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Overview

Pumping is a great way to provide breast milk to your baby when you cannot be there to breastfeed. This could be so you can run errands for a couple hours, enjoy a night out with friends. This is a must if you are returning to work. Breast milk is often referred to as liquid gold. It is so valuable and amazing that it cannot be reproduced in a lab and only you can make it. Your milk is perfectly formulated for your baby.

Hooking your boobs up to a machine to pump milk is pretty strange. But, the fact that you can give your baby your own breast milk from a bottle is awesome. Pumping breast milk can really make a major difference for moms who need to be away from their baby during a short time and especially if you are returning to work. This article is focused on all the fundamental things you need to know about pumping breast milk.

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Pumping and breastfeeding really go hand in hand. It is so valuable and amazing that it cannot be reproduced in a lab, and only you can make it. Hooking your boobs up to a machine to pump milk is pretty strange. But, the fact that you can give your baby your own breast milk from a bottle is pretty amazing.

Pumping can really make a major difference for moms who need to be away from their baby during a short time. It is especially important if you will be returning back to work after the birth of your little one. Pumping is a subject that I have a lot of personal experience with. I pumped for over a year after each of my births. Yes, it was a lot of work, but so worth it. This article has the low down on all the basic things you need to know about pumping breast milk.

How Long Should Your Baby Get Breastmilk?

The World Health Organization, and many pediatric associations recommend exclusive breastfeeding (with no other drinks or solid foods) for the first 6 months. Then adding in solid foods gradually after that point with continued breastfeeding for two years. I know two years sounds like a really long time. Any amount of time your baby is getting breastmilk will benefit them greatly. If you do stop breastfeeding before the first year you will need to supplement with formula. An alternative to this is pumping. Your milk, even if it is in a bottle, is still way more amazing than formula for your little one.

Why Pump?

The main reason to pump breastmilk is so that your baby can still drink your milk while you are away. This allows you to get out for a few hours and run errands. You can actually enjoy a night out with your friends. Pumping also allows you to return to work and maintain breastfeeding. Some moms opt to exclusively pump. Another reason you might pump is to build up a supply of frozen milk for future use. It is possible to build up a supply and still be able to feed your little one breast milk once you stop breastfeeding if you have a good supply in your freezer.

It can feel like you are tethered to your baby at all times if no one else is able to feed your baby. If you are breastfeeding and not incorporating formula, pumping is a great way to make this work. I’ve been there, and it can be stressful.

Donating Milk

One final reason you may choose to pump is to donate milk. This could be for a friend’s baby or to a milk bank to benefit a newborn baby you have never met. Donating milk is pretty awesome, and an incredible way to really give a baby who isn’t getting enough milk from their mom, for whatever reason, all the awesome benefits of breast milk.

There definitely are some questionable websites where women are selling their breastmilk, and all the buyers are not necessarily parents of newborns. I’m not going to go there, when I am talking about donating milk, I am talking about donating it to a baby.

If you are building up a stash of milk for your little one keep an eye on the dates and if you have milk that will be expiring before you will be able to use it, please donate it. Don’t let it go to waste. It could make a major difference for another baby. There are also some moms who are have an excellent supply and produce more milk then their baby needs and donate it to another mom. Kudos to anyone who does donate milk, what a selfless awesome thing to do.

If you are considering donating milk or perhaps your baby could be the recipient of donated milk, you definitely want to know your source. Milk banks have high quality control standards for collection, testing, and storage. Likely much higher standards than websites can monitor that are connecting milk donors with recipients. If you are considering this route to give or receive, ask your care provider or a lactation consultant about what options are available to you in your area.

The Breastfeeding Relationship

If you are planning to pump it is really important to understand the pumping breastfeeding relationship. The most efficient way to remove milk from your breasts is to breastfeed. Hands down, an electric pump, even a hospital grade pump will not do as great of a job as your baby. However, they can still do a pretty good job, and in the absence of your baby, a pump will work.

When you remove milk from your breasts you are essentially telling your body, this is a meal, keep producing this quantity of milk at this time. If your baby is getting pumped milk in a bottle at noon on Tuesday, you need to pump at noon on Tuesday. It doesn’t have to be exact, but it should be relatively close to maximize your supply and keep your milk production up. If your baby gets a bottle and you do not pump, you are telling your body, you don’t need to produce as much milk because my baby doesn’t need to eat a meal right now.

