Breastfeeding basics: 10 misconceptions about using breast pumps

Many mothers become worried when they are only able to pump a few ounces per pumping session, believing that the amount of breast milk they have expressed indicates how much milk is in their breasts. This is NOT true, and a cause of much worry and concern. Milk supply and measurable milk output are not the same thing. Milk supply refers in this case to how much milk is available in the breast, whereas milk output is the amount of milk expressed. Using a breast pump to express milk, a woman is essentially using physical manipulation to simulate breastfeeding, thereby "tricking" the breasts into "letting down" (allowing milk to flow out through the ducts in the nipples) by way of the milk-ejection reflex (MER). Babies are much more effective at removing milk from their mother's breast than any pump can actually be, if just because the baby's bond with the mother can itself help to trigger the MER when they are in direct contact. 

 

 

Pumping is an acquired skill, and can be improved upon with practice and using good pumping techniques. It is actually quite normal for women who start pumping to only be able to pump a small amount at first, increasing that amount with time and experience. There are ways to help increase milk output so that mothers who need to pump can not only pump enough daily for their baby's use, but even build a supply of breast milk that can be stored in the refrigerator or freezer. Most often, milk output issues are addressed by using methods to help increase milk supply, as breasts that are producing a great amount of milk (perhaps overproducing a bit) are easier to express milk from. Additionally, many women find that milk output from pumping can be increased by establishing a routine that is comfortable, thinking about their babies while pumping, or even meditation to help them relax. 

 

 

This is not entirely true. Mothers who are able to stay at home with their babies should not need to pump to maintain a good milk supply, unless their milk supply is at risk because of medications they are taking, or some other issue that is diagnosed by a physician. Provided that stay-at-home mothers are properly nourished and hydrated, are reasonably healthy, and feed their babies often and on demand, milk production and supply should remain adequate to suit the needs of their growing babies.  

 

Women who work and want to breastfeed exclusively will need to use breast pumps or hand-expression to help empty their breasts of milk as frequently as they can, to ensure that milk production continues in the absence of their nursing babies. By pumping, working women can ensure that expressed breast milk is (and will remain) available for their babies while they are apart from them.  

 

Many women pump at work, some do most of their pumping at home while not working. It may seem difficult with some employers to broach the subject of using a breast pump, but U.S. employers are legally required to provide employees who are nursing mothers with reasonable accommodations for pumping at work under the Fair Labor Standards Act (FLSA). Some smaller companies (with fewer than 50 employees) may not be subject to FSLA standards for nursing mothers, but must prove that to allow their employee to use a breast pump would cause the workplace "undue hardship". It is important that women stress the importance of this issue to their employers, and avoid letting prejudice or someone else's ignorance of the importance of breastfeeding intimidate them away from pumping as needed. In the U.S., the law is definitely on the side of nursing mothers. 

 

This is not true in most cases. The term "pump and dump" refers to the practice of expressing breast milk and disposing of it without feeding it to a baby. Milk that comes from breasts that are affected by thrush or mastitis will not make a baby sick. Although it is a common misconception that breast milk is "tainted" by thrush or mastitis, unless a woman is specifically ordered to "pump and dump" by her doctor, nursing should continue as normally as possible. It is also perfectly acceptable for a woman to ask her doctor why she has been ordered to avoid breastfeeding on an affected breast. If the answer is that "most women do", then it is in the best interest of a new mother to demand a more detailed reason for interrupting her nursing.

 

Women who are suffering from mastitis can actually recover more quickly, are more likely to avoid advanced infection, and can experience a great deal of pain relief by allowing their babies to nurse on the affected breast. Hand expression or pumping can help to reduce pressure if breasts are too swollen for a baby to latch on well, or if the baby is temporarily refusing the affected breast. However, it is best to try to encourage the baby to nurse through mastitis, as the baby's suckling will reduce pressure from building milk supply much more efficiently than a pump can. 

