Pumping Your Breasts: Building and Maintaining Your Breast Milk Using a Quality Electric Breast Pump
Purpose: To stimulate the production of colostrum/breast milk and to build and maintain an adequate supply of breast milk for:
Premature or hospitalized baby
Mother needing to pump and bottle feed long term
Types of Electric Breast Pumps
Hollister/Ameda/Egnell Electric Breast Pumps
Medela Electric Breast Pumps
Medela Lactina Plus/Medela Lactina Select
Pumping Equipment Needed
Hollister/Ameda/Egnell or Medela electric breast pump
Compatible double pumping kit
Hollister/Ameda/Egnell Dual HigieniKit Collection System with Flexishield Areolar Stimulator
Medela Universal Pumping System
Storage containers and breast milk labels:
5 cc to 10 cc sterile plastic syringes and caps (if collecting very small amounts during baby's hospital stay)
Sterile polycarbonate or polypropylene breast milk collection and storage containers and lids
Sterile Breast Milk Freezer Bags and freezer self-sealing bags
Baby's hospital generated identification labels
Method: When the breast pump does all or most of the work to build and maintain your milk supply.
Wash hands and have available electric breast pump and dual set up.
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 a lactation consultant for advice.
Plan to pump each breast every 2 hours during the day hours and every 3-4 hours at night. Write your schedule down each day and follow it as closely as possible. Some days you may 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.
Initially plan to pump your breast every 3-4 hours at night. As your baby's nutritional needs increase, it may be necessary to pump every 2-3 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.
Aim to pump for a total of 120 minutes in 24 hours at least.
Place your nipple centered in the breast shield (flange) Hold the shield (flange) snugly to your breast, maintaining a firm seal. Hollister/Ameda/Egnell soft 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. Hollister/Ameda/Egnell and Medela have extra large custome flanges (shields) that may help you build a large milk supply for your baby. If interested, ask your baby's staff nurse or the lactation staff for the custom flanges.
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 breastfeeding while you are pumping. Look at snapshots of your baby. Tape and listen to the sounds your baby makes while sleeping or crying. "Practice makes perfect". Pump with your baby close beside you if possible. Pumping is a learned experience, and will take you at least 1 week to feel comfortable and confident.
Save all (every drop) of colostrum/breast milk that you are able to collect.
Pump your breasts together for 15 minutes with your double pumping kit. Use the large custom flanges for maximum results.
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 minute 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. Follwo the manufacturer's directions. As your milk volume builds, pump for a few minutes aftger you milk flow stops. Try all the suggestions and use which plan works best for you and your breasts.
When your breast milk supply is fully established, pump both breasts for a few mintues after your milk flow stops.
If your baby is hospitalized, contact the lactation staff through your baby's nurse if you have any questions about your breast milk volume. Your goal should be to expect between 25-35 ournces each 24 hour period by 2-3 weeks of pumping.
Care of Your Double Pumping Kit
Obtain the pumping kit that is compatible for your electric breast pump. Read and follow 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 the tubing. Warm/hot water and any mild liquid soap are recommended. bottle br5ushes are recommended to get deep inside the collecting bottle and nipple flange. Do not use the bottle brush inside the white valve. Avoid using antibacterial soaps. Bring a small bottle of a mild liquid soap with you to use while visiting your infant in the hospital. 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. You may also clean your pumping kit in your dishwasher (top shelf, small pieces in a closed nipple basket).
If you are pumping with the Medela Universal Pumping System inspect the tubing carefully after each use for accumulated moisture. Any moisture in the pump tubing can contaminate your breast milk. if any moisture or breast milk is found, read and follwo the manufacturers directions for cleaning the tubing or replace with new tubing immediately. The Hollister/Ameda/Egnell diaphragm barrier (silicone cup) will prevent moisture from entering the tubing during pumping. Choosing to wash the white cap or the white pump connector can result in moisture collecting in the tubing. Do not wash or dishwasher the Hollister/Ameda/Egnell tubing, white cap or white connector unless moisture is present.
Purchasing a second dual set up will allow you to have one set up soaking in warm/hot soapy water while you are pumping with your second set up.
Collecting and Storage Breast Milk for NICU/Pediatrics Babies:
These methods for storage of pumped breast milk are recommended. Follow the method that works best for you and your family. Discuss the benefits of fresh versus forzen breast milk with your baby's staff nurse or physician.
Hospital supplied sterile polycarbonate or polypropylene breast milk collection and storage containers and lids (5 cc to 10 cc syringes and caps if collecting very small amounts).
