Hand expressionis used by most of the world’s women. It takes some practice, but can be quick and easy, and your hands are always available… and free. Massage your breasts and shake them gently. Put your thumb on one edge of your areola (the darker part around your nipple) and two fingers on the opposite edge. Press back toward your chest. Now press your fingers toward each other and draw them out away from your chest. Don’t slide your fingers on your skin; slide your skin over the underlying tissues. After a few repeats, shift your fingers to new positions on the edge of your areola and continue. When you see milk spurt, you’ve got it right.
Rental pumpsare usually the most effective pump besides a baby. The heavy ones are better if you’re pumping for a baby who doesn’t nurse, but most working mothers do fine with somewhat lighter ones. Rental cost is usually under $200 for 5 months – about the same as 2 months of formula, not counting formula-feeding’s added medical costs. If there are mechanical problems, the rental station is responsible. With the right attachments, all rental pumps allow “double pumping” – both sides at the same time – which reduces the time and often yields a bit more milk. Rental pumps don’t lose suction or speed when you change to double-pumping. You can double-pump with hands free if you buy a snug sports bra and cut a hole at each nipple just big enough to slip the pump funnel through. Almost all women are happy with a rental pump, and it is usually the best choice if you need a pump to help with a breastfeeding problem. For the name of a rental pump provider near you, two good starting points are Medela (1-800-TELL YOU or www.medela.com) and Ameda (www.ameda.com).
Pumps for purchase vary greatly in quality. Very lightweight ones may be fine for an occasional bottle but are unlikely to suit a working mother. It takes a lot of power to mimic a baby’s suction (maximum about -220 mm Hg) at a baby’s speed (about 1 per second). Most small electric pumps can manage only one or the other. Look for a pump with a one-way valve or membrane somewhere between the motor or piston and the bottle. That means the amount of suction won’t change if the size or fullness of the bottle changes. Avoid a pump that simply adds extra tubing for double pumping. If nothing else changes, the suction will drop when you try to double pump. Any pump should release its suction automatically, to avoid hurting your breast. If you must buy and keep a pump without being able to try it, look elsewhere. Expect to pay $300 or more for a really good pump. Occasional-use hand pumps may be available for much less. Some mothers buy a one-handed hand pump and, if they like it, buy a second one so they can double-pump.
Breast flanges(the funnel part) vary in size, just as mothers do. If a standard flange is uncomfortable, talk with a breastfeeding helper about trying a larger diameter funnel.
The pump company makes a difference. A company that also makes bottles or formula often makes more money if its pump helps breastfeeding fail; a company that makes only breastfeeding products will fail if its pump isn’t good.
Above all, remember that by far the simplest, most enjoyable way to get milk out
is with a correctly nursing baby, so be sure to get the help you both deserve.
©2006 Diane Wiessinger, MS, IBCLC www.normalfed.com