Milk Expression

If you are expressing milk after you have established a full milk supply, a personal pump such as a Hygeia Enjoi, an Ameda Purely Yours or a Medela Pump in Style will likely be adequate for your needs.  If you are establishing a milk supply for a baby who is not directly breastfeeding, a multi-user pump will likely be necessary.  This type of pump is also referred to as a, “hospital grade pump.”

Be sure that you check and change membranes and tubing as needed and have properly fitting flanges.  Your nipples should fit well into the flanges with just a little space between your nipple and the flange.  Your nipples should not rub the sides of the flanges.  If a there is a lot of space between the sides of your nipple and the flanges and areola is being pulled into the flange, this would indicate that the flanges are too large.

http://www.ameda.com/breast-pumping/getting-started/flange-fit

http://www.medelabreastfeedingus.com/assets/file/1908488_RevA%20Breastshield%20Sizing%20Tool.pdf

After finding your correct size, you may want to experiment with flange sizes to find which remove the most milk and/or is most comfortable.  Some individuals have better success with alternative type flanges such as Pump in Pals.

Before begining to pump try these techniques developed by Chele Marmet for hand expression.

-Massage your breasts in concentric circles as when doing a breast self exam.

-Draw the backs of your fingers or a comb across your breasts from the chest wall to the nipple all around your breast.

-Lean forward and shake your breasts.

Use reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC) until you see drops of milk, then apply the pump.

Use hands-on double pumping. Whenever milk flow slows, take the pump off and repeat massage techniques including the reverse pressure softening and re-apply the pump. Try to do this cycle three times.

Hands on pumping:

http://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html

Reverse pressure softening (developed by K. Jean Cotterman RNC-E, IBCLC):

http://www.youtube.com/watch?v=tCWisBRmzpw&feature=c4-overview&list=UU3ttCe8WtZqHsCorrY6VJkg

Some individuals find it difficult to relax enough for their milk to let down well. There is an audio galactogogue available on i-tunes for free download that may help.

http://bfmed.wordpress.com/2011/04/14/now-on-itunes-an-audio-galactogogue/

If you only have single pumping capacity, just switch back and forth between breasts a few times using all the techniques in this article.  If you do not have a pump, use these techniques and then hand express.

http://www.bfmedneo.com/BreastMassageVideo.aspx (from Breastfeeding Medicine of Northeast Ohio)

http://ammehjelpen.no/handmelking?id=907  (video created by the Norwegian mother to mother breastfeeding support organization, Ammehjelpen–scroll down for English video)

http://newborns.stanford.edu/Breastfeeding/HandExpression.html

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