In today’s world, with working moms and short maternity leave, pumping has become a major part of our breastfeeding journeys. And let’s just get honest for a moment: pumping can be really hard! Sometimes pumping enough milk seems like an impossible task. If you’ve been struggling to pump enough milk, I have good news for you: this post is chock-full of tips and tricks to help you pump more milk.
Get to the root of the problem
I’ve written about this in another post when we were talking about poor weight gain in breastfed babies: you need to find out what the real problem is. If you cannot pump enough milk, you probably have one of two problems: either you have a low milk supply, or you are not pumping effectively. In this post, I will focus on effective pumping techniques, and keep the supply issues for another post. Suffice it to say for now: if your baby has been gaining weight well up to this point, your supply is probably not the problem. But remember, because of the way milk production is regulated, using a more effective pumping technique – and therefore removing more milk from the breast – will also boost your supply. Double win!
Getting a let-down: the key to effective pumping
When it comes to pumping, there’s one thing that is absolutely vital to understand and achieve: the let-down reflex (also known as the milk ejection reflex). In simple terms, this is what allows your milk to flow. What happens in the body is the following: when the breast is stimulated (e.g. by a baby suckling, or by a pump) the brain releases a hormone called oxytocin. Oxytocin causes all the little muscles surrounding the milk ducts and milk glands to contract, which “pushes” the milk out of the breast. Sometimes you can feel the let-down reflex as a tingling or squeezing sensation in the breast, or you may notice that the other breast starts leaking. Some women never feel it, though, or you may feel it at some feeds and not at others. But if you notice the milk flowing as you pump, you can be pretty sure that you’ve had a let-down.
Fun fact: oxytocin also causes labour pains and orgasms! It’s also responsible for those period-pain like cramps you get after birth when your uterus is contracting – that’s why your uterus shrinks back down to its normal size faster if you’re breastfeeding. And as if that wasn’t enough, it’s also a bonding and mothering hormone, so it gives you the warm fuzzies about your baby. Oxytocin is awesome!
But back to the let-down reflex. The let-down reflex plays a vital role in pumping: the majority of the milk you express comes during a let-down. Before the let-down reflex, there is only about 10 ml of milk available in the breast – so if that’s the kind of volume you are getting, you are possibly not having a let-down.
How to improve your let-down
Because the let-down is driven by oxytocin, it’s useful to look at the factors that will increase or decrease your oxytocin reflex. Oxytocin secretion is stimulated by:
- Stimulation of the breasts and nipples. For this reason, it helps to start off with your pump on gentle suction until the let-down comes, or to hand express a bit first. Massaging the breasts before expressing and whenever the milk flow slows down also helps a lot.
- Hearing, seeing, smelling or touching the baby. If you are pumping at work, watch videos or photos of your baby on your phone and take a piece of baby’s clothes to smell. If your baby is in NICU, ask if you can pump next to baby’s bed. You can even pump one breast while baby drinks from the other one.
- Positive emotions. Think happy thoughts while you are pumping. Visualise streams of milk flowing from your breasts. It sounds kind of crazy, but it works!
- Gentle massage along the spine. We’re not sure why this works, but it does seem to help: ask someone to massage your back in small circles along the sides of your spine before you pump.
On the other hand, you want to avoid these things that can inhibit the action of oxytocin:
- Negative emotions. Stress is a big problem here, especially if you’re stressing about how much (or how little!) you’re pumping. It’s a downward spiral: stress inhibits the let-down, which means you get less milk, which makes you stress even more, which inhibits the let-down, and so on into infinity. I find the best way to deal with this is to distract yourself: cover the pump bottle (otherwise you’ll keep looking at it and freaking out), and either read a good book, watch a TV show that makes you laugh or close your eyes and listen to some soothing music. Deep breathing, visualization and guided relaxation or meditation exercises can also be very useful for this.
- This is important: if you’re still in pain from the birth, don’t try to be a superhero; take your pain medicine. Nothing stops the let-down reflex like pain. The same applies if your pump doesn’t fit well or if you have the suction too high: if it hurts your nipple, you won’t get a good let-down.
- I’ve never found this described in any of my academic books, but from experience I can tell you it’s absolutely true: you can’t have a let-down if you’re shivering. You can use this to your advantage by placing a hot beanbag on your breast before or while you are pumping.
- Alcohol inhibits the release of oxytocin, so you will pump less if you’ve had a drink. So no, grandma, milk stout is not a good idea.
Extra tips and tricks to help you pump more
There are a few more ways to increase the amount of milk you get out of your breasts. Here goes:
Stimulate more milk production
If you want to boost your milk production, keep pumping for a few minutes after the milk stops flowing. This sends your brain a loud and clear message that “we need more milk here!”
If you’ve never tried hand expressing, now may be a good time. Hand expressing can be especially useful if you struggle to get a let-down while pumping: sometimes the warmth of your hands is more conducive to a let-down than the cold, hard plastic of the pump.
You can also try hand expressing after you’ve finished a pumping session. I find that hand expressing can almost always get a bit more milk out when the pump can’t. It’s also more effective to hand express when you’ve only got colostrum.
