BREASTFEEDING 101: TIPS FOR PUMPING WHILE BREASTFEEDING

This is a guest post written by Jada Glover, a certified lactation counselor over at lactationmamas.com. She offers online breastfeeding support, education, and coaching to help you along the way! For more information on her services and to contact her, click HERE.

Breastfeeding may be the greatest gift you can give your child and yourself for many reasons, including the long-term health for both of you. Whether you are breastfeeding exclusively at your breast, or pumping for your baby exclusively, or somewhere in between, it takes hard work and dedication. These tips for pumping while breastfeeding will help you in all your efforts if you have to go back to work or you’re bottle-feeding your baby your breast milk.

How to Get the Most Out of Your Pumping Sessions

If you are exclusively pumping in the early days, here are a few extra tips to get the most out of each of your pumping sessions, especially in the early weeks as you develop your milk supply.

1. In the first 24-48 hours after your baby is born, hand expression is usually more effective at milk removal than pumping. Speak to your lactation provider about how to hand express.
2. If you are only pumping, pump at least 8 times a day to establish a good milk supply. This will help you transfer your baby to your breast to feed in the future if you choose to do so.
3. Frequent pumping is more helpful in establishing supply than long pumping sessions. It’s the starting and stopping of the sessions that is the most effective.
4. Massage your breasts prior to starting the pump to encourage your letdown.
5. Look at photos of your baby while listening to relaxing music. This has been shown to have a positive effect on the quantity and fat content of your milk.

Milk Letdown Reflex

Sometimes mothers struggle with a milk “letdown” if they are pumping at work or not around their baby. Your body produces two key hormones that make milk. The prolactin hormone makes the milk, and the oxytocin hormone releases the milk. If your breasts feel full, but your milk isn’t “letting down,” it could be that your oxytocin levels are not increasing enough for a milk release. There are a few things that may inhibit your letdown reflex such as chronic stress, pain, and negative self-talk, and grief in your personal life. As you build up your confidence and experience with pumping, here are a few practices you can implement to encourage your milk flow.

1. Create a peaceful place for you to pump, such as a quiet area away from the noise.
2. Relax by practicing deep breathing and imagining yourself in a peaceful place like relaxing at the beach.
3. Guided imagery, visualization, or hypnotherapy can help in relaxing you and taking you to a place that will allow your milk to flow. You can search YouTube for tracks using search terms like “guided imagery breastfeeding” and “guided imagery making milk” or “relaxation for pumping.”
4. Distracting yourself from worrying about your letdown can be an effective method. Focus on reading a book, watching TV, listening to music, or talking to a friend.
5. Positive affirmations or self-talk can encourage a more positive experience for yourself. Instead of negative self-talk, say things like “My body was made to produce milk.”

If your letdown reflex is slow to respond, you can try hand expressing and breast compressions to extract more milk. Give yourself grace as you practice pumping, it does take some experience and time for your body to understand what it needs to do. And don’t forget a baby is always going to be more efficient at milk removal than any pump on the market, so if you’re pumping and feeding at the breast, don’t feel discouraged if your output is low. Keep an eye on your baby’s weight gain and the number of dirty diapers–these are good indicators of a healthy milk supply.

Storing Breast Milk

Here are a few general tips for milk storage:

• Start with the oldest milk and move your way forward.
  • The exception to this is if your baby is sick. Your milk will change based on your baby’s needs, so if your baby is sick, you are actually better off using the milk you expressed most recently to offer your baby to ensure the best antibodies are passed on for your baby’s quick recovery. If you can nurse at the breast as much as possible during this time too, your baby is more likely to receive key nutrients that he/she needs to recover.
• Label all your milk containers with the session time of day (a.m. or p.m.), date, and the number of ounces.
• Store your milk in 2-3 ounce containers to avoid waste if your baby doesn’t drink it all in one session.
• If you store in the refrigerator with the guidelines provided below, there is less fat loss and more nutrients than frozen milk.
• If you want to combine newly expressed milk to previously expressed milk, make sure both are chilled before you combine them.
• Chill or refrigerate your milk after expressing it, unless you are offering it to your baby immediately.

