Mothers may have to pump when the baby is very premature and not yet ready to go the breast (by the way, unlike what goes on in North America, very premature babies are going to the breast in Sweden for example, and breastfeeding by 30 weeks gestation, some breastfeeding exclusively by 32 or 33 weeks gestation, even before they are "allowed" to go to the breast in most North American special care units (yes, breastfeeding at the breast, not being fed breastmilk by bottle). See the information sheet on Breastfeeding the Premature Baby.
Finally, if you don't have adequate maternity leave you may need to express your milk. Incidentally, anything less that 6 months maternity leave is inadequate. See the information sheet, Feeding Baby when Mother Works Outside the Home,/a>. This information sheet is geared, however, to those mothers who do have at least 6 months maternity leave.
If, in your country, you have less than 6 months maternity leave, when you start having a little free time, start lobbying government to do something about such a disgraceful situation.
Breastfeeding is so much more than breastmilk and whenever possible, the baby should be at the breast. A pump is not as efficient as a well-latched baby and so a baby who breastfeeds well is the best pump. Of course some babies don't breastfeed well.
• Obviously, if you can pump or express a lot of milk, you are producing a lot; however, if you cannot pump or express a lot, this does not mean your milk production is low or inadequate. Do not pump to find out how much you are producing. This is not a good way to judge milk supply and if you pump just before the baby feeds will result in "emptier" breasts for the baby. See the video clips that show how to know a baby is getting milk well from the breast (or not).
• The most effective artificial pumps are high-powered, double, electric, and hospital-grade with adjustable pressure/suction and speed. There are many pumps on the market that are just not very good. Some hand pumps are adequate for occasional pumping.
• Hand expression can be very effective and certainly is the least expensive. See below.
• Improper use of a breast pump can lead to problems. Read all instructions thoroughly. Make sure you get a demonstration and instructions from the person who is renting or selling you the pump.
• It is important that milk be expressed and/or pumped after the feed as the breasts should be as full as possible for the baby's feeding. Babies respond to fast flow (see information sheet Protocol to Satisfy Baby and Breast Compression), and pumping before the feed will reduce the amount of milk in the breast and reduce the flow of milk to the baby.
1. Pump immediately after the feed -- waiting an hour or so decreases the likelihood the breast will be full as possible for the next feed.
2. Wash your hands
3. Place your nipple in the center of the flange (when your baby is breastfeeding, it is best that your baby be latched on "off-center" or "asymmetrically" with your nipple pointed toward the roof of baby's mouth (see the information sheet When Latching and the video clips.
4. Put the pump on the lowest setting that extracts milk, not the highest setting you can tolerate.
5. Pump for a maximum of 15 minutes each side. If breasts run "dry" before 15 minutes is up, pump until dry then add 2 minutes. Compression can be used when pumping as well and increases the amount you can pump. See the information sheet Breast Compression.
6. Remember, pumping should not hurt. If it hurts:
• All pumping equipment should be sterilized before first usage, thereafter it only requires washing with hot, soapy, water or by dishwasher.