Breast milk serves as a complete and optimal nutritional source for babies during the first 180 days of life. Packed with essential nutrients crucial for their growth and development, breast milk also enhances the infant’s immune system, fostering resilience against infections. Moreover, breastfeeding nurtures a profound bond between mother and child.
While many mothers experience successful breastfeeding journeys, some may encounter hurdles along the way. For those who face challenges nursing directly, the practice of expressing breast milk offers a valuable alternative to ensure infants receive the crucial nourishment they need. This alternative can be effectively pursued through the use of a breast pump. The effectiveness of breast pumping is influenced by several factors such as suction strength, expression duration, breast fullness, timing, surroundings, and the mother’s emotional state. Notably, the frequency of breast emptying has been found to be directly linked to increased milk production. Let us understand how we ensure the highest possible milk output through the proper utilization of a breast pump.
How a Breast pump works
The Breast pump doesn’t actually pull or suck the milk from the breast; instead, it decreases the resistance of the alveoli to facilitate the discharge of the milk. This process allows the internal pressure within the breast to increase, ultimately resulting in the expulsion of the milk.
When a baby feeds, the suction pressure applied during the feeding session is not consistently constant. A vacuum is created, which subsequently increases before being released, and a steady pressure is maintained to ensure the nipple remains in the baby’s mouth. This vacuum effect stretches the teat up to 70% of its length. Breast pumps are engineered to replicate this phenomenon, aiding in the extraction of breast milk.
One of the first breast pumps was developed by Engel in 1956, operating in four phases per cycle: initiation, a rise in vacuum, a slight decrease in suction, a resting phase, and followed by a small positive pressure.
Stimulating the milk ejection reflex is essential for milk extraction, whether it’s through the breast pump or while a baby feeds. Oxytocin, the hormone responsible for triggering this reflex, plays a crucial role. When a baby suckles at a mother’s breast, it signals the brain to release oxytocin, which in turn reaches and facilitates milk flow during that particular feeding session. This reflex is triggered by the touch and scent of the baby.
However, when using a breast pump, this natural trigger can be overlooked, necessitating its activation before a mother begins expressing milk. This can be achieved by holding the baby close for a moment before starting expression. In cases where the mother and baby are separated, keeping a picture of the baby in front of her or watching the video of the baby can help initiate the release of oxytocin and facilitate the milk flow.
Balancing Suction Pressure for Effective Breast Milk Expression and Production
Suction pressure also plays a role in milk production. If the suction power is too low, it might not generate the necessary negative pressure to effectively expel milk from the breasts. Conversely, excessive suction can lead to higher milk production while potentially causing discomfort or injury to the mother’s breasts, thereby compromising her post-expression comfort. Achieving an optimal suction pressure or efficiency is crucial, ensuring an adequate amount of milk is extracted to meet the baby’s requirements and preparing the mother’s body for the next feeding interval. This factor significantly contributes to the overall experience of expressing milk for mothers. The milk extraction process, to a certain extent, provides a sense of fulfillment.
Establishing a Proper Fit
In addition to suction pressure, another important factor in breast milk expression is the fit of the breast pump. The fit of the pump is determined by the flange, which is a funnel-shaped part in the breast pump and attaches to the breast. An appropriately sized flange helps create a vacuum, allowing the process to proceed smoothly. If the flange is too large, it will fail to create a proper vacuum, thereby negatively impacting milk production. On the other hand, if the flange is too small, the nipple may rub against it, potentially causing soreness around the mother’s nipples and making it difficult for her to continue.
To assist the mothers in finding the right fit, there are multiple flange sizes available, ranging from 21 mm to 36 mm. The available sizes might also vary across different brands of breast pumps. A simple method to determine the flange size is by using a ruler or a measuring tape. Measure the diameter of the nipple(in millimeters) and add 4 mm to this measurement. That calculation should provide you with the appropriate size to achieve the correct fit. Many brands may offer a chart along with the breast pump to aid you in determining the fit.
Pumping techniques to maximize suction efficiency
An essential factor to consider during expression is the duration of breast pump usage. Ideally, this duration can mirror the time a baby spends feeding directly. Mothers can express milk for about 15-20 minutes on each side or simultaneously. When a mother senses that her breasts are adequately drained, she can conclude the expression session. Ensuring the breasts are emptied will also prompt the body to generate milk for the subsequent feeding. Maintaining a comfortable suction pressure throughout the session is crucial in order to maximize milk production.
