2336 and press 2 for a few of the current locations in Bucks, Delaware, and Montgomery Counties. Call the lactation center if questions about purchasing versus renting a quality breast pump. Search the internet for cost savings. Double pumping set ups are recommended to stimulate your full production of breast milk and to save time spent pumping.

The preferred models to rent are the Hollister/Egnell Elite electric breast pump or the Medela Lactina Plus/ Medela Lactina Select electric breast pumps. Mid weight, easy to carry, pump both breasts at the same time efficiently, user friendly, and adapter available for the cigarette lighter in your car. Excellent choice for long term frequent pumping. Double pumping set ups are recommended and are a separate purchase.

The preferred models to purchase are the Hollister/Egnell Purely Yours electric breast pump or the Medela Pump In Style electric breast pump. Light weight, pumps both breasts at the same time efficiently, user friendly, and come with a carry case. Excellent choice for long term frequent but less often pumping. Double pumping set ups are included. Costs range from $180.00 to $240.00. Available for purchase on the internet at reduced costs.

Rental costs range from $1.10 to $3.00 per day depending on the length of time you rent the pump. A small charge may be required to cover loss or damage to the pump. Costs are subject to change. An initial deposit may be required or waived depending on the policy of the rental depot. Discuss any questions with the lactation staff at the Lactation Center.

Rental costs, not purchase costs, are covered by some insurance plans. Also some insurance plans will arrange for your pump and it’s delivery to your home, your hospital room, or the N.I.C.U. Please ask the N.I.C.U./ Maternity Case Manager to contact your insurance carrier to check on coverage of your rental breast pump and any specific requirements that your must follow to have your pump covered. For your records, save any information given to you by the Case Manager about your pump coverage.

Method:

1. Wash hands and have available electric breast pump & double pumping kit.
2. Begin pumping with suction at the lowest setting. Increase the suction to your tolerance. Pumping should not be painful or cause nipple damage. If pumping is painful on the lowest setting, call the lactation center for advice.
3. Plan to pump each breast every 2 hours. Begin pumping when you wake in the morning and finish when you go to sleep for the night. Write your schedule down each day and follow it as closely as possible. Some days you will be able to pump only every 3 hours or less often if time is a problem. Do the best you can for your baby and yourself.
4. Initially, while in the hospital it is not necessary to schedule pumping session during the night. When you are discharged home, plan to pump your breasts every 4 hours at night. As your baby ‘s nutritional needs increase, it will be necessary to pump every 2 to 3 hours during the night. Continue to be aware of your breasts. If fullness or discomfort wake you at night, get up and pump! This will help your milk supply and prevent engorgement, plugging, and breast infections.
5. Aim to pump for a total of 120 minutes in 24 hours, at least.
6. Place your nipple centered in the breast shield. Hold the shield snugly to your breast, maintaining a firm seal. Hollister/Egnell silicone flexishields are included in the pumping kit. Experiment and try pumping with and without the flexishields. Use the flexishields if you like them. If the flexishield causes friction on your nipple, discontinue use. Medela has a larger nipple flange available for purchase, if needed to accommodate larger nipples. If interested, call Medela at their 800 number to purchase the Extra Large Glass Breastshield Kit.
7. Practice relaxation. Listen to soothing music. Minimize stress. Stress inhibits letdown. Breast massage and the use of moist warm compresses prior to pumping can be helpful. Meditate about your baby. Visualize your baby breast feeding while you are pumping. Look at snapshots of your baby. Tape and listen to the sounds your baby makes while sleeping and crying. Do not worry about the amount of colostrum/breast milk that you are able to collect, “practice makes perfect”. Pumping is a learned experience, and will take you at least 1 week to feel comfortable and confident.
8. Save all (every drop) of colostrum/breast milk that you are able to collect for your baby’s feeds.
9. Pump your breasts together for 15 minutes with your double pumping kit. Breast massage for a few minutes and applications of moist warm compresses for 5-15 minutes prior to pumping can be relaxing and encourage letdown. You may pump straight for 15 minutes or divide the time into 5 minutes sessions with breast massage and moist compresses after each session. Some women prefer to pump each breast separately. Your double pumping kit will function as a single kit if preferred. Follow the manufacturer’s directions. If pumping with a single kit, pump each breast for 15 minutes as directed above. Try all the suggestions and use which plan works best for you and your breasts.

Care of Your Double Pumping Kit:

1. Obtain the pumping kit that is compatible for your electric breast pump. Read the manufacturer’s directions included in the kit.
2. Double pumping kits must be completely taken apart and each part washed separately after each use except the tubing. Do not wash the tubing. Warm/hot water and any mild liquid soap are recommended. Rinse parts in warm/hot clean water and completely air dry on a clean towel or drying rack. Cover between uses with a clean, dry towel. Larger pieces may be cleaned in your dishwasher on the top rack.