There’s one caveat, though: you have to use the correct technique, otherwise it’s utterly ineffective. You can read here for the technique that I’ve been using for years, and it’s the most effective by a long shot.
Hands-on pumping is an excellent technique to get more milk out of the breast faster. It’s very simple: while you are pumping, just use a free hand to grab hold of your breast, quite close to your chest, and squeeeeeze. What you are effectively doing is “pushing” the milk out from behind while the pump is “pulling” it to the front. It can really speed up the pumping process.
Pumping both breasts at once will allow you to get the milk out much faster, for obvious reasons. But it also provides a much stronger stimulus for milk production and for the let-down. There are a number of ways you can do this. The most obvious is to use a double electric pump, but they are quite pricey. You can improvise by using a single electric pump on the one breast and a manual pump on the other breast, or by using two manual pumps, or by using a pump on one breast and hand-expressing the other one (yes, that will take some practice!). You can even let baby help and express on one side while baby drinks on the other side. Whichever way you do it, your body will think you’re suddenly feeding twins, which should give your supply a big boost!
“Power pumping” is a pumping regimen designed to mimic the way a baby feeds during a growth spurt. If you’ve never experienced a growth spurt, it goes like this: baby drinks for a while, stops, relaxes for about ten minutes and then wants to drink again. Repeat, and repeat, and repeat. These short frequent feeds give your supply a major boost.
When you are power pumping, you will do the same thing: First, you pump both breasts well, until the flow of milk slows right down (this usually takes about 20 minutes). Then you take a 10-minute break, and pump again until the milk flow slows down or stops (usually also about 10 minutes). Repeat this pattern of intermittent resting and pumping two or three times. A whole round of power pumping usually takes an hour or a bit more. You can either do one session per day, or do a “boot camp” where you do several sessions a day for a few days (3 sessions a day for 3 days is a good goal). “Boot camp” will get you results quicker, but it’s a lot of effort, so I’d suggest you do it when there’s someone else around to help with the baby.
If all this talk of timing and minutes is a bit technical for you, try this relaxed version of power pumping: Put on one of your favourite TV shows (on TV, not video – this is one time when ad breaks are a good thing); then simply pump during the show and rest during the commercials. Or put on a nice CD and pump for two songs, rest for two. As long as you have rhythm of pump-rest-pump-rest-pump, you should get good results.
Power pumping has one other benefit: it takes advantage of the fact that the first let-down of a feed (or a pumping session) usually gives the most milk, because your brain secretes more oxytocin when it’s starting from a “zero” level. The breaks in-between give your brain a chance to reset back to that “zero” level, so you get more oxytocin secreted and a stronger let-down when you pump.
Remember the basics
Having said all that, you must always remember to check the basics: that you have a good pump, that it’s working well, that it fits you properly and that you’re using it correctly. If you’re not sure that you have all those things in place, check out this post for more info.
Also, as simple as it seems, you need to make sure you’re pumping often enough. Generally, you should try not to go more than 3-4 hours without either pumping or breastfeeding. If you need to boost your supply, increase that to two-hourly. And if you’re exclusively pumping (no breastfeeds), absolutely do not go below 8 pumping sessions per 24 hours. Whenever you need to get more milk out, add in an extra session or two. Early morning is often the best time to add extra sessions, since most women have more milk early in the morning.
Pulling it all together
So after all that info, let’s just put together a list of all the main points:
- First and foremost, make sure that your pump is working well, fits your nipple properly and that you’re using the right level of suction.
- Stimulate your let-down reflex:
- Massage your breast before starting to pump and whenever the flow of milk slows down.
- Start your pumping session with light, gentle suction to stimulate a let-down.
- Keep baby close: pump at baby’s bedside, look at photos or videos of baby on your phone or smell a piece of baby’s clothing while pumping.
- Use the power of imagination – visualise streams of milk flowing from your breasts.
- Get a quick back massage before you pump.
- If you tend to fret, cover the pump so you can’t see how much you’re expressing.
- Relax: do deep breathing, listen to soothing music, or follow guided relaxation exercises while you pump.
- If you’re in pain, treat the pain.
- Use warmth on the breast before pumping. Keep your body warm while pumping. Shivering will stop your let-down reflex dead.
- If you struggle to get a let-down for the pump, try hand-expressing.
- Use hands-on pumping.
- Pump both breasts at once, or let baby drink from one breast while you express the other one at the same time.
- Keep pumping for a few minutes after the flow of milk stops to boost supply.
- After pumping, hand express to get the last few drops of milk out.
- Power pump to boost supply! Either do one power pumping session per day, or do a boot camp of three sessions a day for three days.
- Make sure you’re pumping often enough. If you need more milk, throw in an extra session or two – morning is best.
- Stay away from alcohol.
And if you’ve tried all that, and you still can’t get enough milk… well, then it’s probably time to consult a professional. A lactation consultant will help you to find where your particular problem is and give you some strategies for overcoming it. Good luck on your pumping journey, and good job for putting in all this effort!
Do you know any good tricks for getting more milk out? Please share them in the comments below!