Many electric /battery-operated pumps offer two modes of operation – Stimulation and Expression. The stimulation phase is shorter and serves to prepare the breasts to release milk. Once the milk starts flowing, one can switch to the expression mode. The suction pressure slightly varies between these modes. To ensure optimal pressure, mothers can test the pressure by placing the palm or forearm against the flange and exploring the range of suction pressure to determine what feels most comfortable.
A hot shower or a warm compress on the breasts for a few minutes can aid in facilitating the flow of milk during expression. Gentle massage before expression helps to release any tight areas or lumps, thereby promoting better milk flow. Massaging during expression is also beneficial for enhancing milk production.
Environmental Factors and Comfort
Like breastfeeding, the environment, stress, and distractions can affect the milk output during a pumping session. A calm and relaxed environment facilitates the process and helps maximize milk output. On the other hand, stress acts as a deterrent to breast milk supply and breastfeeding as well. It inhibits the release of the breastfeeding hormones, thereby negatively impacting breastfeeding. Playing soothing music in the background can help the mother relax. Finding a calm and isolated spot in the house can enable the mother to breastfeed or to express the milk comfortably, ensuring that the baby receives all the required nutrition. During this time, family members or partners can help ensure that she is not disturbed. They can take care of any other child in the house, and offer her something to eat or a glass of water to drink during this period. These small gestures will also help the mother feel cared for and support positive breastfeeding.
Taking Care of Breast Pump
In addition to taking care of the mother, it is essential to also take proper care of the breast pump. All the parts that come in contact with milk must be sterilized to prevent and reduce the risk of infection. For sterilization, thoroughly rinse all pump parts with warm soapy water and then cold water. Afterward, allow them to air dry and store them in an airtight container until the subsequent use. An important point to remember is that the pump needs to be sterilized after every use. One particular component of the electrical pump that is particularly susceptible to infection is the tubing. It’s crucial to replace the tubing if any signs of growth or change in color are observed. Sterilization is a vital process that ensures the proper function of the breast pump and prolongs its lifespan.
Special Circumstances for Pumping
The Breast Pump can be used by mothers in various conditions. If a mother faces an issue of low milk supply, pumping in addition to breastfeeding can help stimulate the body to produce more milk. Many mothers often employ the technique of power pumping to rapidly increase milk supply. This technique mimic’s a baby’s cluster-feeding pattern and effectively maximizes breast milk production. In this technique, the mother pumps multiple times with intervals of rest in between.
Simultaneously, if a mother is experiencing hyperlactation, using a breast pump can assist her in removing the excess milk, thereby making the feeding process easier for her baby. Using a breast pump is also recommended when a mother is separated from her baby for any reason. Pumping at frequent intervals helps the mother maintain her breast milk supply.
Breastfeeding embarks on a remarkable journey for both the mother and the baby. Since each pair is unique, they may encounter their distinct set of challenges. The decision to use a breast pump rests entirely with the mother. A lactation consultant can always assist you in determining the right type of pump for your needs or creating an expression schedule, among other challenges you might face. Remember that you are striving to provide the best for your baby. As an amazing mother, your best efforts will suffice for your baby. Every drop of breast milk you produce is more than nourishment: it is akin to liquid gold that will contribute to your baby’s growth.
References:
- Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. Geneva: World Health Organization; 2009. SESSION 2, The physiological basis of breastfeeding. Available from: https://www.ncbi.nlm.nih.gov/books/NBK148970/
- Breastfeeding and Human Lactation, 3rd Edition (Jones and Bartlett Series in Breastfeeding Human Lactation)
- Sakalidis VS, Ivarsson L, Haynes AG, Jäger L, Schärer-Hernández NG, Mitoulas LR, Prime DK. Breast shield design impacts milk removal dynamics during pumping: A randomized controlled non-inferiority trial. Acta Obstet Gynecol Scand. 2020 Nov;99(11):1561-1567. doi: 10.1111/aogs.13897. Epub 2020 Jun 5. PMID: 32401335; PMCID: PMC7687096.
- Isis Davis-Marks/Designing Motherhood https://www.smithsonianmag.com/smart-news/philadelphia-museum-chronicles-reproductive-history-new-exhibition-180978389/#:~:text=Among%20these%20upgraded%20designs%20was,more%20effective%20for%20nursing%20mothers