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Pumping Breast Milk 101

Medically Reviewed by Dr. Pierrette Mimi Poinsett, MD
What you need to know to get started with breast pumping.

As a breastfeeding mama, the breast pump is one of your most trusted allies. It allows you to create a freezer stash of your precious milk, helps relieve engorgement, and can also help you maintain your milk supply. But choosing the best breast pump is only the first step of many you’ll need to master to maximize the benefits you receive from this handy little machine.

In this guide, we’ll discuss the basics of when to start pumping, how to use your pump, and some of the frequently asked questions you might have right now.

When Should I Use My Breast Pump?

Women who are only pumping occasionally and are feeding their babies directly from their breasts most of the time should pump milk in the morning where they are likely to get the most. Space breastfeeding sessions with pumping sessions by about an hour. You can either pump an hour before you expect your baby to be hungry again, or an hour after she breastfeeds. That will give you milk for both sessions (1).
Women who are only pumping and aren’t doing any actual breastfeeding should pump about every 2 and a half to 3 hours — efficiently emptying your breast milk signals your body to make more.

How Do I Use a Breast Pump?

How you use your breast pump will depend on the type of pump you choose (manual or electric).

Manual pumps are cheap, small, portable, and easy to operate. Because you are the one supplying the manpower to express your milk, you’ll only be able to do one breast at a time so it might be best for moms who are only going to pump occasionally.

Moms who are going to be pumping a lot will want to consider a double electric pump that will allow them to pump both breasts at once. It’s a time saver being able to pump both at once, and you won’t have to do any work. They are much more expensive however than manual pumps.

How to Use a Manual Breast Pump

  1. You need to encourage what is known as letdown. Letdown is milk moving from the back of the breast to the front. You can gently massage your breasts or place a warm washcloth on your breasts to encourage letdown.
  2. Cover your nipple with the breast shield and make sure it forms a tight shield.
  3. Use one hand to hold the shield in the correct place, and start squeezing the handle of the pump with the other hand.
  4. If milk isn’t wanting to flow, lean forward, and put gravity to work.
  5. Keep pumping until your flow starts to slow.

How to Use an Electric Breast Pump

  1. Cover your nipple with the breast shield. Do the other side as well if you are using a double pump.
  2. Then you turn the machine on.
  3. Pay attention to your comfort level. If the suction level hurts, turn it down. If your milk is coming out too slowly, turn up the suction.
  4. Once your milk starts to slow, turn off the machine and break the vacuum of the pump with your finger.

Other Important Tips to Remember

  • No matter which pump you use, you need to make sure your hands and pumping equipment are clean before you begin.
  • Your milk won’t come out immediately – it’s not like turning on a faucet.
  • Don’t pull off the breast shields while your electrical pump is still on unless you love pain. Instead, turn off your pump. The suction will be gone, but the shields will still be suctioned onto your breasts. Use your finger to break the seal, then gently remove the breast shields.

What are Breast Shields?

Breast shields are one of the most important breast pump features. Proper fitting breast shields, also called flanges, are crucial to your success while pumping breast milk. Breast shields are the cups that you put on your breasts.

You choose your size of breast shield on the size of your nipples, not the size of your breasts. And if you’ve used a different pump in the past, don’t depend on the size of breast shield you once used. Sizes of flanges aren’t uniform from brand to brand, and your pre-birth nipples may not stay that size after you have your baby.

When Size Matters

If you get a flange that is too tight, you can scrape and hurt your already sore nipples. It can be so painful that it might even cause you to reconsider whether you want to breastfeed at all.

You don’t want to purchase a flange that is too big either. Because your breast, not just the nipple, will be sucked in. That can mess with the flow of your breastmilk. Breastfeeding can be difficult enough without your milk supply dwindling.

If you begin breastfeeding and the process is painful rather than just uncomfortable, you should reevaluate the size of breast shields you are using in case they are the wrong size.

How Do I Clean a Breast Pump?

Some pumps may have separate instructions for cleaning, and some will be easier to clean than others.

But, in general, you’ll want to rinse every individual piece that comes in contact with breast milk with hot water, or wash them with soapy water before rinsing them well. Some pieces can be put in the top rack of the dishwater as well (2).

Let the pieces air dry. Some breast pump pieces for certain brands can be sanitized in a baby bottle sanitizer or a bag in the microwave.

Tips for breast pumping hygiene:

  • Avoid creams, lotions, or nipple creams that are scented.
  • Change your breast pad at least twice a day, if you’re using them.
  • Wear light, loose clothing made of breathable natural fabric.
  • Wear a clean nursing bra every day.
  • Wash your hands before every feed.
  • Clean your breast pump as soon as possible after using it.
  • Shower frequently, and give your breasts a quick wash before a feed if you’re sweaty from exercise.
  • Use warm water to rinse nipples throughout the day, and dry with a clean, soft towel.

