Pumping or Not? Deciding What You Need and Making Sessions Productive

Choosing to Feed Expressed Breastmilk

Some mothers may need or prefer to feed expressed breastmilk for various reasons, including:

• Medical Needs, babies in neonatal care or with feeding difficulties can still receive breastmilk, which may be expressed and given by syringe, bottle, or feeding tube.

• Temporary Latch Issues, expressing milk can provide time for mothers and babies to resolve any latch challenges, such as tongue-tie or latch discomfort, without needing formula.

• Returning to Work, expressing milk allows mothers to continue providing breastmilk even if they are separated from their baby during work hours or other commitments.

• Mastitis and Engorgement Relief, expressing milk can relieve engorgement and help prevent or manage blocked ducts, when baby is not relieving the symptoms.

•  Breastmilk contains antibodies and live cells that help protect against infections, especially important in the early weeks. Breastmilk changes to meet the baby’s nutritional needs, providing the perfect balance of fats, proteins, and vitamins, The unique natural composition of breastmilk is also very gentle on a newborn's developing digestive system and promotes a healthy gut microbiome.

• Reduced Illness Risk, breastfed babies have a lower risk of respiratory infections, ear infections, gastrointestinal issues, and some chronic conditions such as asthma and obesity later in life.

•  Feeding breastmilk through pumping or expressing still supports bonding and emotional connection, particularly when caregivers can be part of the feeding process.

• Offering expressed colostrum and encouraging skin-to-skin contact can often reduce the need for supplements.

Why Collect Colostrum?

• Colostrum, often referred to as "liquid gold," is rich in antibodies and nutrients that help protect and nourish a newborn.

• Collecting colostrum can be beneficial for:

• Feeding sleepy or reluctant newborns.

• Providing extra nourishment and immune support, particularly for sick or preterm babies.

• Supporting mothers who may experience delays in milk coming in fully, or who need a backup source of nutrition if their baby struggles to latch.

How to Hand Express:

Preparation is key

• A warm bath or shower can help you relax and stimulate milk flow.

• Find a comfortable position, perhaps seated and leaning slightly forward, but see what feels best for you.

• A very gentle breast massage, moving from the back of the breast toward the nipple, can help the let-down reflex. (hand like reading a book

• Place your thumb above and fingers below the nipple, forming a ‘C’ shape around the breast.

• Position your fingers a couple of centimetres back from the nipple, then press inward toward your chest. Squeeze fingers together and draw them forward to express milk.

• Repeat rhythmically, adjusting finger placement slightly if milk isn’t flowing. (do not slide your fingers over your skin)

• Use a clean, sterile container or cup to collect milk, especially in the early days

• For small amounts of colostrum, a sterile syringe can be used to gently draw up drops of colostrum from the nipple.

• Keeping collection tools sterile is crucial to ensure milk is safe for your baby and to prevent contamination, especially if your baby is preterm or has special medical needs.

• it can take a few days to see any results.

Which Breast Pump to Choose?

Breast pumps come in four main types, each differing in cost, portability, and efficiency:

• Manual Pump Includes lever-operated and silicone pumps , which rely on hand power and/or suction to work.

• Single Electric Pump, pumps one breast at a time.

• Double Electric Pump, pumps both breasts simultaneously, ideal for exclusive pumpers. Portable, hands-free, and wireless options are available, with some controlled via smartphone apps.

• Hospital-Graded Pump, high-powered double electric pump for multi-user needs; often rented due to higher cost and robust motor.

• Wearable Pump: A cordless, discreet pump worn inside a bra, allowing for hands-free pumping while moving around.

  
  

Look for adjustable speed and suction settings, a range of flange sizes, and reliable reviews.

How to get the most out of your pumping session:

• Holding your baby close (skin-to-skin): Skin-to-skin contact releases oxytocin, which encourages milk flow and strengthens bonding, making your body more responsive to producing milk.

• Breathing in your baby’s scent: Your baby's unique scent triggers oxytocin and can naturally stimulate your milk let-down, connecting you to your body's natural rhythm for milk production.

• Taking deep breaths and relaxing: Relaxation reduces stress, which can inhibit oxytocin, and helps create a calm environment that makes pumping and milk flow easier.

• Setting a regular pumping time: Pumping at the same time daily helps train your body to expect milk removal, supporting a consistent supply as your body adjusts to a routine, can make things easier as your body learn to make milk for those time.

Relaxation is key

• Relaxing during pumping can make a big difference, as oxytocin, the hormone that supports milk flow, responds well to calm moments. Holding your baby close, feeling their skin, or even breathing in their scent can encourage this hormone, helping your milk to release naturally. Stress, on the other hand, can disrupt this process, so gentle relaxation can be a helpful way to support milk flow.

• Incorporate meditation or breathing exercises to relax while pumping.

• Choose a time when you feel most at ease, though this can be challenging with a newborn.

Routine

• Your body makes milk in response to demand: the more often you pump, the more it learns to produce.

• Choose times that feel realistic and calm for you. A few manageable sessions are better than lots that feel stressful or overwhelming.

• Keeping your pumping sessions at roughly the same times each day can help your body get into a rhythm and support a more steady milk supply.

Power pumping

• Power pumping is a way of mimicking a baby’s cluster feeding to ask your body to make more milk.

• It can be helpful if you are trying to boost supply, especially if you have had a dip after illness, missed feeds, or are building a freezer stash.

• It is usually done once a day for a few days or a week, rather than all the time.

Example power pumping session (with a double pump):

• Pump for 20 minutes

• Rest for 10 minutes

• Pump for 10 minutes

• Rest for 10 minutes

• Pump for 10 minutes

You can shorten or lengthen this to fit your life. The aim is several short bursts of pumping with rests in between, not perfection. If it feels too intense or stressful, it is fine to stop and go back to your usual routine and get support to review your plan.

Hands-on pumping

• Hands-on pumping means using your hands during pumping to help the milk flow and drain the breast more fully.

• It can help you get more milk in the same amount of time and may be especially useful if you are exclusively pumping or expressing for a baby in NICU.

Simple steps for hands-on pumping:

• Start your pump as usual.

• As the milk starts to flow, gently massage and compress different areas of the breast with your fingertips or the flat of your hand.

• Think “firm but comfortable” pressure, not painful. Move your hands around the breast so you are not always pressing in the same place.

• When the flow slows down, you can pause and massage again, then restart or change the pump setting if needed.

If you notice any pain, bruising, or your skin becoming sore, ease off and speak to a contact us to review your technique. This is a good video on hands on pumping https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html

Last but not least reach out for trained and qualified support the National Breastfeeding Helpine is open 24h 365 days 0300 100 0212

Marion Frey-Alquarshi Breastfeeding Counsellor & Certified Breastfeeding & Lactation Specialist.