Parent purchased sterile Breast Milk Freezer Bags placed in a sfreezer self-sealing bag and stored upright to avoid leakage.
Fill the container up to 3/4 full, leaving air space for expansion if freezing. Attempt to store in the amounts that your baby is consuming per feeding or per 24 hours. Using your baby's hospital generated identification label obtained from your baby's nurse, label each container with the date and time of pumping. Affix the baby's hospital generated identification label to the storage container immediately after pumping. To avoid smearing of the label, place a later of transparent scotch tape over each approved printed lable prior to storage. Use a separate container for each pumping session. Place the container in your refrigerator or the back of your freezer. Do not store frozen breast milk on the door of your freezer (too warm). Follow these strict directions for storage of breast milk while your infant is hospitalized:
Fresh breast milk at room temperature: 4 hour @ 79 degrees F / 26 degrees C; refrigerate in 1 hour if warmer
Fresh breast milk refrigerated: 8 days @ 39 degress F / 4 degrees C or cooler
Frozen breast milk: 3 months @ 0 degrees F / -20 degrees C
Previously frozen breast milk that is thawed in the refrigerator (not warmed or used): up to 24 hours after thawing; do not refrigerate or refreeze.
Previously frozen breast milk that is thawed in warm water: discard after 1 hour; do not refrigerate or refreeze. Thaw only amounts to be used within 1 hour.
Send collected fresh or frozen breast milk to your baby daily. Use a cooler bag and freezer gel packs (not ice) to maintain the fresh or frozen state of your precious breast milk during transport to the hospital.
You may contact the staff nurse who is caring for your baby any time of the day or night. Calls and visits are welcomed. Visitng hours for baby's parents are unlimited. Baby's siblings, grandparents, and family members may visit according to restricted hours. Discuss these restricitons with your baby's nurse.
Remember to wash your hands before each pumping and pouring of your expressed breast milk into your sterile storage containers. Thank you for keeping your baby's breast milk as clean as possible.
Rental of the Electric Breast Pump:
Hollister/Ameda/Egnell and Medla electric breast pumps are available for rental and purchase through local neighborhood rental depots. Search the internet for cost savings. Double pumping set ups are recommended to stimulate your full production of breast milk and are recommended if your baby is in the hospital. Remember, larger custom flanges (shields) may help build a large milk supply for your baby. Rental pumps are recommended while baby is hospitalized.
Rental costs range from $1.10 to $3.00 per day, $45 to $90 per month 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.
Hospitalized babies: Rental costs are covered by some insurance plans only while your baby is hospitalized. Recently, some insurance plans are covering part of the cost of purchasing a breast pump. Also, some insurance plans will arrange for your pump's delivery to your home, your hospital room or the NICU or Pediatrics. Costs for purchasing a second pumping set up will not be covered. Your baby's physician can write you a letter of medical necessity which may help your insurance company's decision to cover the costs of rental of an electric breast pump while your baby is in the NICU or Pediatrics. For your records, save any information given to you by the Case Manager about your pump coverage.
Remember, that only you, the mother, can provide breast milk for your infant.
Suggestions for Parents of Premature (NICU) Babies:
Skin to Skin or Kangaroo Care (KC)
Begin as soon as you and your baby are ready.
Ask your baby's nuse when and how often you can do skin to skin/Kangaroo Care with your baby.
Hospital gowns and privacy screens are available for your use.
Bring a special blanket in from home to wrap around you and baby.
Kangaroo Care video is available in NICU library to view.
If You Plan to Ultimately Breastfeed...
Discuss with your baby's nurse about having your baby's first several nipple feedings to be at your breast not on a bottle.
Breastfeed your baby as often as your baby can tolerate. This will depend on baby's age, underlying illness, respiratory status, rate of weight gain, developmental maturation and other factors.
Breast Milk Volume
If any concerns with volume obtained with your breast pump, have your baby's nurse leave a message for the lactation staff to contact you. Aim for 120 minutes/24 hours of pumping.
Breast milk volume should be well established by 14 to 21 days. expect the goal of 25-35 ounces each 24 hours.
Wash separate pumping pieces (not tubing) after every use with very warm.hot water and mild non anti-bacterial liquid soap.
Remember to wash your hands before handling your breast pump, pumping equipment and storage containers.
Breastfeeding After Discharge
When your baby is getting close to discharge, meet with the hospital lactation staff to assess your latch and positioning.
Consider renting a Medela BabyWeigh scale for home use to help you measure how much your baby is getting with each breastfeeding, determin if supplements are needed and monitor your baby's weight gain.
For more information, call 1.866.CALL.MLH.