Breast-Feeding Information

This page provides information for new mothers about:

• Breast pumps - reasons for use 
• Recommended breast pumps and equipment
• Renting or purchasing a breast pump 
• Using a breast pump 
• Caring for a breast pump 
• Collecting and storing breast milk 
• Care of your nipples and breasts

Why Use a Breast Pump?

Breast pumps stimulate the production of breast milk and help you to build and maintain an adequate supply of breast milk for your baby.

There are a number of reasons to use a breast pump, including:

• You have a premature baby or a baby in the Neonatal Intensive Care Unit (NICU)
• You are receiving medication that is contraindicated in breast-feeding
• Your baby is unable to breast-feed due to an illness or required treatment
• Your baby is unable to latch on to your breast and successfully breast-feed

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Recommended Breast Pumps and Equipment

Electric breast pumps are recommended for frequent use over manual or battery-powered models. Electric pumps come in light-weight, mid-weight and heavy-weight (hospital-grade) models. The following models manufactured by Ameda and Medela are recommended by the lactation staff.

• Large, heavy hospital-grade pumps: Ameda SMB, Medela Classic 
• Portable mid-weight pumps: Ameda Elite, Medela Lactina , Medela  Symphony 
• Light-weight pumps with carrying case: Ameda Purely Yours, Medela Pump In Style
  Note that light-weight models are not recommended if your baby is in the NICU, when you are trying to stimulate the production and build the full volume of your breast milk. 

We also recommend double pumping set-ups, which can be used to extract milk from both breasts at the same time, over single pumps. Double pumps better stimulate your full production of breast milk and save time spent pumping. (Note that even if you have a double pumping kit, it can function as a single pumping kit if you decide you prefer to pump one breast at a time.)

Additional equipment you will need:

• A compatible pumping kit for your chosen pump (contains breast shields, tubing, etc.). For double pumping, we recommend the Hollister/Egnell Dual HygieniKit Collection System with Flexishields Areola Stimulator or the Medela Universal Pumping System.
• Various sterile collection/storage containers: plastic syringes or plastic Volu-Feed bottles with sterile caps or nurser bags used in conjunction with self-locking freezer bags or specially made freezer bags, such as Hollister/Egnell Mother’s Milk Freezer Bags or Medela CSF ("Collect, Store and Freeze") Bags
• Tape for labels

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Rental or Purchase of Your Electric Breast Pump

Hollister/Egnell and Medela electric breast pumps are available for rental and purchase through your neighborhood rental depot. To find a local rental depot call:

• Hollister/Egnell local rental depots:  1-800-323-8750 
• Medela local rental depots:  1-800-435-8316

You may also call the Main Line Health Lactation Center at 484-476-2336. Press 2 for a few of the current locations in Bucks, Delaware and Montgomery counties.

Rent or Purchase? Call the Lactation Center if you have questions about purchasing versus renting a quality breast pump.

Preferred models to rent: Hospital grade mid-weight models are recommended as rental units (the Ameda Elite, Medela Lactina, Medela Symphony). Easy to carry, these models pump both breasts at the same time efficiently, are user-friendly, and have an available adapter that plugs into the lighter in your car. They are excellent choices for long-term, frequent pumping. Double pumping set-ups are recommended and are a separate purchase.

Rental costs vary, depending on the length of time you rent the pump. A small deposit 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.

Preferred models to purchase: If you are going to purchase your breast pump, we recommend one of the light-weight models (the Hollister/Egnell Purely Yours or Medela Pump In Style). They pump both breasts at the same time efficiently, are user-friendly, and come with a carrying case. They are excellent choices for long-term, less frequent pumping. Double pumping set-ups are included. They range in cost from $180 to $240 and are available for purchase on the Internet at reduced cost.

Insurance: Rental costs, not purchase costs, are covered by some insurance plans. Also, some insurance plans will arrange for your pump to be delivered to your home, your hospital room or the NICU. Please ask the NICU/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.

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Using Your Breast Pump

Pumping frequency:

• Daytime: Plan to pump each breast every two hours. Begin pumping when you wake in the morning, and pump every two hours until you go to sleep at night. Write your schedule down each day and follow it as closely as possible. Some days you will be able to pump only every three hours, or less often, if time is a problem. Do the best you can for your baby and yourself.
• Nighttime: While you are still in the hospital, you do not need to schedule pumping sessions during the night. When you are discharged home, however, plan to pump your breasts every four hours during the night. As your baby's nutritional needs increase, you will pump every two to three hours during the night. 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.
• Aim to pump for a total of 120 minutes in 24 hours, at least.

