Breast milk is made by supply and demand so that the more milk taken out of the breasts by either your baby, hand expression or a breast pump, the more breast milk will be made to replace it. This article shares pumping tips to increase milk supply when pumping.
How often should I pump?
How often to pump depends on why you are pumping but generally the more often you pump today the more milk your breasts will make tomorrow.
- If your baby is not latching at all in the early days you will need to pump as often as your baby would be breastfeeding to build a full milk supply. Aim for at least eight pumping sessions per day; try not to go more than two hours in the day and four hours at night without pumping.
- If your baby is breastfeeding but needs more milk because of low weight gain, try pumping and/or hand expressing after each breastfeed to ensure your breasts are drained and boost your milk supply. If there isn’t much milk at that time, try pumping about an hour after a breastfeed. Any pumped milk can be used to top your baby up. It can be helpful to work with an IBCLC lactation consultant to identify the reasons why your baby isn’t getting enough milk.
- If you are pumping to stockpile breast milk for a separation or ready for going back to work, you could start pumping once or twice a day according to your needs and build up as needed. Mothers often have more milk early in the morning so this may be a good time to pump. Once you are at work, the milk you can pump for your baby when you are away from each other can be stored in the fridge for use the next working day. See LLLI’s Pumping in the Workplace for more ideas about pumping and working.
- If you are exclusively pumping long term you will want to discover the number of times that you need to pump to maintain your production for your baby. Nancy Mohrbacher calls this the “magic number” and for some mothers it might be four or five times a day while for another mother it might be nine or ten.
How long should I pump?
- Pump until the milk begins to drip slowly/stop. Keep a record of the milk pumped to encourage you.
- Most milk is removed in about 10-15 minutes and there is not thought to be an advantage to pumping for much longer than this in one session. A higher number of shorter pumping sessions is more beneficial for supply than fewer long ones.
How much milk should I pump?
- If you’re pumping for a replacement feed this could vary widely from 30ml to 120ml depending on your baby’s needs. A rough average guide to the daily volume of breast milk a baby takes from one month to six months of age is 750-1035 ml or 27-35 oz 1 or an average 800 ml/day 2.
- If you’re pumping to get top-up milk because your baby isn’t gaining well, stay in close contact with your IBCLC or health professional to find the amount of milk you will need to keep your baby well fed and for help with the other issues that have led to low weight gain.
How to pump more breast milk
There are several ways to increase your pumping output:
- Massage or hands on pumping is a technique to increase the amount of milk you can pump that involves gentle breast massage before and during pumping. See this helpful Hands on Pumping video (see 5:15) developed by Jane Morton MD from Stanford School of Medicine or this little video from Robin Kaplan IBCLC;
- Hand expressing after pumping has been shown to produce much more milk 3. See Hand Expressing Breast Milk for tips and videos.
- Double pumping (pumping both breasts at the same time) typically produces more milk and saves time too. Some single pumps can be converted into doubles (contact the manufacturer). For hands on pumping and double pumping at the same time you can buy hands free double pumping bustiers.
- Power pumping is a short-term technique to make more milk and mimics a baby cluster feeding. It involves setting up a pump in a handy spot and every time you pass by, pump for five or ten minutes. West and Marasco describe the technique here. Power pumping is suitable for mothers of healthy full-term babies.
- Try a different pump. See “How to choose a breast pump” below.
- Try pumping at night especially if you happen to be awake anyway, because prolactin levels (an important hormone in milk production) are higher at night. If you usually breastfeed at night, that will also stimulate milk production.
- Pumping on one breast while baby breastfeeds on the other works for some mothers who find it difficult to let-down to the pump.
- Spending time skin-to-skin can help boost another hormone involved in milk production; oxytocin. Some mothers find holding their baby while they pump can help their ease of pumping.
- Music and relaxation. One study found that mothers who listened to relaxation recordings, music and looked at baby photos while they pumped, could pump much more breast milk 4 5.
How to choose a breast pump
As a general rule the more you pay for a breast pump the better it will work. An electric pump will usually be much more efficient than a manual one and hospital grade pumps (expensive multi-user pumps used in hospitals) will be better still. But there can be exceptions to every rule and some mothers may even find hand expressing works better than pumping for them. Tips for choosing a pump include:
- Look for a pump with multiple settings for speed and suction to give you more comfort and control. Some breast pumps can generate unsafe vacuum levels or maintain a vacuum for too long.
