Lots of misinfo surrounding pumping! Let’s go over some of it.

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Pumping is a tough job and sometimes is made even harder by misunderstandings or misinformation surrounding pumping.

I want every mom reading this to understand that pumping is hard. It’s harder than breastfeeding in my opinion. It takes longer in terms of actually pumping and cleaning parts and freezing milk, then cleaning bottles, and doing it all over again 2-3 hours later. Adding in the cost of a pump (not everyone gets a free pump through insurance), the cost of the bags, bottles, pump parts that MUST be replaced every now and then. Pumping at work, pumping multiple times in the middle of the night when you just want to sleep.

Pumping is HARD.

Let’s go over somethings you may not know, that may help make your life easier!

First of all, flange size, flange size, flange size. The flange size is one of the most important parts of pumping. If this size is off you could be damaging your tissue and your milk supply.

Getting sized at the hospital is “fine,” but your size will change in a few days to a week or two. This will also change depending on the type of labour and delivery/birth you had. This is because csection mamas and mamas who were on fluids for their whole stay will be plump, they will have nipple/areola edema. Your flange size will change.

(Also just a note on csection moms and moms who had traumatic vaginal births meaning they lost a lot of blood. Your body will not produce milk the same way a normal vaginal birth will. This is because at this moment your body is in fight or flight, and is fighting to keep you alive vs focusing on making milk. This is one reason I always encourage moms to remember the cascade of interventions when they voluntarily, freely, and willingly opt for a csection. This does not mean that you can’t breast feed or produce milk. It means you will have to work a little harder and be more disciplined about your pumping schedule. Again, reiterating, just because you had a traumatic birth or csection does not mean you can’t breastfeed—you absolutely can and you should. You just need to know it will be a little harder in the very beginning).

Some people add 4mm (or something) to their measurement. I have never in my life suggested this and never will unless there is valid and significant research that this does anything other than size a mom wrong.

You must be properly sized for your flange, and again, it will change…and it’ll change again probably a few months from now….and then it’ll change when you have your next baby. Hoard all of the flanges!

How often to pump?

For an exclusively pumping mom, this means a mama who isn’t latching baby or a mama who barely latches baby, you must pump every 2-3 hours around the clock. If your babe is gaining well in the first few days you can move the night time pumps to ever 3 hours. This is an absolute MUST. Doing anything other than every 2-3 hours right now will negatively affect your supply. The first few months is when your supply is being established securely. Where you are telling your body, “Hey! I need milk, keep making milk!” If you’re not telling your body that, your body will say, “oh ok so I guess we don’t need to be wasting energy doing this, let’s cut back and stop producing milk.”
You MUST be demanding milk from your body effectively and often.

After around 12-16 weeks, you can trial longer spaces at night (so maybe 4 hours instead of 3). If your output drops, check flange size and then move back to every 3 hours or even 3.5 hours.

How to pump?

Ideally, you will pump both breasts at the same time. This will give you the best output. One unfortunate thing about pumps is that you might not respond to the pump you chose and you won’t know until you’re not responding. You can try to troubleshoot this via flange size, oxytocin release, pump settings etc, but some women just don’t respond to pumps or specific pumps (I’m one of those moms. I only respond to Medela pumps. I’ve tried Evenflo, Spectra, manual pumps, Haakaa and I don’t respond to any of those. Reminder Haakaa is a pump.).

Electric pumps will, generally, work better than manual pumps and do work better than hands free pumps. I never recommend hands free pumps to moms who exclusively pump. If you need to use it one time a day because your breastfed baby slept thru a nursing session, that’s usually okay. For a mom who relies on pumping to feed her baby, it is not recommended (they also don’t work great for women with bigger chests).

How long to pump for?

I’ve seen moms say anywhere from 5 minutes to 50 minutes. I love peer support, but let’s make sure it’s factual. 5 minutes is no where near long enough to keep supply up. 50 minutes is wayyyy too long and you’re risking tissue damage (plus a ton of wasted time)! I always suggest mamas do about 20 minutes to start with and no more than 30 (and even 30 makes me uncomfortable to suggest). At 20 minutes your milk will stop flowing (generally), continue pumping for 5 minutes after (there won’t be anything coming out but it’ll mimick how a baby nurses.

Pumping for too long not only risks tissue damage and wasted time, but it also risks oversupply (which we all know has a ton of other issues mentioned in my Milk Stashes post)

What’s a normal output?

This is going to vary between moms. It’s also going to vary between pump sessions. Day, time, emotional state, mental state, etc etc. No two pump sessions will be the same.

At the very minimum, I want to see one ounce combined (so both breasts together making 1 oz minimum). If you can make two, three, four, five ounces combined, great. For me, as an LC 5 ounces is not something I see and go “YESSS YOU DID IT! NOW YOU’RE SUCCESSFUL!” *throws confetti in the air.* As an LC if I see 1 ounce combined pumped, I’m more likely to do the confetti stuff because that’s all you need. If you’re pumping as often as you should be 1-2 ounces is PLENTY of milk for your baby (we don’t need stashes). And that’s for an exclusively pumping mom. For a breastfeeding mom who’s babe just missed a nursing sesh, I’m beyond happy and content to see .5 ounces combined.

For a latching mama, when should you pump?

You don’t ever have to pump if you don’t want to. If you’re going back to work, I recommend a week or so before you start back to work, you start pumping. And you really only need to pump once or twice a day. If you’re not going back to work, don’t pump. There’s no need to. If you’re a latching mom and will be away from babe, you will need to stimulate the breast either by pumping or hand expressing to keep supply up and this would go with the every 2-3 hour rule.

You’re two days postpartum and have engorgement, should you pump?

This is a toughy because this needs to be remarkably clear with zero confusion or misunderstanding. For engorgement, if you do a full 20 minute session, on top of nursing, you are signaling to your body that you need DOUBLE the milk. If you’re already naturally engorged you do not want to signal to your body to produce even more milk. You will be in pain, you most likely will get a clog that will most likely lead to mastitis (this isn’t guaranteed, but why risk it).
For engorgement, try reverse pressure to get your babe to latch. Ideally, all engorgement issues would be fixed by a baby latching, from personal and professional experience that isn’t always going to happen.

When that’s not possible, try hand expression.
If that doesn’t work, try pumping for 5 minutes. Does that relieve the pain and pressure? If so, stop immediately and latch your babe so they can finish.

Again, you do not want to pump a full 20 minute session for engorgement. You will make the issue worse.

When to change parts?

Each pump has different parts, but they all generally are the same and some pumps might not have certain pieces (like one pump brand will use duck bills, but another will use membranes).

For flanges, change them when you need a new size or the flange is damaged.

For backflow protectors, tubing and valves, if there’s mold or it’s damaged.

For membranes and membrane cups as well as duckbills, replace them every month.

What questions do we have about pumping? I’m sure I’ve forgotten something!

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