CHOOSING A BREASTPUMP
Do you REALLY need a breast pump? Not every nursing mother
needs a breast pump--need for a pump is the exception rather than
the rule.
Some mothers never need to express milk, as babies are very portable
and you can usually arrange to be together at every feeding time.
So, if you were thinking of getting a pump for occasional use,
you likely can just arrange things to avoid those occasional separations.
Another option is manual expression. The technique is explained
in most breastfeeding books and you may find it easier than pumping.
No equipment is needed other than a clean cup.
Breast pumps can be helpful in allowing a mother to breastfeed, in cases where without the pump she would have to stop. They allow more "freedom" but can create problems with milk supply if used unnecessarily. "Freedom" is in quotations, because one might ask the philosophical question of whether nature designed baby's natural feeding method in order to keep baby and mother close together--more than meeting baby's nutritional requirements might have been in mind!
Some women have a quick let-down and can hand-express or hand pump large amounts of milk easily and quickly. For others, it may be necessary to pump 5-10 minutes before the first few drops of milk appear. Just because milk doesn't appear within the first few minutes doesn't necessarily mean your pump is defective. Once the first drops of milk appear, it may be a few more minutes before the let-down occurs and milk comes streaming out. Because it will take time to become accustomed to pumping, it's a good idea to start practicing with the pump at least 2 weeks before being separated from baby.
Listed below are some of the reasons you may be thinking of
buying a breast pump, and the type of pump we recommend.
1. To have milk on hand for the occasional separation from baby
(once or twice a week).
*Hand expression or manual pump (NEVER bicycle horn/bulb style--they
can cause very sore nipples). The Kaneson
and Ameda
One-Hand Pump are excellent quality manual pumps.
2. Pumping at least twice a day due to mother working.
* While some mothers find hand expression quick and convenient,
others prefer to use a pump. The best pump for this purpose is
either battery-operated or has an A/C adapter. If you have a slow
let-down and find it difficult to relax when pumping, a battery-operated
or electric pump is best for you. It allows mother to relax while
the motor does the pumping, which helps the let-down. Before you
return to work, begin pumping about 2 weeks ahead of time, in
order to become accustomed to the pump and to have some milk stockpiled
in your freezer. If you are returning to work and expect to pump
3 or more times a day, a larger pump like the Ameda
Purely Yours is recommended.
3. Pumping for the preemie baby. (This means pumping many times
over a 24 hour period to build up and maintain milk supply.)
* Electric pump only--and this means one of the large pumps, not
the hand-held and not battery-operated. These pumps must be loaned
or rented from a hospital or breast pump depot. They are too expensive
to buy (over $1500). Electric pumps have variable suction, most
like baby, require no effort to operate, and are the most efficient
at getting milk out.
4. Temporary interruption in breastfeeding due to hospitalization,
medication, travel, etc.
* If pumping several times a day, electric pumps or battery-operated
pumps are the best. In many cases, arrangements can be made to
avoid the separation. e.g. Modern hospitals now encourage baby
to be brought for nursing if mother is in hospital; if baby is
in hospital, mother can stay with him or come in for nursing.
If you are travelling, most young babies travel well because the
motion is soothing, and the sights, sounds, and smells are distracting.
If you are on medication, often a doctor can prescribe something
that will not affect baby through your milk if he knows you are
nursing.
5. Relieving engorgement, or oversupply of breastmilk
* Use a manual pump or hand expression. In most cases of engorgement
or oversupply, pumping is NOT advisable, if it is done, it should
be only enough to make any discomfort bearable. Breast milk is
produced according to demand. Your body won't realize that milk
that is pumped isn't going into baby's tummy; therefore, it will
produce the same amount of milk (including the amount that you
pumped!) the next day. Pumping may the relieve the pressure at
the moment, but pumping too much milk could create a real oversupply
problem. You may feel as if you have an oversupply of milk, but
remember that each day your body produces the same amount that
baby consumed the day before. If baby is several months old and
your breasts are always uncomfortably full--in other words, if
you are certain that you have an oversupply, you can decrease
the milk supply by nursing at just one breast per feeding, switching
to the next breast at the next feeding. (You may have to nurse
a little on the other breast to relieve a bit of the pressure.)
After about 2 days, return to normal nursing. If you have a problem
with engorgement only because baby sleeps for long periods between
feedings, you can solve it simply by nursing more frequently.
If baby is really sleepy, he'll fall back asleep after nursing
anyway.
6. Weaning
* Manual pump or hand expression Ideally, weaning should be done
VERY gradually, for the sake of both your child and your body.
If this is not possible, and you find it necessary to pump, just
pump enough to relieve the pressure, not to maintain the supply.
It is not necessary to have a very efficient pump for this purpose.
7. Increasing the Milk Supply
* Under normal circumstances a breast pump is NOT necessary to
increase milk supply!
We have been surprised when mothers who are trained medical professionals
tell us they are buying or renting a pump because their milk supply
is dwindling. Our advice to these moms is to take the weekend
off (no guilt here--it's for the baby!)--forget about household
chores, let someone else cook, nap and sleep (bringing baby to
bed with you might make nursings a lot easier), and putting your
feet up for day time nursings. Most working moms are just plain
tired, and nursings may be infrequent or rushed. All of this interferes
with milk production, and if you take a few days to nurse on demand,
your milk supply will increase again. The easiest way to increase
your supply is simply to nurse more frequently. A breast pump
cannot completely empty your breast as it draws the milk from
the lower ductal areas under the nipple, but not the deeper ducts.
.
8. Relactation; premature weaning.
* Sometimes baby is well on the way to being weaned, when it is
discovered that, due to intolerance of formula, or some other
reason, that it is desirable to continue breastfeeding. If the
milk supply has declined to the point where there is so little
that baby will not nurse, a pump can be used to increase supply
until baby will nurse. We recommend the large electric pumps for
this purpose. Another method is to use a supplemental nutrition
system (a bottle containing formula is hung around the mother's
neck; a tiny tube leads to the mother's nipple, so that when baby
sucks he gets formula, while the sucking stimulates mother's breast
to produce milk and the supplementation can be decreased gradually).
9. Lactation for an Adopted Baby
It is possible by using a large electric breast pump and pumping
as frequently as baby would nurse, to stimulate the breasts to
produce milk for an adopted baby. Ideally this should be started
well in advance of baby's arrival. The SNS (see above) is another
method that can be used. If you want to nurse your adopted baby,
we recommend that you contact a lactation consultant or La
Leche League for advice.
10. Cleft Palate In most cases, it is possible to nurse a cleft lip or cleft palate baby, but if not, the large electric pump will build up and maintain the supply so that baby can still receive the benefits of breast milk.