The complete guide: How to make pumping more comfortable and efficient
Pumping milk for your baby might be something you do occasionally or it might be your baby's sole nutrition. No matter your goal or frequency, you want your pumping experience to be as quick and comfortable as possible so that you can get back to work and/or back to your baby sooner, without resenting the task. Pumping is definitely work, but there are simple things you can change that can make a big impact on your experience.
- Create a pleasant environment. You can let down more easily if you are feeling safe and calm. Play relaxing music and keep pictures of your baby with you if you are away. You can even make a slideshow to play on your phone or computer to watch while you pump. 1
- Get the right flange size. Maymom has a downloadable nipple caliper here (click for a .pdf download). Start with a flange that is 3-5mm larger than your nipple before pumping, or 1-2mm bigger than your nipple after pumping. Many women don't fit properly in the standard sizes provided out-of-the-box with a breast pump. An improperly sized flange can cause pain from excess pulling and/or friction. It can also cause you not to be able to empty all the way because the milk ducts haven't been properly compressed.
You might be surprised at the variations out there! We sell flanges from size 15mm-36mm, and you can buy them individually as its common to need a different size for each breast. Some women even switch flange sizes halfway through the session for optimal expression. You can find the Medela- and Spectra-compatible, wide and narrow mouth flanges / breastshields we sell here.
- Use breast compressions (hands-on pumping). Some products on the market do this for you, like Pumpin Pals flanges, which are angled and gather more breast tissue than a normal flange (affiliate link: https://amzn.to/2K15niy).
Another product is the Spectra massager insert (available on our site here). Spectra's massager inserts can do double duty by slightly decreasing the size of a flange that's too large and stimulating more of the milk ducts. To completely and quickly empty your milk ducts, you need to compress the milk ducts up and around your areola and encourage the milk to drain.
You can also do this without any products at all, as long as you have a hands-free set up (get our favorite made-in-Canada pumping bra here [affiliate link]: https://amzn.to/2WAZ4DX). Gently shake and massage your breasts to “wake them up,” then press and release areas of your breast around the areola rhythmically with the pump. You can also gently stroke and massage down from the top of the breast (all the way by your armpits!) to the flange. Change up which milk ducts you press by alternating positions around the flange. When you've got a good pattern, you'll be able to see when you've stimulated additional let downs or expressions with this technique. In time, you will be able to tell the specific technique variation that works best for you. A note if you have breast implants: you will want to compress the milk ducts from the sides so as not to put too much pressure on the implant.2
You can also use this technique while nursing your baby to get extra hind milk (the fattier milk that is harder to move out of the breast at the end of the feeding) into baby for better weight gain. A great video from Stanford that shows hands-on pumping techniques can be found here.
Far from it, hand expression is the easiest way to get the last drops / streams of milk out. Simply pump as you would normally, then hand express, switching sides until no more “streams” come out. It might not look like much, but the more completely you empty the breast with each session, the more milk it tells your body to produce. Hand expressing afterwards also helps if you don’t respond to the pump as well as you’d like, by combining the consistency of the pump with the completeness of hand expression. In time, this may teach your body that it is okay to let down to the very un-baby-like pump because you are combining it with a more manual stimulation, especially if done on a regular schedule.
The great news is, if you already understand how to do breast compressions, you can follow a very similar process to hand express. Instead of compressing from all around up above a flange, you work you way closer to the nipple--but not right at it! If you pinch you will likely hurt yourself. Be careful not to push too hard--bruising your milk ducts will not help, and neither will the pain! Here is a good description of hand expression from the NHS: https://www.nhs.uk/conditions/pregnancy-and-baby/expressing-storing-breast-milk/
Of course, if you don’t respond well to a pump, the first things to try are sizing and compression (see above), and then look into other options (see below).
If you are having trouble responding to the pump you are using, trying a different pump can mean saving your breastfeeding relationship if you are away from your baby frequently, so it is definitely worth a try. On sites like Mama-roo.com, you can use your HSA / FSA card to pay for the pumps, bundles, and accessories (like flanges) that you need.
