A breast pump is a mechanical device used by breastfeeding mothers to extract milk from their breasts. It is used when the mother is not able to breastfeed her baby directly from the breast due to any reason.
Indications and Uses of Breast Pump
A breast pump is a very useful tool for a mother even if she plans to exclusively breastfeed her baby.
- Help working mothers to exclusively feed breast milk to her baby. Some mothers may have to return to work sooner. A breast pump allows the mother to pump and store her milk. A caregiver can feed that milk to the baby while the mother is away for work.
- Completely avoid formula feed. Breast pump enables a mother to feed her child only breast milk. If the mother and the baby can’t be together during every feed, pumping helps to avoid formula feed altogether.
- Provides stimulation to breasts to maintain milk production. Continuous milk production requires positive feedback from the breasts. If the baby does not suckle or milk is not removed from the breast regularly, a negative signal is sent to the body to decrease or stop milk production. (Read more about Breast Milk Production and Regulation.) Pumping ensures that milk does not accumulate in the breast and the body continues to maintain adequate milk production. (Read more about Foods that Increase Breast Milk Production and Other Breastfeeding Tips)
- Feeding a premature or sick baby. A premature or sick baby who is not able to suck properly can be offered pumped breast milk.
- Relieve pain from breast engorgement. Full and engorged breasts can be drained with the help of breast pump. This provides relief from pain to the mother. The milk thus stored can be fed to the baby later.
- Draw out flat or inverted nipples. Flat or inverted nipples can make latching difficult for the baby. Pumping a few minutes before breastfeeding, can help a mother to draw out her nipples.
- Provide adequate back-up or additional supply. In case the mother falls sick and needs to take some medicine which can be harmful to the baby, she can pump and store an adequate supply of breast milk before starting the medication.
- Using breastfeed while weaning the baby from the breast. Breastfeed can be used as a supplement or add-on feed when the mother wants to wean the baby from the breast.
- Enables mothers to relax. Feeding every 2 or 3 hours including night time can be very exhausting for the mother. Difficult labor or a surgery coupled with a tiring feeding schedule can take a toll on the mother’s health. Pumping and storing of breast milk can help to mother to relax for some time while someone else feeds the baby.
- Providing breast milk to multiple babies. In the case of twins or multiple babies, expressing breast milk and feeding to all the babies is a better option than round the clock nursing by the mother.
- Allows bonding between the father and the child. Feeding expressed milk to the child can enable other family members and especially the father to create a special bond with the child.
- Donate excess milk to a milk bank. Some mothers may be producing milk in far greater quantity than needed by their babies. Such mothers may choose to donate the excess milk to milk banks to be used by babies whose mothers can’t feed them their own milk.
Parts of Breast Pump
A breast pump consists of 3 basic parts:
It is a cone-shaped cup that fits over the nipple and the areola.
The pump is attached to the breast-shield either directly or through plastic tubing. It creates a gentle vacuum that helps to expresses milk.
It is a detachable container attached below the breast-shield. Milk is collected into this contained after being pumped. A reusable bottle or a disposable bag can be used as a milk container.
Parts of Breast Pump
a: Breast Shield b: Pump c: Milk Container
The breast shield creates a seal around the nipple. Applying and releasing suction to the nipple through the pump expresses milk from the breast. Each suction and release combination is called a cycle. The expressed milk is collected in the detachable container which is then stored.
Types of Breast Pump
There are 3 types of breast pumps. The difference in these is the manner in which the pump is operated. The breast shield and the milk container have essentially the same structure in all the types.
It consists of a handle or lever which is manually operated to create suction and express milk from the breast.
Battery operated Pump
It consists of a motorized pump which is operated by batteries.
It consists of a motorized pump which is operated by electricity.
One or more long tubes are present which connect the breast-shield to the electric pump. A control panel is present on the pump which helps to regulate the speed and the amount of suction applied to the breast.
Two types of electrical pumps are known
Hospital-grade electric breast pump
It is used in hospital settings and can be safely used by multiple women. It is the most efficient, easiest, and fastest type of pump. It is a double pump that is it can empty both the breasts at the same time. However, it can also be used to drain one breast at a time. It takes about 10-15 minutes to empty both the breasts using this pump.
Personal electric pump
It is for personal use and is to be used by a single person. It is smaller in size. more handy and convenient to use by working women or during traveling. However, it is less efficient as compared to a hospital-grade pump.
Single-sided and Double Pump
A single-sided pump is used to pump milk from one breast at one time. Double pump, on the other hand, extracts milk from both breasts at the same time.
If you want to use pumping occasionally, a single-sided breast pump may be the best option. If pumping is required more frequently or used to maintain your milk supply, then it is better to go for a double pump.
Open System and Closed System Pump
In an open system pump, there is no barrier between the milk container and the pump. This means that milk is exposed to the outside air which is drawn through the pump.
Any impurity found in the air such as dust, smoke, allergens, bacteria, or viruses can enter the milk container and contaminate it. Also, small milk particles can enter into parts of the pump and tubing and get lodged there. This contamination can go unnoticed. Also, it is difficult to clean many of these parts. So there is a risk of development of mold on these milk particles. This exposes the collected milk to contamination as the pump draws air through the moldy tubing and pump motor.
Open system milk pumps require thorough cleaning, sterilizing and air drying of the tubing.
Also called “overflow protection”, closed system pumps have a barrier between the milk container and the pump.
This doesn’t allow the milk to be exposed to the outside air. Also, there is no possibility of milk particles entering into the pump tubing or motor. This decreases the chance of mold growth and infectious particles keeping it free from contamination.
A disadvantage of the barrier is that it may reduce the amount of air/suction available to extract milk from the breast. In addition, the barrier may not be able to compensate for larger shield sizes.
