Dear mamaS,
Ideally when pumping you should have the settings as slow as possible. When the baby is sucking at the breast he usually isn't using that much suction if latched on correctly. When latched on incorrectly he is using a lot more suction because he is trying to pull the nipple into the right place with the suction.
When you breastfeed directly three things are working together to help the milk leave your body and enter the baby's body.
- Your hormone levels are raised, especially oxytocin. Oxytocin helps the milk ejection reflex - this is the reflex that squeezes the milk out of the aveoli, the milk producing cells, and pushes it into the ducts which take the milk to your nipple. When you pump or hand express the levels of oxytocin are much lower.
- The baby uses suction to help the milk come out - the pump tries to duplicate this but hand expression doesn't.
- The baby's mouth milks the breast with its tongue and jaw movements. Hand expression tries to duplicate this but the pump doesn't.
On top of this many mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump.
Many things that don't matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.
You can also encourage the let-down reflex artificially,
- By looking at your baby, or by having a piece of his clothing next to you.
- Apply a warm wet cloth to your breasts.
- Massage the breasts in small circular motions around the perimeter of the breast.
- Gently stroke your breasts with your fingernails in a downward motion toward the nipple.
- Lean forward and gently shake the breasts.
- Gently roll the nipple between your finger and thumb.
- Warm the flanges of the pump before putting them to your breast.
It may help to try a hand expression technique called the Marmet Technique,
http://www.lactationinstitute.org/MANUALEX.html
This is useful because it helps the let-down and so you get more milk.
(Please note that the diagram of the breast anatomy is out of date. Recent research has discovered that the milk reservoirs under the areola, the dark coloured part of the breast near the nipple, do not exist. The method, however, still works.)
Some mothers have found that the pumps are not good at getting the let-down to happen and so they use hand expression until the let-down and then swap to pumping. You can also use the times at the end of the Marmet Technique, including the massage, stroke and shake but instead of doing the hand expression use the pump.
And remember that if you need more milk simply express on more occasions and add the milk together. In this respect expressing is like breastfeeding - the more you do it with more milk you will get. Thus if you express six times for 10 minutes you'll get more milk than it you express once for an hour.
Some mothers are able to collect all the milk they need while at work but other mothers can't manage this and have to add extra pumping/expressing sessions in while at home. One trick is to pump on one side while the baby is feeding on the other side, as the baby will then get the let-down working for you. If you can't manage this then try feeding on one side for the morning feed and pump on the other side. Many mothers do this before going to work and find it is a real boost to know that even before work starts they already have some milk saved for the baby.
Best wishes,
SARAH