Module 1: Optimizing pumping

Introduction

• Optimizing pumping: Educational webinar focused on strategies for effective pumping in lactation care.

• Disclaimer: No conflicts of interest.

Importance of Pumping

• Reasons for pumping:

  • Patients may choose to pump exclusively or occasionally.

  • Building a freezer stash for convenience.

  • Addressing low milk supply (increasing supply through pumping).

  • Managing breastfeeding difficulties while maintaining milk supply.

  • Poor breast drainage during breastfeeding may prompt pumping.

  • Inducing lactation or relactating.

  • Returning to work, separation from infant (e.g., caring for twins).

  • Addressing issues such as clogging, engorgement, and mastitis (though pumping may not always be recommended in these cases).

Types of Pumping and Techniques

• Types of Pumping:

  • Hand expression

  • Manual pumping

  • Single pumping (one breast) vs. double pumping (both breasts)

  • Hands-free pumping (e.g., wearable pumps)

  • Hands-on pumping

  • Pumping while breastfeeding (collecting milk)

Hand Expression

• Preferred method in the first few days postpartum, especially for colostrum.

• Teach patients hand expression during prenatal consultations:

  • Technique:

    • Form a 'C' shape with fingers; press back, compress, and release rhythmically.

• Effective for patients with pain or when flange fitting is not yet available.

Manual Pumping

• Utilizes a manual breast pump; differs from hand expression.

• Convenient for mothers who may find it more comfortable or effective at times.

Hands-Free Pumping

• Popular due to convenience; encourages pumping on-the-go, but may have downsides for some patients.

• Monitor pumping output; may not be ideal for those with low supply who need more hands-on techniques.

Hands-On Pumping

• Combines pumping with breast compressions:

  • Flange applied correctly; compress and release to optimize output.

  • Benefits: Can increase output by over 50% in same time.

Pumping While Breastfeeding

• Clarify differences between pumping (using a pump) and collecting milk (silicone pumps).

• Recommend against silicone pumps in the first month due to potential issues in flow and stimulation.

Breast Pumps: Overview

• Categories of Breast Pumps:

  • Silicone Pumps/Collectors: Inexpensive and good for selective use, not ideal for all situations.

  • Manual Pumps: User-controlled; good as a backup or for infrequent use.

  • Electric Pumps: Can be single or double, with closed systems preferred.

    • Examples: Spectra, Medela, Novella.

  • Wearable Pumps: Convenient but may hinder visibility of flow/milk output.

  • Downsides include inability to easily switch flanges for sizing adjustments.

Flange Fitting and Settings

• Proper flange size/shape is critical to effective pumping.

• Assess fitting using nipple measurements; adjustments made based on comfort and output.

  • Experimenting with size or shape (cone vs. regular) may yield better results.

  • Lubrication may be required to prevent discomfort.

Optimizing Pumping Sessions

• Frequency and Timing:

  • Generally recommended pump frequency varies by infant age and feeding schedule.

  • Must pump when the baby is not breastfeeding (e.g., while bottle feeding).

  • Exclusive pumping recommendations:

    • 7-9 sessions in 24 hours for newborns, gradually decreasing with age.

• Management:

  • Ensure pumping aligns with breastfeeding to maintain supply.

• Active Pumping Techniques:

  • Switch suction modes to simulate natural breastfeeding behavior (letdown and draining).

Common FAQs

• How soon to pump after breastfeeding?

  • Ideally, pump thirty minutes after breastfeeding for optimal stimulation.

• How long should I pump?

  • Generally recommended 10-20 minutes, based on output needs.

• Are used pumps okay to use?

  • Yes for closed systems; check parts for replacement.

• Should I pump right after birth?

  • Usually not needed unless specific situations arise; hand expression can be beneficial.

• Should I try power pumping?

  • Alternatives to power pumping may be more effective and less exhausting for some patients.

Follow-Up Support

• Importance of continuous monitoring and follow-up for optimal results.

• Provide clear guidelines on what to expect and when to reassess techniques or schedules.

• Recommend flexible pumping strategies to avoid overwhelming the patient.