The closeness and comfort of nursing your baby can be the most wonderful and unique experience. But for most nursing moms, the time comes when you need to be away from your little one -- for work, because of illness, or just for a night out to reconnect with your partner. At times like these, a breast pump is the nursing mom's lifesaver.
But buying and starting to use a pump can be daunting. How do you choose the one that's right for you? How can you be sure you're pumping correctly? How do you safely store and use pumped breast milk? This guide can answer those questions and help you get off to a good start.
It may not be as hard as you think, says Diana West, an internationally board-certified lactation consultant."You just have to find the right pump for you and learn techniques for getting the most milk with your pump," she says. "You almost have to make it a friend because, especially for working mothers, it's going to be with you a lot!"
Choosing a Breast Pump
There are four main categories of breast pumps to choose from.
- Consumer-grade electric breast pumps. Generally costing between $200 and $300 to buy, these are the pumps you'll see featured at baby stores. They usually come in discreet black carrying cases and contain everything you'll need to start pumping, including tubes, flanges (the plastic part that you put over your nipple), and a few bottles and storage bags. If your breasts are making milk, "and you're going back to work and will be separated from your baby and pumping several times a day, this is the kind of pump you need," West says. At its best, a baby's suck is far better at removing milk from the breast than any pump, but some babies don't have the best latch. Many of the consumer-grade pumps offer various bells and whistles, West says. Some, for example, can pump both breasts at once or have fewer pieces to clean. Any of these perks can be convenient for a working mom who doesn't get many pumping breaks. But these features are all a matter of personal preference. Most basic pumps will do the job.
- Smaller electric or battery-powered breast pumps. These smaller pumps run either on electricity or battery power and usually cost less than $50. But, West says, you get what you pay for. "They're really awful for removing milk. If you try using them regularly as a working mother, you'll take a real hit on milk production. But if you're breastfeeding all the time and you just need something to pump once in a blue moon when you go out to dinner, they're fine."
- Manual breast pumps. Costing about $30, these breast pumps work just as well as electric or battery-powered pumps for many women, West says. "You just use your own hand to work a pump like this, and some of them remove milk really well." Even if you have a consumer-grade pump to take to work, some women like using a manual breast pump at home, simply because there are fewer parts to juggle. And if you can't afford to spend $200 to $300 for a consumer-grade electric breast pump, West says you might be able to do just fine with a high-quality manual version. "Get the best you can afford and make do."
- Rental-grade breast pumps. If you cannot afford to buy a breast pump, there are rental breast pumps available. The Affordable Care Act requires that most insurances cover the cost of a pump. The FDA recommends against renting for safety purposes. Even a device that looks clean can have potentially harmful bacteria which could harm both you and your baby. That said, the so-called rental-grade pumps are “workhorse,” according to West. "They're like the Mack trucks of breast pumps." They're also expensive and bulky, so you probably wouldn't want one for daily pumping while at work. But they're ideally suited for helping make milk early on.Their pumping action is most like a baby's natural suck. You can use these electric pumps in the hospital or at home, and pump after every feeding or instead of nursing if you are separated from your baby -- for example, if he's in the intensive care nursery. As the name indicates, these pumps are most often rented rather than bought. They are typically used in the first month of your baby’s life as you establish your milk supply and breastfeeding goals.
Breast Pump Flanges: Size Matters
To pump most effectively, West says, first make sure the flanges fit properly. Some women don't realize that these horn-shaped pieces of plastic come in different sizes.
"The default size is often too small," West says. "I once worked with a woman who had been using a flange that was too small, and she had cuts on her areola and her nipples."
You can't tell what size flange you need by looking at your nipples, because the suction of pumping makes nipples larger. West's trick: "I usually recommend that women go one size up from the standard flange as a starting point," she says. "Your areola should move freely within the flange and behind it. And you should see the nipple moving freely forward and back in the whole tunnel, not just the tip. If it's too tight, the nipples aren't moving and you're not getting full stimulation."
Getting Pumped: Maximize Your Breast Milk
How much milk one pumping session should yield varies widely. Some women can get 10 ounces in 10 minutes; others are pleased to get half as much in 20 minutes.
To maximize your how much milk you release, West recommends these steps for doing breast compression while pumping:
- Hold your breast with your fingers underneath and thumb on top.
- Lift up on the breast and find a hard spot on the top of the breast -- the glandular tissue.
- Press down firmly on the spot and hold it. (Don't pump.) Milk will start spurting when you've found the right spot. (If you're nursing, the baby will start gulping.) "You're creating the pressure of a milk ejection, causing more milk to be removed and more made," West says.
- When the milk stops flowing, lift your thumb and find another spot of glandular tissue. Compress that spot firmly, but not painfully.
You can never completely empty the breast when pumping (or nursing), because as milk is removed, more is always being made. But to get the most milk that you can, West also suggests "hand-expressing" a little milk after you've pumped thoroughly. Simply take the flange off the bottle and "milk" your nipple directly into the opening. You can get as much as another half ounce this way, adding to your stash.
More Tips for Breast Pump Success
West also offers these three tips:
- Find a private place for pumping. Federal law requires that businesses with 50 or more employees provide a clean, completely private pumping space with an electrical outlet.
- If it helps, bring a reminder of your baby. For some women, an article of the baby's clothing, a photo, a cell phone video, or a recording of her cooing or the sounds she makes while nursing help get milk flowing. Others prefer not to be reminded of being separated from their baby, so you might read e-mails or do some other simple task while pumping.
- Pump as often as you nurse, if possible. If this isn't possible, try to fit in at least a pump in the morning, at lunch, and in the afternoon.
Breast Pump Basics: Storing Pumped Milk
So now you have all this freshly pumped milk. What do you do with it?
Begin by safely decanting it. With clean hands, transfer the breast milk to a clean screw-cap bottle or heavy-duty, sterile bag that will fit into a nursing bottle. Avoid regular plastic storage bags, which can leak. Special breast milk storage and freezer bags are convenient and widely available. Then label the milk with the date, so you can use the oldest supply first.
Pumped breast milk stays fresh longer than mixed formula, but it still can spoil and must be stored properly.
The CDC provides these guidelines for storing breast milk:
- At room temperature (up to 77 degrees F or 25 degrees C), freshly pumped milk can be kept and used safely within 6 to 8 hours.
- In an insulated cooler bag, such as the kind provided with many pumps, milk can be kept for 24 hours.
- In the refrigerator, pumped milk can be stored for up to 5 days. Breast milk should be kept in the main part of the refrigerator.
- In a freezer compartment that's in a refrigerator, you can store pumped milk for up to 2 weeks.
- In a freezer compartment that has separate doors from those of the refrigerator, frozen pumped milk can be safely thawed and used for up to 6 months.
- In a "deep freeze" -- such as a chest-style freezer -- the milk can be kept for 6 to 12 months.
It's always best to store pumped milk toward the back of the refrigerator or freezer, where it's coldest. Milk will stay fresher longer in a freezer or fridge that isn't opened often. (A spare refrigerator or freezer in the basement that's used for bulk items and not opened as often is a good place to store breast milk.) Don't mix fresh breast milk with frozen breast milk or save leftover milk in a used bottle for another feeding.
Frozen milk can be thawed in the refrigerator. You can quickly thaw frozen milk by swirling the container in a bowl of lukewarm (not hot) water. Don't thaw it in the microwave -- that can break down some of its valuable nutrients and cause hot spots that could hurt your baby.