While it can be nice to have someone else be able to give your little one a bottle, it may not make sense for you to pump just to give your little one a bottle, when you could just breastfeed. Some mothers do choose to exclusively pump so their little ones are always getting a bottle, and this is an option. Ultimately whatever is best for you and your baby is best.

Options for Pumping

To pump milk you have three options. You can hand express, use a manual pump, or use an electric pump. Hand expressing is pretty simple and you can do a quick search on YouTube to see how it is done. I do recommend watching a few videos and this is something that gets better with practice. With hand expressing you just do it straight into a bottle or cup and you don’t need a pump or any additional accessories. Using a manual pump is pretty simple it is usually a contraption with a level that you just squeeze by hand, and you would pump one breast at a time.

Electric pumps tend to be the most effective for removing milk. One option for this is a hospital grade pump. If you had your baby in a hospital, you may have access to this during your stay at the hospital after having a baby, or you have the option to rent one once you get home. Most moms that use a hospital grade pump rent it because they are pretty expensive to buy. The other option for an electric pump is to buy one for home use. Home use electric pumps are the most widely used and the focus of the episode today, but everything we are talking about could also be applied to a hospital grade pump, a manual pump or even hand expressing milk. You will just have to use whichever method is best for you.

Getting a Pump Through Insurance

Breast pumps are not cheap, but at the time of this episode breastpumps are covered by your health insurance. For my most recent baby I went through Aeroflow who coordinated with my insurance company. Even if you aren’t sure if you will want a breast pump order one, especially if it doesn’t cost you anything.

The lifetime of a breast pump is about a year. So you really want a new one, they tend to lose some power over time, which can really make pumping less efficient. Your insurance should cover it so why not get one? If you are in a position where you do not have health insurance and are having trouble affording a pump, you still may be able to get some assistance to buy one. Talk to your care provider and ask about any low-income programs that may be available to you.

Getting Started with an Electric Pump

With an electric pump you have the actual pump, which is usually a small box with a motor in it, and the unit tends to be a little heavy. This is plugged into an electrical outlet, they also make battery packs for these, and you can even get a car charger so you can pump in your car. Although different brands of pumps differ, they all operate relatively the same. Before you ever use your pump for the first time you want to sterilize all of the parts by boiling them. To do this you just boil a large pot of water and once the water is boiling, add all of the parts to the pot and boil for ten minutes. You will also want to do this with any bottles and nipples before using them for the first time.

Once you have sterilized everything it is pretty easy to hook it all up and get it going. Before you start a pumping session you want to wash your hands. The best time to pump is when you are relaxed and your breasts feel full. Generally you connect two small, thin tubes to the pump, the other ends connect to a plastic piece which connects to a bottle or other collection container like a bag, and is also connected to the flanges, which are cone shaped pieces that you are putting on your breasts.

Once everything is hooked up you turn on your pump. Generally it will start out quickly, and then once there is actually milk coming out, which is called your milk letting down, you hit a button and the sucking motion slows down a bit. The majority of pumps will also automatically switch over to a slower mode after a few minutes. This is very similar to how your baby acts during breastfeeding. They start out with quick sucking motions, then slow down to a slow and steady sucking once your milk lets down.

There should be a knob to control the speed and intensity of the suction. This shouldn’t hurt and it you are uncomfortable, turn it down. You can experiment with some different settings to find out what level of intensity works best for you. Once it is going and milk is being pumped you let it run for around 10-15 minutes or until you aren’t producing much milk.

Disconnect the bottles or collection bags from the pump when you are done and leave your pump running for a few minutes just to get any extra condensation out of the tubes and the pump. You can just leave it running while you are disassembling everything and putting stuff away. You package up the milk for storage, we will talk about that in a bit, then disassemble your pump parts and clean them.

Cleaning Your Pump & Parts

The best method to clean the parts is to wash in warm water with gentle dish soap. Generally, with a full term baby there is no need to sterilize pump parts in between pumping sessions. Instead, just washing in warm soapy water should be fine. You can sterilize the parts at the end of the day if you wish. If you aren’t sure, you can always ask your care provider or pediatrician what their recommendation is.

