• You or your baby are ill.
• You are going to return to work.
• You need to be away from your baby for a period of time.
• You wish to have others feed your baby.

When to begin to pump:
If you can, wait to begin pumping until your baby is 3 weeks old, unless you are pumping to relieve engorgement or to increase milk supply. This gives you time to establish a good milk supply and for you to feel comfortable about your milk supply.

Times you may want to pump:

• One hour after a morning feeding.
• If you are using an electric or battery pump, you may pump one breast while your baby nurses on the other side.
• If your baby takes a 4-hour nap at a certain time, you may pump every 2 hours during the nap.
• Pump before you go to bed, or in the middle of the night if you wake up with full breasts.
• Pump at work in place of nursing.

How often to pump:
Many women pump at least every 2 to 3 hours during the day or at the times their babies would normally have breast-fed. This type of schedule will help keep you comfortable and maintain your milk supply.

How long to pump:
The average time is 10 minutes on each breast once the milk starts to flow (about 10 to 15 minutes total if double pumping). You may pump longer if you still feel full. Most women pump until they feel comfortable. You will probably notice your milk supply is greater in the morning when you are well rested and your hormone levels are
the highest.

Before you start to pump:
Here are a few hints to make pumping easier:
1. Have all your clean supplies handy.
2. Wash your hands with soap and water.
3. Take a warm bath or shower to help you relax and start your milk flowing.
4. Put a warm, moist cloth on each breast before you pump and during pumping.
5. Relax in a warm, comfortable place.
6. Lean forward and gently shake your breasts. A light fingertip massage or stroking of your breasts may be helpful.
7. Use the heel of your hand to gently stimulate the nipple in a circular motion. This will stimulate a “letdown”
of the milk.
8. Massage and express before you pump.
9. Moisten your breast to create a better seal with the shield.

During pumping:

• Look at a picture of your baby or think about your baby to help you relax.
• Drink fluids during pumping. Try nonalcohol, non-caffeine drinks.
• Listen to soft, relaxing music.
• Lavender scent as in aromatherapy may help with your let down.

How to pump:
Place the funnel over your nipple and areola. Hold the pump firmly in place. Sit up and lean slightly forward so the milk will flow into the bottle more easily. Each pump is different. It is important to check the
package instructions that come with your pump.

ELECTRIC PUMP:
1. Start on the lowest setting and increase the setting a little at a time.
2. Pump each breast at least 10-15 minutes, or longer if you still feel full. Pump at your Maximum Comfort Vacuum for efficient pumping. Continue to pump 2 minutes after the milk stop flowing to make sure you have adequately drained the breast.
3. Make sure the pump flanges fit correctly.

• The nipple should move freely in the tunnel.
• Minimal or no areolar tissue is pulled into the tunnel of the breastshield.
• The entire breast drains.
• The nipple is not painful or traumatized after pumping.

4. Break the suction by inserting a finger between the breast and the funnel.
5. If pumping is uncomfortable or nonproductive, call the Lactation Center and schedule a “Pumping Consult.” The
consultants will make sure your pump fits you properly for optimal milk removal. Most of all, be patient. Pumping like breastfeeding is a learned behavior that will improve with practice.

HAND PUMP:
1. Pump 10 to 15 minutes on the first breast.
2. Break the suction by inserting a finger between the breast and the funnel.
3. Pump the other breast for 10 to 15 minutes.
4. You may continue to go back and forth between breasts if you still feel full.

Amount of milk pumped:
The amount of milk pumped will depend on:

• Your baby’s age and strength of sucking.
• Your level of relaxation when pumping.
• Your diet.
• The amount of sleep or rest you are getting.
• The time of day. You will probably obtain more milk early in the day when your hormones are at a higher level. It is common to obtain less milk later in the day.
• How soon you pump after nursing.
• REMEMBER: Your baby is the best pump! Babies are better at obtaining milk than any pump.

Milk storage:

• Pump your milk into a clean bottle.
• After pumping, take apart all of the pump parts that came in contact with the milk. Wash the pump parts in warm, soapy water. Rinse well and air-dry.
• You may need to sterilize if your baby is sick or premature. Check this with your doctor or nurse.
• After pumping, store the milk in glass or plastic bottles. Fill the bottles only ¾ full, because breast milk expands when frozen. Cap the bottle tightly.
• Milk may be kept at room temperature (78° or lower) for 6 to 8 hours.

DISPOSABLE BOTTLE LINERS:

• Disposable bottle liners can be used, but it is better to use glass or clear plastic bottles if you can. These bottles keep the breastmilk from changing properties.
• Place liners in a freezer bag or use Medela™ bags made for freezing.

Refrigeration:

• Breast milk can be safely refrigerated for 8 days.
• After 8 days, discard unused milk.
• While at work, you can use a small cooler and ice packs to keep the milk cool. When you return home, refrigerate or freeze the milk.

Freezing:

• Milk should be frozen within 24 hours after pumping.
• Do not add warm breast milk to frozen breast milk. This will thaw the top layer and allow bacteria to grow.
• Cool your breast milk in the refrigerator for ½ hour before adding to frozen milk.
• Breast milk can be stored for 3 months in a standard refrigerator-freezer with the freezer set at 0°F. Breast milk can be stored up to 6 months in a deep freezer.
• REMEMBER: Your breast milk changes as your baby grows, so milk pumped now won’t be as perfect for your baby in 6 months.
• Store milk at the back of your refrigerator or freezer.
• Avoid storing your breast milk on the refrigerator or freezer door. Frequent opening of the door results in warming of the milk and increase in bacterial growth.
• Write the date and time on tape and place it on the bottle or bag. Use the oldest refrigerated milk first.

Using your breast milk:

• Breast milk can be thawed overnight in the refrigerator or by holding under warm running water. Thawed milk can
• be refrigerated for 24 hours, but never refrozen. Each time you defrost breast milk, it loses some of its antibacterial
• properties.
• Never defrost breast milk in a microwave oven; this damages its composition and forms hot spots that can burn your baby’s mouth.
• Warm the milk by placing the bottle in a pan of lukewarm water or run warm tap water on the bottom of the bottle or bag..
• Shake the thawed breast milk to mix the fat into the milk before feeding. Milk separates as it cools and creates a thick, yellow layer of fat on top and a watery layer on the bottom. This is normal. Your milk is NOT SPOILED.
• Check the temperature of the milk by dripping a few drops on your wrist. It should be lukewarm to the touch.
• Any milk left in the bottle at the end of a feeding should be used within 1 hour.