Steps for use:

1. Wash your hands and have your electric breast pump and double pumping kit readily available.
2. Whenever possible, massage your breasts for a few minutes and apply moist, warm compresses for 5 to 15 minutes prior to pumping. This helps you relax and encourages letdown.
3. Place your nipple centered in the breast shield. Hold the shield snugly to your breast, maintaining a firm seal. A Note About Breast Shields: 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 toll-free number to purchase the Extra Large Glass Breastshield Kit.
4. 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 Main Line Health Lactation Center at 484-476-2336 for advice.
5. Pump each breast for 15 minutes. You may pump each breast separately, if you have a single pumping model, or pump both breasts simultaneously, if you have a double pumping model. You may pump for 15 minutes straight or divide the time into three 5-minute sessions, with breast massage and moist compresses between sessions. Try all the suggestions and use which plan works best for you.
6. Save all (every drop) of the breast milk that you are able to collect for your baby’s feeds.

Relaxation Tips: Practice relaxation when using your pump. Listen to soothing music. 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 anything that you find helps to minimize stress, as stress inhibits letdown. Massaging the breast and applying moist, warm compresses prior to pumping can be helpful. Do not worry about the amount of milk that you are able to collect—practice makes perfect. Pumping is a learned experience, and will take you at least one week to feel comfortable and confident.

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Caring for Your Breast Pump

Obtain the pumping kit that is compatible for your electric breast pump. Read the manufacturer’s directions included in the kit.

Double pumping kits must be completely taken apart and each part washed separately after each use, except for the tubing. Do not wash the tubing. Warm to hot water and any mild liquid soap are recommended. Rinse parts in warm to 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.

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Collecting and Storing Breast Milk

In the hospital:

1. Obtain sterile plastic syringes or sterile Volu-Feed bottles and caps from your maternity nurse or your baby’s NICU nurse.
2. Save all the 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.
4. Label with tape. Write your baby’s name, the date and time of pumping, and any medications you have taken within the last 24 hours.
5. Send the collected milk to your baby immediately. The NICU staff will refrigerate or freeze the milk until needed and will use the oldest milk first.

At home:

Three types of storage containers for pumped breast milk are suggested. Choose the type that works best for you and your family:

• Small 4-oz. plastic baby bottles, sterilized in your dishwasher or boiled in a large pot for 15-20 minutes prior to each use
• Small 4-oz. Gerber or Playtex sterile nurser bags, placed in a self-sealing freezer bag (check with the NICU staff to see if your freezer bags are acceptable)
• Sterile freezer bags, such as Hollister/Egnell Mother’s Milk Freezer Bags or Medela CSF Bags, available through the local pump depots or the toll-free phone numbers

If you have any questions or concerns about which type of container is best, discuss them with your baby’s neonatologist or pediatrician. Once you have selected your preferred storage method, follow these steps:

1. 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.
2. Label each container with your baby’s name, the date and time of pumping, and any medications taken within the last 24 hours. Use tape for labels, do not write directly on the container, as ink may leach through into the milk.
3. Place the container in the back of your freezer. Do not store frozen breast milk on the doors of your freezer, as it will be too warm.

4. Send collected frozen breast milk to your baby at the hospital NICU daily. Keep the breast milk frozen during transport to the NICU by use of picnic-type cooler bags and freezer gel packs.

Breast milk storage times for premature or ill babies:

• Fresh breast milk at room temperature: 1 hour
• Fresh breast milk refrigerated: 48 hours
• Frozen breast milk: 1 month
• Frozen breast milk at 0°F (-19°C ): 6 months
• Thawed, refrigerated breast milk: 24 hours
• Thawed, warmed breast milk: 1 hour

Breast milk storage times for full-term, healthy babies:

• Fresh breast milk at room temperature (79°F): 4 hours
• Fresh breast milk refrigerated 32°-39°F (0°-4°C ): 8 days; if uncertain of refrigerator temperature, store for only 2 days

You may contact the NICU 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 other 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.

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Care of Your Nipples and Breasts

Follow these basic care instructions. Call the Main Line Health Lactation Center at 484-476-2336 if you have any questions or concerns.

• Do not use soap on your nipples. Wash only with warm water as needed and daily in your shower or bath.
• Avoid the routine use of breast creams or lotions. If your nipples become tender or sensitive, apply a few drops of breast milk after each pumping session by hand, rubbing gently into your tender nipple and areola. Air dry for a few minutes. Breast milk contains 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.
• Air dry your nipples for a few minutes after each pumping.
• Use of a nursing bra is optional. You may leave your bra off until your milk supply builds and your breasts need the support. Use a few layers of towels on your bed at night to absorb any leakage and keep your bed dry. Avoid underwire bras.
• Nursing pads are optional. If needed, use only 100-percent 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 old, soft, cotton tee shirts or folding men’s cotton handkerchiefs inside your bra.

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