There are some additional things that can make sterilizing and cleaning parts pretty easy. One way is to put everything in a dishwasher. There are some small baskets made for small parts that make putting this stuff in a dishwasher super easy, and the high temperature of the dishwasher will sterilize the parts. Many dishwashers also have a sterilize setting that you can activate when you run it. There are also microwavable bags that you can put everything into and pop the bag in the microwave to sterilize all the parts. So you have options and the easier you make pumping on yourself, the better.

If you are a planner and want to make sure you know how all of this works before your baby arrives you can take care of sterilizing all the parts and assembling everything so it isn’t new to you when you first use it. Be aware that nipple stimulation does cause your body to release oxytocin, which could trigger labor. Some women do use an electric pump for nipple stimulation to try and naturally jump start labor. If you are past your due date and want to try this you certainly can. I do not recommend actually trying to pump before you have your baby. If you are thinking about using a breast pump for nipple stimulation to jump start labor it is a good idea to run it by your care provider and make sure they are on board with that.

For the first few days after your little one is born your body is producing colostrum, in very small amounts. Your milk doesn’t actually come in until day two, three, or even four. The first days and weeks of taking care of a newborn and figuring out breastfeeding are a major adjustment period. It may be nice to get the hang of breastfeeding before you introduce a pump and incorporate that into your schedule. Your immediate focus once your baby arrives is not to start building a freezer stash from day one. Give yourself some time to get the hang of breastfeeding. Knowing the ins and outs of breastfeeding will set you up to be a pro with pumping and making the two work together.

How Much Milk Will Your Baby Need?

By the end of the first week after your little one is born, you will be producing somewhere between 19-30 ounces (550-875 mL) of milk every day. The average feeding will be around 3-5 ounces (90-150 mL). This is going to stay pretty consistent for the first six months. Keep in mind that these estimated measurements are for breastmilk. Formula is harder to digest and the nutrients are not as easily absorbed. For these reasons, quantities of formula may be higher. You can check with your pediatrician for exact guidelines, but we are talking specifically about breastmilk in this episode.

Storing Breastmilk

The guidelines for storing breastmilk for a healthy term baby:

  • 4-6 hours at room temperature
  • 24 hours in cooler with frozen ice packs
  • 3-8 days in the fridge
  • 6-12 months in the freezer

Once you take milk out of the freezer and thaw it out, it should be used within 24 hours. You would not want to refreeze it once it has been thawed out. To thaw it out you could put it in the fridge the night before you plan to use it. Or place it under warm running water, or in a bowl of warm water.

You would never want to microwave breastmilk. Microwaving can create hotspots that could burn your baby’s mouth, breaks down some of the nutrients, and changes the composition of the milk. If your baby was born premature, these guidelines may differ slightly. You should check with your care provider or your pediatrician for the recommended storage guidelines for your specific situation. The fresher the milk is the better. Over time, and with cooler temperatures the properties in your milk will become less effective. Breastmilk has a ton of ingredients that cannot be synthetically recreated in a lab with formula, even if frozen for months.

You do want to be organized with labeling and storing milk. It is fine to mix milk from different pumping sessions together, as long as you are mixing it at the same temperature. You wouldn’t want to add warm milk you just pumped, to cold milk that had been sitting in the fridge. If you are planning on using the milk soon you can store it in the fridge. You can use a piece of masking tape with the date on it if storing it in bottles in the fridge. If you are taking milk to day care you may also want to include your baby’s name on it.

Freezing Breastmilk

I recommend using freezer bags that are made especially for milk storage. I highly recommend the bags from Lansinoh. They have markings on the side so you can see how much milk the bag contains and a spot to write in the date and the amount. When you do freeze these bags I recommend laying them flat to freeze them. It will be efficient to store them this way and easier to fit more into a small space in your freezer.

You will want to use the oldest milk first to make sure that it is not going past the time it should keep well in the freezer. You can freeze milk in different portion sizes, generally between two to five ounces (60-150 mL) portions. Smaller amounts will thaw more quickly and you will waste less milk this way. If you only froze 5 ounce (or 150 mL) portions and every day your baby only ate four ounces, you would be wasting an ounce (or 30 mL) each feeding. With smaller portions you will waste less.

