Pumping Breast Milk: How to Do It the Right Way

Whether you are returning to work, need to exclusively pump for your baby, or have a medically fragile baby who can’t breastfeed directly yet—sometimes pumping breast milk is truly the best gift you can give your baby.

But lots of moms fear pumping because they aren’t sure how to do it correctly or are afraid they won’t be able to “let down” for the pump. Don’t worry—almost all moms can successfully pump. We’ll walk you through the whole process, including:

When to Start Pumping

If you or your baby do not have an immediate need for pumping, talk to your lactation consultant about when to start pumping. Generally, it’s not recommended to pump until after your milk comes in—about 3-4 weeks after birth—to let your supply adjust to your baby’s needs.

Note: Although you may begin pumping 3-4 weeks after birth, lactation consultants recommend waiting until 4-5 weeks to introduce a bottle. (Learn how to store breast milk.) This is considered a sweet spot to prevent nipple confusion, but to avoid baby resisting the bottle altogether. Feed baby 1-2 times a week with expressed milk in a bottle so they have continual “practice” and will take a bottle willingly.

There are, however, some circumstances where you would need to start pumping soon or immediately after birth, including:

1. If your baby is premature or has special needs that don’t allow you to nurse directly, start pumping as soon as you can. Ask the NICU nurses for help with this, because you may need to store your milk a certain way or in NICU-specific receptacles. You will also want to make sure you follow the sanitizing guidelines carefully.
2. If you give birth in a hospital, nurses may offer a hospital-grade pump. Even if you have no intention of using it, you may want to take a look and/or give it a try to familiarize yourself with the process while you have someone there to help. You may also consider asking for help with hand expression at this time, because hand expression is a skill that all nursing moms should know, and is often combined with pumping.
3. If your milk is slow to come in or your baby is slow to gain weight, you may need to pump to increase your supply and/or supplement your baby (pumped breast milk is usually the first choice of supplement, if possible, followed by donor milk, then formula). You and your lactation consultant or breastfeeding helper can discuss a pumping routine that allows you to breastfeed your baby as much as possible and also increase your supply and/or collect milk for supplementation.

What’s the Best Breast Pump?

Of course, before you start pumping, you’ll need to get a breast pump. It’s a good idea to get one, even if you don’t anticipate needing it very often. It never hurts to be prepared, plus many moms qualify for a free breast pump through insurance.

It can be easy to feel overwhelmed by all the pump possibilities out there, but there are only two main kinds of pumps that breastfeeding mamas use: electric and manual pumps. 

1. Electric pumps:
   • Either plug into the wall or are powered by a battery source
   • Allow you to pump both breasts at once (double pumping) to maximize output
   • Generally cycle between different pumping speeds and suction strength to increase how much milk you pump
   • Can be attached to hands-free nursing bras
   • Are generally recommended for moms returning to work or who will need to pump frequently

Note: If you are pumping to increase your milk supply or exclusively for a NICU baby, consider renting a “hospital grade” pump, which is the strongest and most effective electric breast pump out there.

1. Manual pumps:
   • Do not require a power source—they work by a lever/handle that you compress to create suction around your breast to extract you milk
   • Only stimulate one breast at a time
   • Are easier to transport and less expensive than electric pumps
   • Typically don’t express as much milk as electric pumps
   • Are more difficult to multitask with, because your hand is busy compressing the lever (unless you use a hands-free pump)

Read all about the best breast pumps here. 

How to Use an Electric Breast Pump

Before you begin, it’s helpful to set up a “pumping station” with everything you need (drinks, snacks, phone, etc.).

1. Start by finding a comfortable, quiet spot where you feel relaxed and at ease.
2. Plug in your pump or make sure it has working batteries.
3. Wash your hands thoroughly with soap and water.
4. Center the flanges over your breast(s); center the nipple in the flange opening, making an airtight seal. (Note: Your nipple should not feel compressed; it should be able to move comfortably in the flange.)
5. Turn your pump on. Start out at a high speed and low suction in order to elicit milk flow (let down); then adjust speed to medium and increase suction based on comfort level.

How to Use a Manual Breast Pump

Find a comfortable, quiet spot to pump in, and have your “pump station” set up.