Tips for Expressing More Milk

Your breasts work on a kind of feedback system: when they’re full and there’s nobody to drink the milk, your body gets the message and slows production. If, on the other hand, milk is flying off the shelves faster than your body can restock it, so to speak, supply will increase to match.

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This means that if you want to increase supply, you need to remove milk from your breasts often, rather than waiting for them to fill up (3).

Even if your baby isn’t drinking yet, keep on expressing milk so that you establish a regular supply. It’s tempting to think that the more you pump, the less there will be for your baby, but it’s actually the opposite. Getting used to regularly draining and refilling your breasts means your body is more able to adjust to your baby’s needs.

Besides, if you do pump and end up with extra, it can always be frozen. Focus on maintaining an even, steady flow and you’ll soon come into sync with your baby.

Other Pumping Tips & Hacks

As long as your baby is gaining weight on your milk, you’re producing enough (4). But if you’re worried your supply is low, here are some other things you can do to increase it:

  • Efficient nursing: Firstly, make sure your baby is nursing well and has a good latch, since a suckling baby is the best way to drain your breasts thoroughly and completely.
  • Nurse frequently: Aim for every 2 hours during the day and every 3 hours during the night.
  • Galactagogues: Try using a substance that can increase milk supply (however, always consult your doctor before taking new medication while breastfeeding).
  • Pump to increase supply: Try pumping for a few minutes after the last drop to encourage flow.
  • Keep healthy: You need a balanced diet with plenty of rest and fluids anyway, but even more so when breastfeeding.
  • Alternate: Offer both breasts at feedings and switch sides during a feed to encourage even milk supply.

Frequently Asked Questions

Are Breast Pump Covered by Insurance?

Generally, yes, although your insurance provider may have some fine print. Breast pump rental and lactation consultants are all covered as part of the Affordable Care Act if you joined after 2010, but you may not always be reimbursed for the purchase of a new one.

The downside is that you may need a doctor prescription and you may not get to choose the pump you get, or will have to hunt one down from the right supplier. The first step is to call your insurance company and ask.

Some insurance companies require you to first buy or rent the pump from a pre-approved store before they reimburse you. Others require you to go through an application process and will send the pump directly to you, providing you qualify.

Can Pumping Damage Breasts?

The wrong setting on a breast pump can definitely be one of the factors causing pain. A suction that is too hard can cause trauma to the delicate tissues of the breast, although in most cases this doesn’t last.

Pumping too much or too often can also disrupt your flow, causing an overactive letdown or leaking as the body fills with the necessary breastfeeding hormones. Over-pumping can also lead to swollen breasts or blocked milk ducts, which can cause further issues.

More serious tissue damage will only happen if you push yourself too far and ignore the pain signals your body is sending you. Long-term breast damage is a possibility if you pump too hard for too long, but this is easily avoided if you choose only a comfortable setting and don’t pump more than you need to.

Can Pumping Cause Mastitis?

Clogged milk ducts can cause one of your breasts to swell up with inflammation. This is called mastitis, and as you can imagine, it’s pretty painful. You may also experience flu-like symptoms.

The treatment for mastitis is pain medication, warm compresses, rest, plenty of fluids, and doing whatever you can to keep your milk ducts clear and open. This means that pumping may help ease mastitis, even if it does feel a little uncomfortable.

Pumping is seldom responsible for causing mastitis unless you are over-pumping and aggravating your milk ducts so that they become clogged. If you experience mastitis, keep expressing milk one way or the other until the ducts clear.

Can Pumping Reduce Milk Supply?

Usually, no. Breast milk flow is encouraged and maintained by nipple stimulation, but this can come from your baby during breastfeeding or from the breast pump you use. Match your pumping schedule to your baby’s hunger and you will not reduce your supply unnecessarily.

Are Breast Pump Flanges Universal?

Nope! Breast milk flanges come in different sizes to fit the size of your nipple (note: not the size of your breast).

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Headshot of Dr. Pierrette Mimi Poinsett, MD

Medically Reviewed by

Dr. Pierrette Mimi Poinsett, MD

Dr. Pierrette Mimi Poinsett is a veteran board-certified pediatrician with three decades of experience, including 19 years of direct patient clinical care. She currently serves as a medical consultant, where she works with multiple projects and clients in the area of pediatrics, with an emphasis on children and adolescents with special needs.