What should I know when I start pumping?
Once you have a pump, you can start collecting milk any time. In the first two weeks after your baby is born, you may want to pump occasionally to relieve engorgement - you can save this milk, but don't get carried away. Pumping a lot in these early weeks tells your body that you had triplets, and brings in an enormous milk supply. While this may sound like a good thing, it puts you at very high risk for breast problems like clogged ducts and engorgement.
When your baby is a little older, you can start adding pumping to your daily routine. While it's not necessary, it's comforting to have a little bit of a stash of milk built up before you return to work. Warning - be sure to read this page on smart use of your freezer stash! To do this, start adding a pumping session at about the same time each day as soon as you want to - but it's best if it's at least two weeks before you return to work.
When you first start pumping, you will get very little milk. This is normal. After all, you've just spent the first weeks of your baby's life getting your milk supply into an exact balance with your baby's needs. There's not supposed to be any extra. What you're doing by pumping in these early days is building a little bit of a stash, and getting used to pumping. You're also increasing your milk supply by just a little bit.
Placing the order: By pumping at about the same time each day, you're telling your body that it needs to make a little more - you're tricking your body into thinking that your baby has really taken to that 10am feeding! Even if you pump and no milk comes out at all, you're placing the order for milk to be made later.
Learning to pump: It may take you a while to get the hang of pumping. You may be tense and worried about whether you'll be able to pump enough (don't worry, you will). You may be uncomfortable with a machine hooked to your breasts (imagine!). Don't worry, that's why you practice. This time pumping at home teaches you how to set up your pump, how to set it so that you get the most milk in the least time, and most importantly, how to relax when you're pumping.
How often to pump: When you're pumping at home to build up your supply and a stash of milk, once a day is plenty. Don't make yourself crazy with it!
Once you go back to work, the common guideline is once for each missed feeding. In general this works out to about three times in a standard eight-hour workday. But you'll have to adjust it according to your baby's needs and your schedule.
If your baby nurses every two hours, you may need to spread out your pumping sessions a little more, but make them a bit longer than your baby typically nurses
If you don't have time for enough pumping sessions during the day, pump when you get up, before work, after your baby goes to bed, or during the night - it can be done!
If your baby nurses very infrequently, you may need to pump more often, since the baby is usually more efficient at getting the milk out. See the typical daily schedule for how most moms fit it all in.
How long should you pump?
In short, you should pump until milk isn't coming out any more. Or, if you're trying to boost your supply, pump a little while longer after the milk stops flowing. I'm just not a clock-watcher, I think you should do things until they're done. But, in general, pumping for 15 minutes should do it for most people. (If you're having trouble letting down for the pump, read Better Pumping, below.)
There is no harm in pumping for a few minutes after the milk stops flowing, and it's a great way to send your body the message that more milk is needed (if it is).
Contrary to popular belief, your pump does not get the milk out of your breasts by brute force alone. Stronger suction does not necessarily mean that you will get out more milk. Stronger suction may mean that you're in excruciating pain, or that you're damaging your breasts, so back off a little, OK? What your pump needs to do to get the most milk out is imitate your baby. Pay attention to how frequently your baby sucks and the strength of that suction. Then try to adjust your pump to match your baby. From there, you can experiment to see if slightly more, less, faster or slower suction feels better and produces more milk. What's the best setting? The one that works for you, so don't pay attention to how other people's pumps are set. It's a personal thing.
A few tricks can increase your pumping output without increasing the amount of time it takes. The most effective ways to increase your output are good relaxation skills and breast compressions - both described here.
Relaxing while Pumping
To some people, relaxing while pumping is akin to asking them to relax during a root canal, but it can be done. Relaxing is important, because it's really hard to have a let-down if you are tense. Some tips for relaxation:
Positioning: Sit back in your chair, don't tense your shoulders, and support the bottles so that you don't have to lean forward.
Environment: Play relaxing music, have a comfortable chair for pumping, have a cup of tea before you start - in general - be comfortable!
Baby Cues: If you are away from your baby when you are pumping, bring some cues to help you think about your baby. Some mothers respond very strongly to the smell of your baby, so bring whatever your baby slept in last night (as long as there's not too much spit-up on it!) Other moms respond better to pictures or sounds - you can put photos of your baby right in many of the pump carriers, or bring a tape of your baby's "hungry noises" (all out crying doesn't usually work - it's too stressful)
Bottle Watching: For me, the best way to stop a let-down in its tracks was to watch the bottles. I always had trouble pumping enough, and the stress of watching the ounces was enough to severely limit my ability to pump. Look at something else - anything! Say to yourself "any breastmilk at all is a precious gift to my baby" and visualize waterfalls, spilled milk trucks, your baby's contented face after a feeding - whatever relaxes you.
Activity: Some people like to work while they are pumping - for me, pumping time was when I rewarded myself for the hard work of the rest of the day (or for a particularly good run at FreeCell). Find something you enjoy doing while you pump - maybe the latest Janet Evanovitch novel, maybe reading the paper or People magazine, maybe surfing the web if you're lucky enough to pump at a computer. Make it relaxing time. Or, if you're stressed about the work you're missing, pump hands-free and keep on working - whatever relaxes you best.
Doing breast compressions while you are pumping can help stimulate additional let-downs, and helps to thoroughly drain all of the milk ducts. While you are pumping, use one hand to massage your breast from the armpits towards the nipple (or as close as you can get without dislodging the pump flange). Gradually increase the pressure, and finish with a few firm squeezes of your breast, like you do when you are hand expressing milk.
Kristen Berggren, PhD, IBCLC
Author of Working Without Weaning and creator of the website, www.workandpump.com