Traveling and Pumping

Traveling with breast milk is pretty easy you just need to pack it well and plan ahead. This applies if you are going out of the house for the day or hopping on an airplane going across the country. Think about the time it will need to be stored and how you can keep it cool. Remember the guidelines we talked about earlier? For a full term baby, breast milk should be fine for 4-6 hours at room temperature, or 24 hours in cooler with frozen ice packs.

If you will be out during the summer plan ahead to bring a cooler or another easy way to keep milk cool. If you are traveling long distance you should put it in a well-insulated cooler with plenty of ice packs to make sure it stays frozen. You could also keep it in a carry on with you. The biggest issue is keeping it frozen. You want to use thawed milk within 24 hours. Ideally, you can keep it frozen and pop it in the freezer when you arrive at your destination. If you are staying in a hotel, you can request a fridge in the room for breast milk if the room does not already come with one.

Changes in Breastmilk

When you breastfeed you don’t see your milk, it is just going directly to your baby. When you pump you see it, and do not freak out if it varies a bit in color. Your milk may even smell a bit different from one day to the next. These changes are usually due to your diet and there is no need to worry about it. You should also know that when milk sits and it is cooled it separates into layers. Cream will rise to the top. Breast milk is really high in fat, which is perfect for a growing baby. The separation into different layers is no big deal and is totally normal. When you do heat milk up to give it to your baby you will want to gently swirl the warmed bottle to mix the milk layers, do not shake it.

Lipase

Lipase is an enzyme naturally produced in breastmilk, that can give your milk an off smell and taste. This is noticeable when you freeze milk, then thaw it out and it may have a funny smell and taste. Some babies do not mind this at all, while others will be fussy and may even refuse it altogether.

If your milk has high levels of lipase and your baby does not like it, there is a solution. You can heat up and scald your milk before you freeze it. To do this you just put the milk in a small pot and heat it on the stove until tiny bubbles form around the edges. This occurs at about 180 F (82 Celsius). Then remove it from heat, cool, then freeze it. Scalding milk does reduce some of the beneficial components. You want to give your baby fresh milk whenever possible.

The issue with lipase only happens after milk has been frozen. The only way to tell if this is going to be an issue is to test it. You can pump a few ounces, put it in your freezer for a few days, then let it thaw and smell it. If it has a slightly sour smell you could have high levels of lipase. See if your baby is bothered by it. Some little ones won’t mind. If your milk does have high level of lipase you may need to scald your milk before freezing it. It is an extra step but it does solve the problem.

NICU Babies

If your little one ends up in the NICU (neonatal intensive care unit) you may need to pump for an extended period of time. Providing breastmilk to newborns in the NICU is even more critical to their health than to a full term baby. In a normal home freezer, lipase increases with longer storage times. However, many NICU freezers store breastmilk at super-cold temperatures of -70° to -80° C. At these temperatures, milk odor and taste changes due to lipolysis do not occur. Talk to your doctor or a lactation consultant if your little one is in the NICU. They can counsel you on how you can best provide breast milk for your little one. They may also have recommendations on whether you need to be more stringent about things like sterilization.

Breastfeeding and pumping early on can seem like a non-stop task. Keep in mind it will not always be like this. As you baby gets older, they get more efficient with breastfeeding. You will get better at pumping with time. You won’t always be hooked up to a baby or a machine. All this hard work you are putting in to making sure your baby has the healthiest nutrition is worth it. Breastmilk will helping your baby build a better immune system and body that will benefit them for their entire lives.

 

Thank you to the amazing companies that have supported this episode.

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Aeroflow is a company that helps you get a breast pump through your health insurance. There can be some hoops to jump through to get a breast pump through your insurance. Thankfully, Aeroflow makes this process so easy and does all of the work for you. All you need to do is fill out a form that takes just a minute.  Aeroflow will contact your health insurance company and get the necessary paperwork from your doctor or midwife. Then they will get in touch with you to help you choose the right breast pump. Click here to get started.

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