Expressing your breast milk by pump

Once your breast milk has come in, you may wish to express your breast milk by pump. This may be particularly the case, if you need to be away from your baby for a longer period of time and/or are returning to work and someone else needs to be able to give your baby your breast milk.

How to use a hand-operated breast pump

• Begin in the same way as you would if you were preparing to hand express – spend a few minutes massaging your breast. Place the funnel attachment of the hand pump against your breast, so that your nipple is central and pointing towards the narrow neck of the funnel. Ensure there is a good seal between your breast and the funnel
• Use your fingers to operate the lever of the hand pump; this will create the suction. It often takes a couple of minutes using the hand pump before your breast milk will begin to flow
• Continue to use the hand pump until the milk begins to flow; when the flow begins to slow down, swap sides and start pumping the other breast. Continue to express until your milk flow begins to slow down and then swap back to the first breast again – continue pumping until the milk flow subsides again and swap to the other breast. Continue to alternate between both breasts until you have expressed each breast three times
• If you find that your milk is still flowing, you may need to express each breast for a fourth time
• If you keep alternating between each breast – pumping for a few minutes on each side – you will express a much larger volume of breast milk!

Using an electric pump

When using an electric pump there is the option to either single pump – where you use one collection set and alternate every few minutes from one breast to the other, or dual or double pump – where you have two collection sets which allow you to express from both breasts simultaneously.

Having spent a few minutes massaging your breast, place the funnel  and attached bottle (collection set) against your breast (as above) so that there is a snug seal

Ensure that the vacuum (suction) lever is set to the lowest setting before you switch on the pump

Keep the pump on the low setting and continue using gentle suction until your breast milk begins to flow. Once you feel happy with the strength of the suction, you can gradually begin to increase the vacuum/suction until you find the setting that is most comfortable for you. Do not be tempted to raise the vacuum/suction setting too high; this will not produce any more breast milk but it is likely to leave you with sore nipples!

As  before, express from each breast until you have expressed from each breast three times

If your milk is still flowing, you should express for longer. Once your milk flow diminishes or stops, swap breasts and begin to express from the other side

You should aim to express for around 10-15 minutes or until your milk stops flowing. Should your milk flow stop before this time, switch the pump off for one minute to allow more breast milk to be ‘let down’; then start pumping again

After expressing with the electric pump, you may want to do some hand expressing to obtain breast milk with a higher calorie/fat content for your baby

How frequently do I need to express?

The number of times that you express over a 24 hour period will vary depending on your individual circumstances and the needs of your baby.

Babies can sometimes be ‘reluctant’ to feed in the first few days following their birth, or may be separated from you because they need to be cared for on the neonatal unit (NNU). Where this is the case you will need to express in order to stimulate your lactation and set up a milk supply. You should aim to express 8 times over a 24 hour period, including at least once during the night (when Prolactin levels are higher). You do not need to express at timed intervals, but it is recommended that you do not leave it longer than 6 hours, as this could adversely affect your milk supply.

If your baby is not taking breastfeeds, the maternity staff will encourage you to continue to offer your baby breastfeeds three hourly. You will then need to express your breast milk after each feed that you have offered your newborn.

Breastfeeding and returning to work

Maternity leave tends to fly by and before long it can be time to think about returning to work. Returning to work doesn’t mean you need to stop breastfeeding – you can continue to express your milk and store it for someone else to feed to your baby. It is helpful to build up a good supply of frozen breast milk before you return to work, so try to begin expressing a few weeks before your start back date. There are a number of different ways of doing this:

You may find it easier to express a little breast milk at a time, rather than expressing a whole feed at once. This way you can gradually build up a milk feed. You can put three expressions of milk into one container, keeping it cooled in the fridge in between expressions

You could express your milk when your breasts are feeling full

You could try expressing from one breast while your baby is breastfeeding from the other

You might want to try wearing breast shells inside your bra. Breast shells are useful for collecting breast milk that leaks/drips from your breast when your baby is feeding from the other breast. However, this milk will not be so high in fat/calorie content because it is made up of breast milk from the start of the feed. It can be used as a nutritious drink though!

Varying the methods you use to express your breast milk can help to encourage your milk supply. You may find that using a combination of hand expressing, as well as using a hand pump and an electric pump, stimulates your breasts to produce more milk.