1. Wash your hands and ensure the breast pump is clean and assembled correctly.
2. Place the breast shield on your breast, with the shield centered around the nipple.
3. Squeeze the handle or lever to begin pumping. You may need to pump the lever quickly at first to encourage let down.
4. Once the milk begins to flow, switch to slow, rhythmic pumps, quickening again when you are ready for another letdown.
5. Switch breasts every 5-10 minutes, but make sure each breast gets about 15 minutes of total stimulation.

The Best Time of Day to Pump

When to fit your pumping sessions in depends on your individual situation, but here are some general guidelines:

• Pump after the first morning feed—most moms have the most milk then.
• Wait one hour after a feeding, and ideally when baby is sleeping, because you will have allowed your breasts some time to refill.
• Pump after baby goes to bed at night, since they usually sleep for the longest stretch then.
• Pump from the other side while your baby is breastfeeding. It can take a little maneuvering with your breast pump, but lots of moms find that pumping the other side while their baby nurses not only saves them time, but also allows them to take advantage of the natural “let down” their baby helps to elicit.

Help! I’ve Pumped and Baby Just Woke Up

Sometimes our babies wake up at inopportune times. but try not to stress. Your breasts are never totally “empty”—if you start pumping consistently at a certain time, your body will naturally start to produce more milk for you to pump then. Your baby can also always elicit another let down to get things flowing.

If your baby seems impatient, give your breast a little squeeze, or massage. You can also try hand expressing from your other breast to help encourage let down.

Pumping Schedule: How Often to Pump

How often you should pump breast milk depends on your particular situation and varies based on how old your baby is and how your body responds to pumping. But here are some general guidelines, if you are:

• Exclusively breastfeeding and just pumping to occasionally to supplement with a bottle to give yourself a break, pumping once a day, or even less, is plenty.
• Pumping to build up a “freezer stash” for when you return to work, you can pump 1-2 times per day, storing about 2-4 ounces at once.
• Exclusively pumping, you’ll need to pump…
  • Newborn: Every 2-3 hours, with no more than a 3-4 hour break at night.
  • 1-6 months: Approximately every 2-3 hours, with no more than a 4-5 hour break at night.
  • 6-12 months: Once baby starts solids, most moms find that they can pump less frequently, and may be able to go 3-4 (or more) hours between pumping sessions.

Every woman has a different breast milk storage capacity and each mama usually figures out how frequent pumping needs to happen to sustain her supply. From 0-6 months, all babies need approximately the same amount of breast milk: between 25-35 ounces. This amount only begins to decrease as solids are gradually introduced starting at around 6 months.

If You Have Trouble Breast Pumping

Having difficulty pumping breast milk can be frustrating and disheartening. Keep in mind that most women cannot pump more than 2-5 ounces per breast at once, and this amount can vary based on what time of day it is, whether you have recently pumped or breastfed, and how stressed or relaxed you are.

I’ve got a comprehensive list of breast pumping tips to help, but here are a few quick tips: 

• Don’t stress. Never stress out about breast milk or sit and watch the bottles fill up. You know the old saying, “a watched pot never boils”? Well, “a watched bottle never fills!”
• Get a hands-free bra for comfort. The more comfortable and content you are, the more likely you’ll stick to pumping. There are lots of great pumping bras out there and it will seriously transform pumping from a chore to a chance to catch up on things.
• Make sure you’re hydrated. Dehydration is your worst enemy when you are breastfeeding (or at any other time in your life, for that matter). So drink plenty of water. And go easy on coffee or soda.
• Keep a picture of your baby handy, or their baby blanket to smell. This triggers oxytocin encourages let down.
• Experiment with flange size. You may need a bigger or smaller flange size to maximize your pumping output. Angled flanges are also gaining popularity as they reduce spills and tend to have a good fit.
• Check your pump and accessories. In some cases, the pump itself is in need of repair. Other times, your pump parts are worn out and need to be replaced.
• Try galactagogues. There are lots of food and supplements thought to increase milk output. Some great options include oats, brewer’s yeast, flax seed, leafy greens, and fenugreek. You can also try my lactation cookies, which contain a number of these ingredients. Read more about galactagogues.

If you are having issues with breast pumping, don’t give up or feel alone. Breastfeeding and breast pumping can be difficult and there will be a learning curve. When in doubt, get help from a lactation consultant, La Leche League leader, a trusted friend who has pumped herself, or any breastfeeding support counselor.

How About You?

What were some questions you had when you started pumping for your baby? What advice would you give a fellow mama who is just starting her pumping journey?