- The part of the pump that is held to the breast has various names with different pump manufacturers such as breast shield (Medela), breast shell (Ardo), funnel (Ameda) or flange. Look for a pump with different sized flanges because nipples are not all the same size (see “Breast pump flange fit” below).
- Check reviews online from other women who have tried them before buying a pump.
- Hospital grade pumps may be available to borrow from your maternity hospital or for short-term hire from major pump manufacturers in your country e.g. Ardo, Medela, or Ameda in the UK.
- Second hand pumps may not work efficiently and may have hygiene concerns 6.
An alternative style of breast pump
The Haakaa Silicon Breast Pump is a new type of “pump” that works without electricity by generating a gentle vacuum pressure on the milk making tissue of the breast coupled with feeding your baby on the opposite breast to create a let down. For a further discussion of this new device see This Year’s Big Thing… by Shel Banks.
Breast pump flange fit
Using a breast pump shouldn’t hurt, but if the flange doesn’t fit correctly or the vacuum is too high, pain and trauma to the nipples can result. The opening where the nipple sits, is sometimes referred to as the nipple tunnel. If the nipple tunnel is too small your nipple may rub along its sides or get wedged, this can cause cracking at the base of the nipple. If the nipple tunnel is too large, too much areola may be pulled into the tunnel to rub along the sides, causing pain and trauma. Pump manufacturer Medela has a guide to getting the right flange fit. Most pump companies offer a variety of flange sizes for example Ardo Breast Pumps (5 sizes), Ameda Breast Pumps (7 sizes) and Medela Breast Shield Fitting (5 sizes). You may need a different size for each breast.
How to use a breast pump
By adjusting the speed (cycling) and suction (vacuum) you can mimic the faster sucks of a baby’s initial latch—which stimulate the let-down—followed by the deeper rhythmic suck later in the feed which keeps the milk flowing. You can also adjust the settings during the feed to create several let-downs; i.e. increase the cycling speed when milk flow slows and adjust it down again when flow increases. Some pumps will do this automatically for you and may have a special “let-down” button. If you are single pumping (on one breast) switching between breasts several times will mimic switch nursing and stimulate let-downs. A little lanolin or olive oil smeared inside the flange and nipple tunnel can make pumping more comfortable if needed.
Cleaning breast pump parts
Pump parts should be cleaned after each use according to manufacturer’s instructions but the US Food and Drug Administration (FDA) and The Womanly Art of Breastfeeding say that breast pump parts do not have to be sterilised with every use:
Fresh human milk kills almost all bacteria, viruses, and fungi that it comes in contact with, so you don’t have to sterilise pump and bottle parts. Washing them thoroughly with hot, soapy water is usually all they need. If you have a dishwasher, run the pump flange and connector and bottles through it whenever it’s convenient. Don’t sterilise the pump parts that don’t come in contact with your milk; tubes, diaphragms or pistons can melt under high heat.
Wambach and Riordan, 2015, p 443 agree with the above adding:
Sterilising or disinfecting pump parts can be accomplished by boiling the parts, using an electric steriliser, placing the parts in a steriliser bag made for the microwave, or using a dishwasher with a high-temperature sanitizing cycle.
They point out not to use harsh chemicals or abrasive scrubbing which could create small scratches to harbour bacteria or mould and if condensation develops in the tubing it can be “spun like a lasso” to force the water droplets out.
LLLGB’s leaflet Expressing Your Milk, 2014 says:
If your baby is healthy, pump manufacturers generally recommend washing with hot soapy water; if sterilizing, once a day is enough. Just like your milk, pumping equipment can safely be left at room temperature for short periods and refrigerated in a clean container or bag for longer periods, giving you more time for your baby.
Other ways to increase milk supply
Pumping can be a great partner in the process to increase low milk supply, however not all mothers find pumping works well for them and there are many more ideas to try. Our article How to Make More Breast Milk discusses more ways to increase your milk supply and it is helpful to consult your IBCLC lactation consultant to unpick the reasons for low milk supply. With good positioning, some latching tips, breast compression, and by offering both breasts (and more!) you may be able to improve your supply with less need to pump.
These books offer easy-to-read comprehensive help for your milk supply all in one place see:
- The Breastfeeding Mother’s Guide to Making More Milk, RN by Diana West, BA, IBCLC and Lisa Marasco, MA, IBCLC
- Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby by Stephanie Casemore
There are several ways to help increase the amount of breast milk you can pump. Trying shorter, more frequent pumping sessions, using breast massage while pumping, hand expressing after using a pump, choosing the right pump and using the correct sized pumping parts have helped many mothers to increase their milk supply by pumping.