Learning to Pump Effectively
Because it may take some time before the baby can fully breastfeed, parents need information about how to pump effectively. Rental grade breast pumps are the most reliable for establishing a milk supply. Many hospitals have lactation departments that rent pumps, or will direct parents to medical supply stores. It is best to begin pumping as soon as possible after the baby arrives—ideally within the first 24 to 48 hours. Double pumping increases prolactin, the milk-making hormone, and is a great time saver.
Try to use the pump to imitate the nursing frequency of a term baby. This means at least 6 pumping sessions per 24 hours. Most mothers find that 8 daily pumpings gives the best results. Pumping sessions should last about 15 minutes. Robust stimulation in the early days will pay off by providing a full supply that can adapt as the baby grows.
Stress can make pumping seem difficult, but parents are creative! Some tape a picture of the baby to the pump to help them stay focused. One doctor suggests placing a few chocolate kisses on top of the pump as a reward. Some moms watch funny videos or listen to music while pumping. Other moms try using relaxation techniques and guided imagery. (Think pleasant thoughts of flowing streams!)
Pumping technique can make a difference, too. Set the pressure at a comfortable level. Lubricate the opening of the pump flange with expressed milk or sterile water to prevent skin abrasion. Make sure that the size of the pump flange is a good match for the size of your nipple. Some pump kits have adaptable flange sizes. If the nipple appears to fit too tightly in the flange opening, milk flow may be impaired and you should seek a larger size flange.
Use gentle breast massage before pumping and turn off the pump periodically to massage again. This combination of manual and mechanical stimulation increases the amount of milk a mother can pump. If possible, purchase an extra pump kit so that one kit is always clean and ready to use.
Maintaining The Milk Supply
Fathers can be an enormous help cleaning kits and giving encouragement and back rubs. Moms should take naps, rest whenever possible, eat well and drink to thirst. Don't forget: kangaroo care is a proven way to increase milk production.
Some mothers have had good luck using herbs to increase milk supply. Fenugreek and blessed thistle are two traditional herbs with few side effects that can help mothers make more milk. They can be taken in capsule form (generally two capsules of each herb at each meal) or purchased and prepared as teas. Occasionally mothers will report headache while using fenugreek. Hypoglycemic or diabetic women should avoid this herb. A prescription drug, metoclopramide, has successfully been used to stimulate milk supply, although it has significant side effects in some women. Mothers with a history of depression should not take metoclopramide. And of course consult your doctor and your child's doctor about these supplements.
Some maternal medical conditions, previous invasive breast surgery, smoking, and some hormonal contraceptives can reduce milk supply, so be sure to consult your doctor if milk supply problems persist.