 

Thrush is not transmitted through breast milk, but through the baby's mouth and the skin and duct openings around the mother's breasts and nipples. To reduce the chance that the infection may be reintroduced at any point during treatment, it may actually be best to avoid pumping, if possible. Mothers and babies will both need to be treated for thrush if it occurs in either of them, and breast pump parts, bras, artificial nipples, or anything else that is in direct contact with the mother's breast or the baby's mouth will need to be sterilized after each use. 

 

 

Pumping is improved by practice, and when a routine is established it can be detrimental to a woman's milk supply to skip scheduled sessions. When using a breast pump, the mechanical suction of the pump mimics breastfeeding. If a woman who does not pump were to suddenly skip feedings, it could reduce milk supply (temporarily) because breasts would not be stimulated as often to produce milk. Any change to a feeding and/or pumping routine can effect change in milk production. Increased pumping or feeding will increase milk supply, while decreasing the frequency of feedings or pumping sessions can reduce milk production. Supplemental feeding of infant formula with lowered milk production is inadvisable, because it can actually cause even lower milk supply.

 

 

Breast pumps come in many different styles, and what works well for some mothers, may not work well for others.  Many women can successfully express milk with a manual (hand-operated) breast pump, but most prefer electric pumps. Breast pumps are available in different price ranges, but some women choose to rent a very effective hospital-grade pump because the financial cost of purchasing one may be more than their family can afford. It is important to understand that pumps that can be rented are designed differently than most pumps that can be purchased, and are safe for other women to use after the pump is returned. Women may not want to use "hand-me-down" pumps that were purchased and used by someone else, because the different system design does not prevent potential contamination of newly expressed breast milk by bacteria or particles from the previous owner's milk. Even with new attachment parts, contamination is entirely possible if a purchased pump is used between mothers. 

 

 

It is possible for any kind of milk to spoil, but if stored properly, expressed breast milk can be used up to twelve months after being frozen. Length of safe storage of breast milk depends on how and where it is stored. The Centers for Disease Control (CDC) suggests that frozen breast milk is safe for use when thawed, but may undergo some lipid (fat) degradation after six months of storage, resulting in lower quality of milk than more recently stored breast milk. The CDC also offers an informative guide for safe handling and storage of breast milk.

 

 

It is not uncommon for women who start expressing milk in the first few weeks to notice a drop in supply around the second month of breastfeeding. During the first 6 - 12 weeks after her baby is born, a woman's breasts are usually producing milk in excess of the baby's actual needs. This overproduction results in leaky breasts, swollen with milk, and also increases the risk of problems like engorgement, plugged ducts, and even mastitis. When a woman's milk production adjusts to her baby's specific needs, breasts stop leaking and usually feel less full, hard, and swollen. Many new mothers become alarmed at this point, because they've finally adjusted to the ways that overproducing breasts feel, and fear that they may not be producing enough milk if their breasts feel softer and stop leaking. In the case of women who start pumping early, their milk output may drop sharply at this point. With practice, milk output will increase again. Women who become stressed and anxious will have more difficulty pumping, so it is important that they understand this is a natural decline in output that will remedy itself shortly with patience and practice. Milk output can also decrease with hormonal fluctuations during a woman's menstrual cycle, or as a result of skipped feedings or pumping sessions. Again, most of these periods of lowered milk output are temporary. 

 

 

Breast milk that is properly stored is no more likely to spoil than any other milk. Babies will naturally prefer the closeness with their mothers that is only achieved by breastfeeding, especially if they are accustomed to it. They enjoy it, are soothed by it, and it is only natural for them to find it more desirous than bottle feeding. Often, a breastfed baby will not take a bottle from their mother or while she is in the room. Knowing that her breasts and that closeness is very nearby, babies will "hold out" and become confused or upset that their mother is denying them that contact. Often, fathers or or other family members will have more success giving bottles of breast milk to breastfed babies. This doesn't mean the breastfed baby is so much "spoiled" as it means the baby knows that breast is best.

 

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