Should pumping always feel comfortable?

Some moms assume pumping should be painful. Not so! “No pain, no gain” does not apply here. Painful pumping means something needs to be adjusted. What causes pain? The two most common causes are: 1) pump suction set too high and 2) flange fit issues.

Pump Suction Set Too High. First, the strongest pump suction does not always pump the most milk. In fact, too-high suction can actually slow your milk flow. Set your pump at the highest suction that feels good…and no higher. (If you’re gritting your teeth, it’s too high!)

Pumping milk is not like sucking a drink through a straw. With a straw, the stronger you suck, the more you get. When pumping, most milk comes only when a let-down, or milk release, happens. Without a milk release, most milk stays in the breast. What is a milk release?

  • Hormones cause muscles in the breast to squeeze and milk ducts to widen, pushing the milk out.
  • Some mothers feel tingling. Others feel nothing.
     

A milk release can happen with a touch at the breast, hearing a baby cry, or even by thinking about your baby. Feelings of stress, anger, or upset can block milk release.

While breastfeeding, most mothers have three or four milk releases, often without knowing it. To get more milk with your pump, you need more milk releases, not stronger suction.

Flange Fit Issues. Many mothers pump comfortably with the standard size flange (25 mm diameter nipple opening). But if pumping hurts even on low suction, you most likely need another size. If the standard flange is too small or too large, a better-fitting flange will feel more comfortable and may even pump more milk.

To check your flange fit, watch your nipple during pumping. If you see a little space around your nipple as it’s drawn into the flange’s nipple tunnel, you have a good fit. If your nipple rubs against its sides, the flange is too small. If too much of the dark area around the nipple is pulled in or the nipple bounces in and out of the tunnel, it is too large.

Thankfully, Ameda has seven different flange sizes available, so you can go larger or smaller, as needed. Nipple size changes with birth, breastfeeding, and pumping, so the pump flange that fit you well when you started pumping may need to change as you pump more. For that reason, you’ll want to recheck your flange fit from time to time.

Breast or Nipple Issues. There are other possible causes of pain during pumping related to breast and nipple health. If your pain is not due to too much suction or the too-small or too-large flanges, it is time to ask more questions. Do you have nipple trauma (broken skin on the nipple)? Could you have a bacterial infection of the nipple (can occur with a history of nipple trauma)? Do you have an overgrowth of yeast (also known as thrush or candida)? Is mastitis a possibility? Does your nipple turn white, red, or blue after pumping? If so, see your lactation or other health-care provider to rule out Raynaud’s Phenomenon and other possible causes.

Nancy Mohrbacher, IBCLC, FILCA, Lactation Consultant, Ameda Breastfeeding Products
Coauthor of Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers