If you've been following WHO guidelines, or have just been doing what comes naturally, and breastfeeding your baby, this is probably where you get nervous, and wonder how you're going to feed your kid now. Electric breast pumps have been on the market since the early nineties, and before then, many women hand expressed, or used manual pumps, but the whole prospect sounds rather intimidating, doesn't it? It doesn't have to be. With the right equipment, confidence, and some support, you can keep breastfeeding your baby, even if you can't always be with him.
This instructable is still being edited, so currently, it's published to allow mom-friends (or anyone else who wants rambling advice) access.
Step 1: Don't Pump and Dump
If a medical professional ever advises you to do this, or to avoid nursing because of medication you've been given, ask that person to research their information, or look it up/get your friend with the shiny new iPhone to look it up online. Dr Thomas Hale's Medications and Mother's Milk has information on what levels of drugs pass into breast milk; what's safe, and what isn't. His Infant Risk Center has recently started a hotline, at . (806)-352-2519, Monday-Friday 8am-5pm CST. kellymom.com has lists, too. It IS alright to ask to be given an alternative drug if you're worried about how needed medication might affect your child.
Similarly, if you'd like a glass of wine with your dinner, or want to see if your neighbor's homemade beer is as good as he says it is, go ahead and have the drink. Alcohol isn't stored in breast milk, it's metabolized over time, so when you're sober, or very close to sober, your milk is too.
Well-meaning dads and relatives will sometimes suggest you express milk so you can sleep while they give your baby a bottle, or so they can bond with the baby through feeding. Sounds great, but skipping nursing sessions is one of the fastest ways to kill your milk supply. Why not have dad bring the baby to you in bed instead? Never give a baby a bottle when you could give her a boob.
Step 2: Take It Seriously
If your pump fails, get the manufacturer on the phone NOW, and let them know that the medical equipment you bought from them has stopped working, and they will need to ship a replacement to you overnight. You wouldn't write off a case of diapers that disintegrated when you put them on your baby's bottom, or do without for a few days because there wasn't a readily available substitute. This is one case where you really need to hold a manufacturer responsible for their product.
Coworkers and managers should respect your need to take pumping breaks, as well as your need to have a clean, private space (NOT a bathroom) to do so in. Communicate your needs matter-of-factly, and don't apologize for doing something you need to do. Check if there are laws that apply to pumping where you live. If you'd like to try to explain why pumping is important to someone who just doesn't get it, the US gov't offers a nice, free kit called The Business Case For Breastfeeding. You can order it online.
If your employer is hesitant to provide such a space, point out that all that is required is a room (even a large closet) with a locking door, or easily installed latch, a chair, and an electrical outlet. In extreme situations, you can pump in your car, in mild weather only.
Always remember that what matters here isn't your right to pump milk, it's your baby's right to eat. Unless a coworker regularly kicks puppies, that's not something they should feel comfortable arguing with.
Step 3: Stay on Schedule
Step 4: Get Comfortable
Try breast compressions (squeeze as the pump sucks), or simply lay a hand across your breasts while you pump. Looking at pictures of your baby, or watching a baby video on your cellphone can help too. Make sure the room you're in is warm, or put on a sweater.
The picture here gives a pretty good idea of what we did to relax while pumping. The room was full of books.
Step 5: Equip Yourself
The women I worked with had good successful with traditional Medela double-electric pumps (Pump In Style or Pump In Style Advanced), the Lansinoh/Ameda double electric (same pump, different colors), and an Avent double electric pump. We also had reasonable success with the Medela Freestyle (rechargeable, no-cord pump), and Playtex Embrace, which has good suction, but fragile flanges. The Playtex and Ameda flanges were interchangeable. The Lansinoh is the most reasonably priced pump, while the Medela PIS pumps were known to be sturdy, and a good choice for use with multiple kids.
Finding pumping uncomfortable? Invest in some bigger or softer flanges, or get a silicone insert for the ones you have. Medela makes hard and soft flanges, while Lansinoh/Ameda makes squishy inserts, as does Avent. Pumpin' Pals is a third-party company that sells big silicone inserts to allow you to recline while pumping. I've never tried these, but if they sound appealing, you might look up some reviews.
