There are variety of reasons why a mother might want to or need to pump: for preemie or sick infants; to increase her milk supply; to maintain her supply; for when she goes back to work, to name some. The purpose of this article is to address  some of the situations when Mom may need to pump for her babies, and to offer pumping tips.

  1. Begin regular pumping as soon as is possible after their births, short, frequent sessions are better than long, intrequent sessions.
  2. Choose a quiet, private spot with comfortable seating.
  3. Moms of multiple  will usually double pump for efficiency and because they are typically  set for simultaneous letdown. Using a double pump will allow you to take advantage of the  simultaneous letdown. In addition, double pumping saves a lot of time rather than pumping one breast at a time.
  4. When nursing one baby, pumping the other takes advantage of the simultaneous letdown. This may help with better milk production so that one multiple, who may having difficulty breastfeeding, also has enough milk available. Getting organized for such a scenario may take a little practice.
  5. It may be helpful to establish the proper ‘mood’ for expressing, have photos of your babies around you, perhaps listen to a tape of soft music.
  6. Dad/Partner can massage Mom’s back, shoulders and neck to help with relaxation. Bring her a drink, keep Mom Company, wash sterilize pumping bottles/tubing so they are ready for the next pumping session.
  7.  It is important to surround Mom with proper support to ensure a successful pumping session.
  8. Eat nutritiously, rest, minimize stress levels and drink plenty of fluids.
  9. Typically newborns are breastfeed 8 times or up to  12 to 14 times in 24 hours. Simulating a newborn feeding routine helps produce more milk. While each pumping session may take 10-20 minutes, the length of time will vary with each woman. Continue to pump as long as you have a good flow.
  10. The opposite will also help with milk supply: pumping when there is low or no flow, helps stimulate the breasts for the next day.*
  11. Keep a record of the date and time of pumping and how much is collected. This will clarify if pumping is occurring often enough to keep the breasts stimulated to produce.
  12. To keep on a newborn’s nursing schedule, set a timer during the night to ensure that you wake up and pump at appropriate intervals.

Storing And Handling Expressed Breast Milk

Most Neonational Instensive Care Unit (NICU) have procedures in place for storing and handling expressed breast milk. If your babies are in the NICU, you will need to acquaint yourselves with their regulations. Ask the staff if the hospital provides sterile containers will need to be clearly labeled with each baby’s name, date of expression, perhaps a hospital identifying code prior to being placed in the refrigerator. If you are on any medication at all, you may need to also note what they are on container label. Breast milk can be stored in clean, sterile containers:

  1. At room temperature (25C OR 77F) for 4 hours.
  2. In a refrigerator (not the door) for 48 hours [fresh].
  3. In a refrigerator (not the door) for 24 hours [frozen].
  4. In a refrigerator freezer compartment with a separate door for 3-4 months.
  5. In a deep freeze for  6 months.
  6. In a refrigerator freezer compartment for 2 weeks.

Frozen Breast milk takes no time at all to thaw in a saucepan filled with warm water. Do not heat breast milk on a stove or in a microwave. Do not freeze breast milk.

Sore Nipples

If nipples become sore during pumping, make sure that your nipples are properly centered within suction cup. It is easy to become distracted during pumping and inadvertently shift the equipment. Some mothers report that applying a small amount of modified lanolin cream is helpful. If problems continue, contact a lactation Consultant or La Leche League member. Don’t wait for the pain to become severe.

Types of pump:

Electric: efficient, through, expensive, can be rented by day, week or motion.
Battery: good for occasional pumping or not near electrical outlets, not as efficient as electric.
Manual: takes a long time to pump, not practical for women who pump often, inexpensive.
Hand Expression: difficult for some to master, inefficient, helpful for emergency such as engorgement.

Available Pumps:

Medela double pump, lactina, the Avent is is a good manual pump for double pumping. Some considerations: Find out about the level of suction of the pump. Some can be very strong and some inefficient. Are the instructions for using it clear? Does the company have a 1-800 number if you need to ask questions? Some drugstores and hospitals rent pumps, which can be quite expensive. Some Lactation Consultants offer rentals. Check out the Yellow Pages. Do your homework to find out what works for you.

With input form:
Erin shaheen, child birth Educator and mom of 4 breasted babies, including twins; and Valerie Lavigne, Chiropractor and Mom of 3 breastfed babies, including twins.

Bibliography:
*Motherly Multiples: Breastfeeding & caring for twins or more!! by Karen Kerkhoff Gromada, La Le Leche League International.

Resources
Multiple births, Cananda. Breastfeeding Support Network, www.multiplebirthscananda.org
Multiple Births canada’s Breastfeeding Multiples Fact Sheet Series
-Guidelines for transporting Breast Milk to NICU
-Breastfeeding Multiples: Fathers/Partners
-Breastfeeding Multiples: Nipple Pain & Vasospasm
-Are My Babies Getting Enough Breast Milk?
-Breastfeeding Multiples: Resources
-10 tips to successful Breastfeeding
La Leche League Interantional, www.lalelecheleague.org
The Pump List, www.pumpinglist.org
Lactation Consulting Services Canada, www.breastfeedinghelp.ca
Canadian Paedaitric Society, www.caringforkids.cps.ca/babies/Breastfeeding.htm

Additional Reading:

Multiple Blessings, Betty Rothbart, Hearst Books, 1994
Your Premature Baby, Nikki Breadford, Firefly, 2003
The Joy of Twins and Other Multiple Births, Pamela Patrick Navotny, Crown Trade Paperbacks, 1991
Feeding Your Baby the Healthiest Foods, From: Breast milk to table foods, Louise Lambert-Lagace, Stoddart, 2000