• Shruti GOCHHWAL

Breast Milk Pump: How To Use It & All Useful Related Information

Breast pumps have been around for almost a century. However, over the past 20 years, they have gained in popularity and could be considered an asset for breastfeeding mothers.

Expressing breast milk for infant feeding is one way that mothers can address some of the common issues cited as reasons for discontinuing breastfeeding. These include decreased supply, concern about infant nutrition and weight, inadequate latch, mother or infant medical conditions, and returning to work or school.

The breast pump has become a nearly ubiquitous fixture in our society, used not only in maternity hospitals but also at work and at home.

A wide variety of reasons exist for expressing milk, the most common of which are: (1) to allow other caregivers to provide breastmilk, (2) for an emergency supply and (3) to relieve engorgement.

Women learn about pumping from friends, family, online and print resources, and health professionals. As breast pumps continues to evolve and the number of women using them remains a substantial majority, health care professionals need to maintain a thorough understanding of this tool and relevant techniques to help mothers succeed.

Why and how is breast pump used?

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breast milk pump


Lactating mothers commonly use breast pumps to allow for regular human milk expression and collection despite separation from their breastfeeding infant. Most women use an electric breast pump and are provided with a compatible equipment kit from the same manufacturer. Kits contain breast pump tubing, breast shields (also referred to as flanges), valves with diaphragms, and collection bottles.

They are designed by the manufacturer to be used with their matching breast pump model to provide optimal milk expression and comfort. The tubing, valve, and diaphragm create the vacuum suction pressure that is required to drain the breast. The volume of milk expressed by the breast pump is determined by the vacuum suction pressure and the cycle frequency generated by the pump and the amount of breast fullness.

Poor suction pressure can limit milk expression leading to early termination of breastfeeding. Extreme suction pressure can cause discomfort and breast injury and affect long-term breastfeeding success. Despite manufacturer recommendations, breastfeeding expert advice and differences in pump design, some women interchange kits between different manufacturers of breast pumps. Currently, there are no studies that evaluate whether interchanging the brand of kit impacts breast pump performance.

Lactation is dependent on repetitive milk expression that empties the breast and results in release of prolactin and an increase in milk production. Breast pumps are designed to mimic infant oral suction pressure and suckling rate to empty the breast. By frequently pumping, a mother who is separated from her infant can successfully maintain lactation and provide breast milk to her infant. However, low vacuum pump pressure can be ineffective at fully emptying the breast that can lead to lower total milk expression or delay the onset of lactation

Types of Breast Pumps

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breast pump


Breast pumps are either manual or electric. Most women in the United States use electric breast pumps.

MANUAL PUMPS

Manual pumps are operated by the hands or feet with repetitive pushing or squeezing of a device to generate vacuum. They are lower in cost than electric pumps, quieter, and easier to transport. Because they do not require electricity or a battery, they are convenient to use in a variety of places. The majority of manual breast pumps are single-sided. Expressing milk from one side at a time is usually a slower process than expressing milk from both breasts simultaneously using a double-sided electric pump.

Studies do not consistently show that electric pumps express higher total volumes than manual pumps. A manual pump is a good choice for a mother who does not use a pump very often, as they are inexpensive. It might not be an ideal choice for a mother who has time restraints when expressing milk at work, or a mother who is exclusively pumping and bottle feeding an infant.

ELECTRIC PUMPS

These pumps use electricity or batteries to generate its cycles and vacuum, and can be categorized as personal-use pumps or multiuser pumps.

PERSONAL-USE PUMPS

Most electric pumps fall into this category and are not designed to be used by >1 person. These pumps are often described as having an open system. These pumps are at risk for contamination of filters and non-replaceable parts, which can pose the risk of pathogen infectivity from one user to another.

MULTIUSER PUMPS

These are often called hospital grade pumps because they are used by mothers in the hospital. Each mother attaches her own unique pump kit to the pump. The design of the pump prevents contamination from one user to another. These pumps tend to be more expensive than personal-use electric pumps, precluding ownership by most lactating mothers.

ADJUSTABLE SUCTION PRESSURES AND CYCLE SPEED

Nearly all pumps, both electric and manual, allow the mother to alter vacuum pressures. However, many pumps will automatically increase the cycle duration as the vacuum pressure increases, causing the cycles to be longer duration and slower in frequency. Conversely the same pumps decrease cycle duration with lower vacuum pressure, causing the cycles to become shorter and more frequent. Sometimes this relationship between vacuum pressure and cycle duration/ frequency is not desired, so the mother may want to obtain a pump that allows for adjustment of both suction pressures and cycle speed independently of each other. There is not a single pattern of pump efficacy that is ideal for all mothers. Mothers vary in terms of their response to the relationship between cycle frequency and vacuum strength.

PRE-PROGRAMMED SUCTION PATTERNS

Many electric breast pumps have a pre-programmed stimulation phase that is shorter, faster, and lower vacuum as compared with the expression phase. The stimulation phase is designed to mimic the sucking pattern of a baby when the milk flow is slow. Depending on the pump, this phase may automatically begin as soon as pumping is initiated, or can be chosen at any time during the pumping period. Some pumps without a pre-programmed stimulation phase have an option to control both the vacuum and the rate of suction (limerick website), thereby allowing the mother to manually create a stimulation phase.

BREAST SHIELDS

Breast shields tend to be specific to the pump. Some pumps have a flexible 1-size fits-all shield meant to fit all users. Other pumps come with 1 or 2 standard breast shield sizes, with additional sizes available for purchase. There are no proven guidelines on proper fitting of breast shields. Breast shields should be comfortable, provide an appropriate seal, and not cause trauma to the breast or nipple/ areolar complex. Flange size requirements may change during lactation as the mother’s breast shape and size fluctuate, and a woman may even require a different size for each breast.

PUMP KITS

Most double electric breast pumps come with a separate pump kit that attaches to the breast pump. The pump kit is unique to the pump, and usually cannot be used with a different manufacturer’s pump. Some companies include a hand pump in the pump kit. All pump kits include information on how to clean the pump accessories

Many lactating mothers do not nurse their babies, and instead express their milk by manual or pump expression. Health care professionals who gain familiarity with the physiology of lactation and breast pump technology are in a better position to educate mothers on establishing and maintaining adequate lactation, as well as safe weaning.

Is it worth buying a breast milk pump?

Is it painful to use a breast pump

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Yes, definitely. Considerations When Choosing a Breast Pump Factors Suggestions

  1. Lowest cost Manual pump

  2. Intermittent use for a stay-at-home mother Manual pump

  3. Primary need is to increase milk supply Double electric pump

  4. Ill or premature infant in the hospital Hospital grade electric pump

  5. Mother is back to work Double electric pump Infant primarily receives bottles of expressed milk Double electric pump

  6. No access to an electrical outlet Manual or battery operated pump

Lactating women are similar in terms of milk expression dynamics. However, women are unique in their response to individual pumps, such that 1 particular pump style or brand is not optimal for all mothers. Recommendations for milk expression need to be adapted for several situations, such as engorgement, infant prematurity, back to work, and infant adoption.

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