If you find your pump's suction has declined over time, give it a good clean, and get some new membranes! You can find Medela ones at Target or Babies R Us, and Lansinoh/Ameda/Playtex ones (yep, these are all the same) can be ordered online. Try to keep a spare with your pump, in case of emergencies.
If you'll be pumping in your car, make sure you have a power adapter that fits in the cigarette lighter (most manufacturers sell these, and some pumps come with them), a nursing cover, or stretchy shirt, so you can cover up, and an ice pack, to help keep the pump from getting too warm.
Spending too much on collection bottles and bags? Invest a couple of dollars on some standard baby bottles. These will fit Lansinoh/Ameda, Playtex, and Medela pumps. Avent bottles are extra-wide, so no interchanging here. You can get adapters to use wide-mouth bottles with standard-sized pumps. Dr Brown's makes storage caps that fit standard bottles, as well as teeny brushes that are great for cleaning pump parts. For the most part, you don't need to stick with one brand.
Considering a brand I didn't list here? Do some serious research on it. Some pumps are only available in some countries, so their exposure is limited, but other pumps just aren't very good. Please don't sabotage your milk supply by going for a sub-par pump, or trying to make do with a single pump, or manual one, though manual pumps are useful to keep around in case you're missing part of your electric one, or you have problems with it.
If you're eligible for WIC, ask about getting or renting a pump from them. I've got no personal experience there, but a friend got her pump from them.
Step 6: Save Some Time
You can also put your milk and pumps parts in a cooler bag with ice pack after your last pumping session, so you don't need to go back to the pumping room, and possibly interrupt someone else's session.
Step 7: When You Get Home . . .
If your baby has part of a bottle, it's fine to put that bottle back in the fridge, and offer it again within 24 hours. Breast milk isn't formula, and it doesn't go bad as easily.
It isn't unusual for a baby who's away from his mother during the day to nurse more at night. Cosleeping can be really helpful for handling this. Actually, I think that's the only way I managed to get any sleep for the first year of my son's life. There's a really good instructable on that here, with lots of information in the comments. You can also wear your baby in a sling or mei tai so you can do light chores, wander around outside the house, or play with other children, and nurse at the same time.
Step 8: Don't Give Up
If your baby had problems latching, or you ended up having to pump instead of nursing (exclusive pumping), you're in a pretty special group of moms. Even if you're not able to pump all the milk your baby needs, know that trying at all means you're doing a good job. A baby doesn't need to have only breast milk or nurse directly to benefit.
Step 9: Have a Cookie
Step 10: Get Support
If a doctor, relative, or friend urges you to supplement with formula, or do something that otherwise doesn't feel right to you, get a second opinion. There's a lot of commonly spread and believed misinformation on breastfeeding out there -- and there's a lot of commercial motivation to get babies on breast milk substitutes. In the majority of cases, a mother can produce enough milk to feed her child.
If you're having a lot of difficulty, seek out a lactation consultant. When that's not an option, or you need immediate help, look for a website run by one, like kellymom.com.
Step 11: Share and Share Alike
Other women have problems pumping enough milk (even though they can usually get enough when nursing directly) , or experience supply drops after stresses like surgery or illness, or because of pregnancy. Some women have other problems that make it difficult to produce enough milk, and some babies don't live with their birth mothers, and don't have access to milk from the tap.
Any ideas where I'm going with this? It takes a little organization, but milk donation is a truly great thing. There are commercial milk banks, where the milk goes through a lot of screening, and is available at high cost to special needs babies. There are also less formal groups like MilkShare that help people in need of milk find women who have milk to give, and allow the individuals to work out their own screening arrangements. If you have milk to give, don't be shy about offering it to someone who could use it, and if you need help, don't be afraid to ask for it.
Step 12: Know That You Rock/Help Someone Else Rock Too
If you know someone who's struggling with nursing or pumping, and you have any useful advice or encouragement to give, bring it on. Support can mean the difference between a baby getting to nurse as long as she needs to, or being weaned before she's ready, and mom and dad having to find money for formula. On a more selfish level, it can mean not having to cover for a coworker who's off work with a sick baby, since human milk benefits a baby's immune system in ways formula doesn't.
Step 13: Wean Slowly
I failed pretty badly here, so after managing to clear clogged ducts, and possible mastitis, I just ended up pumping longer, and donated the milk. I got to hang out in a nice, private room, and read about vampires, so it really wasn't bad.