Closed system pumps are considered more hygienic than open system pumps. Also, the need to regularly sterilize and clean the pump tubing is eliminated. They are however more expensive than open system pumps.
The first closed system breast pump, the Ameda HygieniKit was introduced in the market about 12 years ago in Purely Yours Breast Pump. Since then, several companies have developed closed system double electric breast pumps.
No definite studies have been performed to determine the supremacy of open or closed-system design. The literature manual provided by breast pump manufacturing companies gives information without studies to back them up.
Some of the examples of closed system pumps are: Ameda (Elite, Platinum, Purely Yours), Medela (Lactina, Symphony), Lansinoh (Signature Pro, Smart pump), etc.
All Medela pumps except Lactina/Symphony and older hospital grade pumps are examples of open system pumps.
How to Choose a Breast Pump
Every breastfeeding mother may not need a breast pump.
If you plan or need to use one, you need to choose the right breast pump for yourself. It is best to wait to buy a pump until after your baby is born; so that you know your individual needs.
The type you should choose depends on how often, how long, and where you intend to use it and the reason for using it.
Depending upon the frequency of use, feeding mothers can be either minimally, partially or completely breast pump dependent.
Minimally breast pump dependent means that you use the breast pump only occasionally. In such cases, a less durable, cheaper and a less efficient pump like personal use – manual or battery pump will be able to serve the purpose. Manual pumps are quite cheap as compared to battery or electric operated pumps.
Partially or completely breast pump dependent means that you are pumping milk using a breast pump for the majority of the time and you depend on it for providing continuous stimulation to your breasts to continue with milk production. In such a case, you need a more efficient, convenient, time-saving and durable pump like that of hospital grade or electrical personal use pump.
If you have no plan of giving expressed milk to your baby but would like to buy a breast pump just in case you might need it for engorged breasts or sore nipples, it is best to go for a manual pump.
A manual breast pump can also be used to draw out flat or inverted nipples before breastfeeding.
If you plan to use the breast pump only occasionally like brief occasional separation from your baby then also a manual pump should be able to meet your basic pumping needs.
If you are a part-time worker and need to pump daily for 1 or 2 feeds, you can opt for a handheld electric pump.
In case you are planning to return to work and need to express milk for most of your baby’s day time feedings, then it is best to go for a good quality electric breast pump. A good quality, double electric breast pump will allow you to express milk quickly and efficiently from both the breasts simultaneously.
If you need to increase or maintain your milk supply using a pump, you need to use a good quality, personal electric pump or hospital grade pump to frequently express milk and empty your breasts. Also, double pumping should be carried out for better stimulation of the breasts.
If pumping is carried out for feeding a premature or sick infant who is unable to feed, a hospital grade pump may be necessary.
If you need to travel a lot and would like to pump milk during traveling, manual and battery-powered pumps should be preferred since they are easy to transport and don’t require much space. Electric pump, on the other hand, would require an outlet for providing electricity. Electric pumps are also larger and heavier and difficult to transport.
In case of emergency situations, when electricity or extra batteries are not available, a back-up option of a manual pump may be needed to maintain your breast pumping schedule.
While buying a breast pump, remember to buy one whose breast-shield opening has the correct size for you. The nipple should be centered inside the breast-shield comfortably. Some pumps come with a standard “one size fits all” breast shield. If you are not comfortable with that size, you need to contact the manufacturing company to see if they can replace it with a different size.
Hospital-grade pumps are available for rent through many hospitals and lactation consultants.
How to Use a Breast Pump
- Read the instruction manual carefully to know about the specific model you are going to use.
- Wash your hands thoroughly before pumping. Also, make sure that all the parts of the breast pump are clean.
- Keep everything you will need including storage containers, clean cloth for soaking any spill, etc nearby.
- Be completely relaxed and comfortable. You can keep your baby close to you to trigger the release of milk releasing hormones. If your baby can’t be close to you, thinking about your baby can also serve the same purpose.
- Make sure the shield is centered over the nipple.
- It is better to wear a specially designed breast pumping bra which holds the breast pump in place while allowing you to keep your hands free.
- If you’re not using a pumping bra, you will need to hold the breast shield with your hand.
- Start pumping. You can initiate your let down by either gently massaging your breast or putting a warm compress over the breast.
- Once the milk starts coming, adjust the speed and rate of suction according to your own comfort. The process of pumping should not be painful at all.
- Once you have finished pumping, remove the breast shield.
- Remove the milk container, close the cap or seal it properly.
- Clean the parts of the breast pump and let them air-dry.
- In case of any doubt or concern, consult a lactation consultant.
Storage of Expressed Milk
Milk extracted with the help of breast pumps is directed into the container and stored there.
It can be given to the baby with the help of a bottle.
Excess milk can be stored in a refrigerator to be used later by the baby. It can either be frozen directly in the bottle or stored in disposable breast milk bags.
Breast milk is safe for consumption if:
- Kept at room temperature for up to six hours ( around 20o C)
- Refrigerated for up to 8 days
- Frozen for 12 months in a deep freeze ( −18o C).
It can also be donated to milk bank which provides human breast milk to babies whose mothers cannot provide them with their own feed due to any reason.
How to Thaw Stored Breast Milk
The milk storage bags or bottles can be put in a bowl of hot water to thaw the milk. This is an easy and inexpensive way to thaw stored milk and also ensures that milk is not overheated.
If you want to heat it faster you can use power warmers; many of which come with timers. It is better not to heat milk in a microwave as it tends to overheat the milk.
Before feeding milk to baby, make sure to test its temperature by placing a drop on your inner wrist. If it feels comfortable, then it is at the right temperature for your baby.