If you are having a baby and planning on breastfeeding, you may want to consider buying a breast pump. The most valuable time to have a breast pump is generally in the first few days after having a baby. So if you’re going to invest in one, do so early.

Consider buying a breast pump if you’re planning on breastfeeding and…

You’re going to go back to work.
You want to be able to leave your infant for more than three hours (you could use formula for the baby, but your breasts will still need emptying).
You ever have to have surgery (you will be advised to “pump and dump”).
You’re going to have more than one child.
Your baby is premature (premie babies often can’t feed initially).
You have anything unusual about your anatomy that may make it hard for a baby to feed directly (inverted nipples, etc. – although, sometimes a nipple shield can help with some of those problems)

Features of a good pump.

I once went to a medical conference when I had a breastfeeding baby at home. I dutifully took my pump, but realized when I got there that I was missing a piece to make the pump work. After traveling for hours, I was dying. It was in the middle of the night and no baby stores were open. The only place open was a 24-hour Walgreens. I bought a cheap hand pump and resolved to hit a lactation store to get the missing piece the next morning. After 40 mins of hand squeezing the dumb pump, I only extracted a small fraction of the milk and my hand muscles were seriously cramped. Needless to say, the hand pump went in the hotel garbage. I learned a valuable lesion that day. When it comes to your boobs, buy the best. Words to live by. Nothing works better than a good, double-electric pump. Be prepared, they can be expensive. (However, some insurance plans are now covering them, so it may be worth asking your insurance company). I bought the Medela Pump in Style Advanced Breast Pump. Although, I bought it 9 years ago, it’s still one of the best pumps on the market. I’ve used it 5+ times a day for over a thousand total days and it has always worked (that is, when I have all the pieces) without problems.

Most women at some time during the breastfeeding experience question how to increase or maintain breast milk supply. The short answer is that breastfeeding is a complete “supply and demand” experience. The body is an amazing machine; if you feed a lot (that is, breastfeed a lot), it will make a lot. How else can we explain women that make enough to feed twins or triplets? So to make more, you have to feed more. As simple as that sounds, there are a few tricks to try.

Timing

The key time to establish a good milk supply is at the beginning. Frequent, effective feeding will really drive your milk to come in. You must stimulate the milk to come in. This is ideally done within the first few hours after birth. If your baby isn’t a great feeder, has problems, or is otherwise unable to eat (e.g., a premie in the NICU), you can “trick” your body after birth into making lots of milk by pumping. Typical newborns feed every 1-3 hrs for 20 or so minutes. If you are going to pump, you must do so as often as a baby would feed. If you want to make milk for twins, you must feed/pump twice as much.

Pumping

Sometimes, when a mom experiences a dwindling milk supply or experiences a problem (e.g., mom or baby got sick) that affects her milk supply during the breastfeeding experience, I will recommend something I call power pumping. Once again, it is the concept of trying to trick your body into making more milk. Know in advance that it is a lot of work/time commitment and doesn’t always work. This is how to do it: pump an extra time for every time your baby eats. Take for example a baby that feeds every 3 hours. First, breastfeed your baby. About an hour later, pump both sides of your breasts (the key is to pump for 3 minutes beyond when there isn’t any more milk coming out, to get any remaining hind milk). Then two hours after that, feed your baby again. The cycle just repeats itself. I typically recommend doing this for 24-48 hours. If your breasts will respond to extra stimulation, you will see an increase in the amount of pumped milk throughout the power pumping.

Drugs

Drugs or medications can increase or decrease milk supply. The most common medications that lactating women unknowingly take which can decrease milk supply include: combination birth control pills (it is usually the estrogen component that creates problems) and antihistamines/allergy medications (esp. those with pseudoephedrine). As for which drugs increase milk supply, there is a drug called Reglan (a.k.a., metoclopramide) that is sometimes used. However, the drug does have a black box warning on it, so I tend not to recommend it. There are also a few other drugs (not commonly accessible in the U.S., so I will not elaborate here). Some women have success with an herb called Fenugreek. If I were to use an herb, this is probably the one I would use (it has a good safety profile and is fairly effective). There are other herbs of note like alfalfa and blessed thistle (I have less experience with them and the safety profile is a bit less established).

Taking Care of Mom

Probably the most important aspect of milk production is appropriate care of the woman producing the milk. Lack of sleep, stress, and not eating well (doesn’t this sound like all new moms) can all contribute to less milk supply. I acknowledge that it is easier said than done, but try to get sufficient sleep. Eat well (especially high-protein foods). Consume enough calories (moms eager to lose baby weight may have strict diets that inhibit their body’s ability to make a good milk supply). Drink lots of water. Decrease your stress load. Stay healthy. All of these things will increase your milk supply.

Age of The Baby

Most babies start solid foods around 6 months of age. Since breast milk production is a supply and demand thing, most babies “demand” less milk as they eats solids. Consequently, most women gradually start to make less milk. You can help offset this effect by having other care givers feed more solid foods when you are not around, so you can breastfeed more when you are around.

Relax

Ultimately, relax. If you don’t make enough milk to feed your baby, it is ok. Many women have this “all or nothing” approach to breastfeeding. The truth is, any amount of breast milk you can give your baby is good. Certainly, something is better than nothing. Do what you can and use formula for the rest. It’s ok, you’re doing great.

Tag: pumping

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