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Expressing milk & using breast pumps

Woman using a breast pumpMost women don't need to express milk or use a breast pump, as they aren't part of normal breastfeeding.

It isn't a good idea to use a breast pump without good reason when you start breastfeeding, especially in the first six to eight weeks. This is because it may cause problems with your milk supply and breastfeeding.

Sometimes women express milk to reassure themselves that they're making enough milk for their pēpi (baby). As a pump will never remove as much milk as a breastfeeding pēpi, this can make you unnecessarily anxious if you see less milk than you expected.

If you're having problems breastfeeding and think you need a breast pump, make sure you talk with your midwife or lactation consultant before you make any decisions. You can usually see a lactation consultant for free if you're referred by your midwife or GP. Or you may choose to pay to see a private lactation consultant.

Reasons to express milk

If you're breastfeeding and need to be away from your pēpi, you can express breast milk. You may also need to use a breast pump if your pēpi won't or can't feed at your breast.

To keep a good milk supply, it's essential that you regularly remove breast milk. So, if you want to keep your milk supply and your baby isn't breastfeeding, or only breastfeeding a little bit, you need to express milk by hand or use a breast pump as often as your pēpi would normally feed.

If your pēpi isn't breastfeeding at all for some reason, you'll need to express milk at least eight times every 24 hours to keep your milk supply. If this is happening to you, you should get help from a lactation consultant.

If you're trying to increase your milk supply, you can express after each feed. You may need to do this for a short or long time, depending on whether your pēpi is feeding at your breast, and how much your supply needs to increase. You should get help from a lactation consultant.

Hand expression

For the first two to three days after birth, it's usually more effective to express by hand, as colostrum is too thick for breast pumps to remove effectively. Some women also find that expressing by hand works well for them long-term if they need to remove milk in between breastfeeding. You can find useful information and tips about expressing milk by hand through these pages:

Types of breast pump

For long-term, intensive use, a heavy-duty electric pump is ideal. These are closed-system pumps, which means that breast milk can't travel into the motor parts of the pump. You may need to hire this type of pump, or you can buy some closed-system pumps.

Rental services clean hired pumps between users.

In some situations, Work and Income (WINZ) may help a mother buy a breast pump if it's clinically necessary. Ask your midwife, GP or lactation consultant for more information.

If you're using a pump for a shorter time, or less intensively (for example, if you need to express milk when you go back to work or you're trying to increase your milk supply), a smaller electric pump (which can also run on a battery) should be suitable. A good hand (manual) pump should also work well.

If you only need the pump for a short time (for example, if you have painful or damaged nipples), a hand pump is usually sufficient. Hand expression can also work.

Renting or buying a breast pump

Open-system single-user pumps

There are many different breast pumps on the market. Unfortunately, many of the cheap ones don't work effectively. Ameda, Spectra, Unimom and Medela brands are reliable.

These pumps are available for sale at many retail outlets including pharmacies and some specialist baby care retailers. Or you can ask your midwife or lactation consultant for advice about local suppliers.

Closed-system heavy-duty pumps

These are available to rent or hire from some baby stores, pharmacies and lactation consultants.

There'll be a weekly or monthly rental charge and you'll need to buy a personal kit with items such as breast shields, collection containers and tubing.

At most rental outlets, you'll also have to pay a deposit, but you'll get this back when you return the pump. At others you'll have to give your credit card details when you hire the pump.

You can buy some closed-system pumps from pharmacies, baby item shops or lactation consultants.

Ask your midwife or lactation consultant for advice about local suppliers.

Breast shields – finding the right fit

It's important to get a breast shield that fits properly. A shield that doesn't fit properly can create friction around your nipple, causing nipple damage and preventing you from getting milk out effectively.

To apply a breast shield, centre your nipple carefully in the opening before switching the pump on and increasing the suction to a level that's comfortable for you. While you're pumping, your nipple should move freely in the shield tunnel. You should see rhythmic movements and milk flowing from your nipple.

Pumping should be comfortable and pain-free. If it isn't comfortable, check these things.

Different sizes of breast shield are available with the breast pump brands mentioned earlier. With some brands, you can even get a comfort shield or soft-fit shield.

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On the next page: Storing & using breast milk

Written by HealthInfo clinical advisers. Last reviewed December 2021.

Sources

Page reference: 47123

Review key: HIBRF-24381