If moisture collects inside the tubing, detach the pumping set up from the tubing leaving the tubing attached to the motor and run the pump with only the tubing attached until the moisture clears.

If tubing is washed accidentally, pour rubbing alcohol through the tubing to remove all the water and allow the alcohol to completely evaporate before using the tubing for the next pumping.

Collecting and Storing Breast Milk

Collecting and Storing Colostrum/Breast Milk (in the hospital):

1. Obtain sterile plastic syringes or sterile volu-feed bottles and caps from your maternity or baby’s N.I.C.U. nurse.
2. Save all the colostrum/breast milk that you are able to pump. Every drop is precious and valuable to your baby’s health and nutrition.
3. Fill syringes or volu-feed bottles ½ to ¾ full and leave a small amount of air for expansion before sealing closed. Label with tape. Write your baby’s name, the date, and the time of pumping and any medications you have taken within the last 24 hours.
4. Send the collected colostrum/breast milk to your baby immediately. The N.I.C.U. staff will refrigerate or freeze the milk until needed, and will use the oldest milk first.

Collecting and Storing Breast Milk (at home):

• Three methods for storage of pumped breast milk are suggested. Follow the method that works best for you and your family. Discuss any concerns with your baby’s neonatologist or pediatrician.  small 4 ounce plastic baby bottles sterilized in your dishwasher or boiled in a large pot for 15-20 minutes prior to each use
  • Small 4 ounce Gerber or Playtex nurser bags (sterile) placed in a self-sealing freezer bag (check with the NICU staff if these bags are okay)
  • Hollister/Egnell Mother's Milk Freezer Bags (sterile) or Medela CSF Bags (sterile) available through the local pump depots or the 800 phone #s.
• Fill the container ½ to ¾ full, leaving air space for expansion during freezing. If using sterile nurser bags, fold the top down 3-4 times and seal tightly with tape. Place the nurser bag in a self-sealing freezer bag. Label each container with your baby’s name, date, time, and any medications taken within the last 24 hours. Use tape for labels, do not write directly on the container. Ink may leach through into your expressed milk. Place the container in the back of your freezer. Do not store frozen breast milk on the doors of your freezer- TOO WARM. Follow these directions, also listed in your breast feeding manual, concerning proper storage for premature or ill baby:
  • Fresh breast milk room temperature: 1 hour
  • Fresh breast milk refrigerated: 48 hours
  • Frozen breast milk: 1 month
  • Frozen breast milk @ 0 degrees F (-19 degrees C ): 6 months
  • Thawed, refrigerated breast milk: 24 hours
  • Thawed, warmed breast milk: 1 hour

For full term healthy babies, the breast milk storage times change slightly.

• Send collected frozen breast milk to your baby daily. Keep the breast milk frozen during transport to the N.I.C.U. by use of picnic-type cooler bags and freezer gel packs.
• You may contact the N.I.C.U. staff nurse who is caring for your baby any time of the day or night. Calls and visits are welcomed. Visiting hours for baby’s parents are unlimited. Grandparents, siblings, and family members may visit according to restricted hours. Discuss these restrictions with your baby’s nurse. Ask your baby’s nurse for a parking pass to help with your frequent visits.

Care of Your Nipples and Breasts

1. Use no soap on your nipples. Wash only with warm water as needed and daily in your shower/bath.
   
   
   
2. Avoid routine use of breast creams/lotions. If your nipples become tender or sensitive, hand express a few drops of colostrum/breast milk after each pumping session and rub gently into your tender nipple/areola. Air dry for a few minutes. Colostrum/breast milk contain enzymes to soothe your nipples and heal damage from friction. If needed, ask for instructions in learning how to hand express. Lansinoh is a safe cream to use if breast creams are needed. Call the Main Line Health Lactation Center at 610 645 2336 if information is needed.
   
   
   
3. Air dry your nipples for a few minutes after each pumping.
   
   
4. Use of a nursing bra is optional. You may leave your bra off until your breasts signal that they need the support. Support may be needed as your milk supply builds. Use a few layers of towels on your bed at night to absorb any leakage- keep your bed dry. It is recommended to avoid under wires in your bras.
   
   
5. Nursing pads are optional. If needed, use only 100% cotton pads. Quality nursing pads may be purchased at the breast pump rental depots or local maternity shops. You may also make your own by cutting up older soft cotton tee shirts, or folding men’s cotton handkerchiefs inside your bra.