- Make clean-up easier / less frequent. As we mentioned before, if you have a healthy full-term baby and a clean space, you can leave your pump parts set up and return to them, as long as your milk is in the fridge or a cooler bag with a frozen ice pack within 4-6 hours of your first pump.
If you don’t have that kind of space, you can put your parts, without washing, in a wet bag (like this wet-dry bag from made-in-America Planet Wise [affiliate link]: https://amzn.to/2OwYDrm) and put it in the fridge. So long as you wash the parts within 4-6 hours of your first pump, you could do this throughout the day. Or, you could have multiple sets of pump parts and simply wash them all at night. You can wash them in a simple basin and then put them in a steam bag (like this one from Medela [affiliate link]: https://amzn.to/2UnysZF) in the microwave to sterilize. Some people even put them in the dishwasher! Leave the parts to air-dry to avoid mold growth, as the parts can really hold moisture. A simple washcloth / kitchen towel or clean cloth diaper can be used to help lay the parts out at the office or at home--they dry pretty quickly!
- Power Pump. If your goal is to pump to tell you body to make more milk, consider an hour a day of power pumping. This is where you mimic cluster feeding by pumping like a baby would nurse. Pump 15-20min to empty, take a 10 min break, pump 10min, break 10min, pump 10min. You don’t need to wash in-between, and in an hour you’ve gotten 3 sessions in!
Do not start the pump at full suction! Start at the lowest amount and slowly work your way up. It takes time to get used to the sensation of pumping, and pumping while gritting your teeth can not only damage your nipples and breasts and make pumping a miserable experience, but it can prevent you from being able to express much, if any, milk. Turn the pump up as high as you can tolerate and then turn it back down a bit--”comfortable” is truly the key word here. If you can’t get comfortable no matter what, it’s definitely time to consider a new flange size, massager inserts, and/or a different pump (see all mentioned above).
Check that your nipples are well-centered in the flanges. If they are bouncing all around, you might have the wrong size! But even if you do have the right size, sometimes shifting can happen. To adjust, you can turn off the pump and move while the suction is off. Or, if you are very careful, slide your finger in to break the suction and adjust your nipple placement that way.
If you notice that your nipples blanch white, you make have Raynaud’s phenomenon of the nipple. This can make pumping painful. The easiest thing to try is warm compresses before and during pumping. Even if you don’t have Raynaud’s, warm compresses or a heating pad over your breasts can make pumping a more pleasant experience and is worth a try.
- Understand how your pump works. Most high-quality pumps, like the Spectra S1 and S2, have 2 different pumping settings. One is to mimic how your baby triggers a let-down, with softer, more frequently suckling. The other is “expression” mode, which mimics the slower, stronger rhythm of a baby suckling once the milk has let down. Start pumping in the let down mode. Once you see that streams of milk are coming out (letting down), switch to expression. When the flow of milk slows or stops, switch back to let down mode. Do this as many times as needed during your pumping session. If you’ve done 2 let down cycles (about 4-5 minutes) and you aren’t getting milk, take a break of at least 10 minutes before pumping again.
Sometimes we seem to get “stuck” not getting milk to flow when we can feel like we are still full. In this case, try breaking the suction and gently re-positioning your nipple in the flange. You can also try breast compressions or take a 10 minute break.
- Stay positive. Your emotional state does impact your milk making abilities. Milk-making is a complicated hormone-driven process, and stress and expectations can really set you backward. Doing what you can to stay positive can really help. That’s also why doing what you can to be totally comfortable (see above) can go a long way.
That being said--your body was designed to make milk for your baby, even in dire circumstances, so although emotions can hinder things, you can still be miserable and learn to pump milk. (But please, try to resolve your misery! This may mean treatment for Postpartum Depression [PPD] / Postpartum Anxiety [PPA], which is well worth it for you and your baby). If you are trying the typical suggestions and aren’t seeing results (baby is not gaining weight well, not having enough diapers, is lethargic), it’s time to seek professional help from an IBCLC. As I know all too well, low supply is a very scary reality. But! Many women can benefit from that one-on-one help, and for many, it’s just a learning curve, not true supply issues, which is wonderful for everyone involved.
Don’t forget to check out the site for more lactation supplies: mama-roo.com