Storage Containers

Your storage containers for your milk, as well as breast pump kit materials, should be completely taken apart and washed in hot water with soap and rinsed, or washed in a dishwasher. They should also be thoroughly air-dried or dried with paper towels to prevent excess moisture.

Bottles or bags can be used to store your expressed breastmilk. If using bottles, glass is preferred to avoid plastic chemicals. Definitely avoid using any bags with BPA in them. The only downside to using glass containers is they tend to take up more freezer space.

You can be milk bags specifically made for freezing breast milk. Lay the bags flat in your freezer initially so you can make room for more. Once they are frozen, you can stack them in a larger container. Make sure you put them on a shelf or in the back of the refrigerator or freezer where the temperatures remain cold even if the door is opened.

Any container you use, be sure to leave a little space at the top, about an inch, to allow the milk to expand as it freezes. If using bags, squeeze out the air before sealing it.

Here are general guidelines for storing breast milk in the refrigerator and freezer from The Academy of Breastfeeding Medicine (ABM 2017).

Storage Location	Temperature	Maximum Recommended Storage Duration
Room temperature	60-85 degrees F (16-29 degrees C)	4 hours is optimal 6–8 hours acceptable under very clean conditions
Refrigerator	39 degrees F (4 degrees C)	4 days is optimal 5–8 days under very clean conditions
Freezer	24 degrees F (<4 degrees C)	6 months is optimal 12 months acceptable

Handling Breast Milk

There are no special precautions that need to be taken when handling breast milk like there are with bodily fluids like blood. If you are pumping at work, you can bring a lunchbox with you and put your milk inside your lunchbox and in the refrigerator. It is a good idea to bring an icepack with you for the return trip home to keep your milk cold, especially if you have a long commute.

Thawing Breast Milk

You can thaw your frozen breast milk using any of these methods:

• Leave in the refrigerator overnight, it can be left here up to 24 hours prior to use but should not be refrozen.
• Run warm water over the sealed container of milk
• Put the frozen container of milk in a warm water bath
• Place frozen milk in a warmer.

Avoid boiling and microwaving as these methods will cause loss of nutritional properties of human milk and could unevenly hot making it dangerous for infants to drink (ABM, 2017).

If you are simply warming it from the refrigerator, you can leave it on the counter for a few minutes to warm naturally in the room temperature environment, or place the sealed container of milk in a warm water bath. Don’t warm it in hot water as it may lose its nutrient components.

Gently swirl the milk around to loosen up the cream layer and mix it gently. Offer it to your baby using a paced bottle feeding method.

If your baby doesn’t drink the entire prepared bottle of breast milk during a feeding session, you can use it within 1-2 hours of preparing. After this time, there is a chance bacteria can build up in the milk from your baby’s mouth. You can avoid wasting milk by storing and warming it in small quantities.

Tips for Pumping at Work and at Home

Before starting any pumping routine, always wash your hands thoroughly and ensure all your parts and storage bottles or containers have been washed in warm soapy water.

• Purchase two pumping part kits so you don’t have to wash them after every pumping session.
• After a pumping session, rinse your parts and put them in an airtight bag in the refrigerator to use at the next session.
• If working, bring all your parts home each night to wash them according to the above guidelines.
• Create a “nursing station” type environment for yourself, bring something to occupy your time or look at pictures of your baby.
• Cover up your bottles with socks or cotton athletic wrist bands to take the pressure off the amount of milk you are pumping.
• Use a double stimulating pump for optimal milk expression.
• Buy a supportive pumping bra with slots for your flanges! This allows you to be hands-free while you’re pumping.

Your Rights

It’s important to know your rights as a working mother if you live in the United States. In the Patient Protection and Affordable Care Act, your employer is required to provide a reasonable break time to express breast milk for your baby for 1 year after your baby’s birth and each time during the day that you need to express. The break space is also required to be a private space other than the bathroom and that is shielded from view and free from intrusion of coworkers and the public.

If you found this helpful, be sure to check out the rest of my breastfeeding 101 series HERE.