As it’s World Breastfeeding Week, I’ve been thinking more about my choice to exclusively express in order to continue feeding Little M breast milk for as long as possible. I still live in fear of her demand outstripping my supply, so I approached Medela to ask for some expert advice. I found the information their in-house expert, Sioned, gave to be super helpful and reassuring so I asked if I could share it with my readers in the hope that it can help out others who are exclusive expressing, as I am. That said, I think some of it is also useful for mums who are primarily feeding from the breast and expressing every now and then.
How frequently should I express? And what is the optimum amount of time spent expressing?
It is up to you how frequently – if you are nursing alongside you need to support this first. You can try and find times that suit you both – if she just has one breast you can pump off the other. If dad is giving a feed you can pump at the time she has daddy time. If you are exclusively pumping – it is recommended to mimic a newborn feeding pattern 8-12 times in a 24 hour period and after the first 2-3 weeks when supply is maintaining to tweak to 6-8 times a day (no longer than 5 hours between sessions at night). Some mums find that first feeds in the morning support a sneaky pumping session, while others prefer to do late evening when baby is asleep – its up to you and how it fits with your feeding patterns and lifestyle.
With a 2 phase breast pump the majority of the milk is removed within the first 7 minutes after a milk ejection – however it is dependable on having the correct shield size , comfort vacuum setting and also if you double or single pump. If you have a large storage capacity it may take longer and you are advised to continue with pumping until the milk flow stops and feel the breasts to see if you feel that they have drained well.
What it shouldn’t take is 30 mins per breast.
What can I do to prevent the breast shield losing suction from my breast? (Sometimes I end up with wet clothes – I’m more concerned about the wasted milk, though!)
This is usually technique. We have worked with lots of mothers over the years and found that many held the shield incorrectly – preferring to hold the connector and this in turn resulted in mums having an intermittent seal and vacuum as the shield tended to be pushed into the upper breast and air leaks on the underside. Resulting in a wet t-shirt and sadly lost milk.
We now recommend cupping the shield with a thumb above and the fingers below – this also helps ladies who are fuller cupped and those whose nipples tend to point down. Heavy pendula breasts may be supported with using a scarf as a sling and this too helps the ductal system on the under breast drain better. When milk has finished flowing, before releasing the shield, lean slightly forwards to pool the milk so that it goes into the centre of the funnel and then drains into the bottle.
A couple of things to remember by cupping the breast shield – if you need to break the seal you can insert your thumb into the upper breast tissue and this will release the vacuum and allow the milk to drain into the funnel and bottle. If you have a significant milk ejection and the milk is pooling you can break the seal and interrupt the cycle of the pump without removing the shield from the breast in order for the milk to drain into the bottle.
If you overfill the bottle and the level of the milk is obstructing the valve and membrane it will impede the drainage into the bottle and again leave you with milk leakage – so ideally use a 250 mls bottle or start a new bottle with the other breast.
I already apply pressure/massage my breasts whilst expressing; is there anything else I can do to increase my yield/supply?
Make sure that you are using the correctly fitted breast shields. Be cautious about using hands on compression as this can impact and constrict on the superficial milk ducts. To increase supply –you need to empty more often – the more you empty the more milk you make. You may not see more milk per session but you may find that over 24 hrs you have a greater total. Double pumping produces more milk than single pumping and this is proven as it triggers an additional milk ejection reflex and both breasts are working at the same time so a lot more efficient.
If you are having a blip and need to supplement it may be worth considering a short term hire with a double pump to boost and then fall back to your personal pump once over your blip. There are medications you can take but it is recommended to consult with a breastfeeding specialist and GP to look at your medical history and ensure that both herbal and over counter remedies are safe for you to take. For more information the breastfeeding network has a great fact sheet about medication called galactogogues that influence prolactin production.
Disclosure: This post is not sponsored; I approached Medela for advice and they kindly agreed that I could share it on my blog. Medela did, however, kindly send me a bottle sample for Little M to try. All opinions given are my own.