In 2010, the Affordable Care Act mandated that all health insurance plans were required to cover the cost of a manual or electric breast pump for pregnant women. This focus on breast pumps thrust pumping into the spotlight and, for most parents, became a previously unattainable alternative to feeding at the breast. However, it also made many women believe that they needed to pump in order to achieve successful breast/chest feeding. 

One of the most common questions I get asked is how one goes about increasing their milk supply — especially regarding breast pumping. While pumping can increase supply, many women cannot pump as much as their baby drinks on a daily basis. This tends to create supply anxiety — that is the fear or worry that their supply is not enough. Often the problem is one of milk removal rather than milk supply. What follows are some tips for successful pumping.

Tip No. 1: Decide whether or not you really need to pump. If you are breastfeeding and your baby is giving you an adequate amount of wet and dirty diapers and gaining weight adequately, then your supply is perfect and there is no need to pump. Realize that babies go through growth spurts (also called leaps), and there will be times when they want to feed more often. That does not necessarily mean you don’t have enough.

Tip No. 2: Don’t judge your supply by how much you can pump. Women turn to social media for information and often expect the amount they can pump to be the same as women with older babies, women who pump exclusively, women with more storage capacity in their breasts, or women who are overproducers. Depending on breast size and tissue distribution, some breast pumps are only able to pull 50% of available breastmilk out of the breast.

Tip No. 3: Do not assume that once the breast stops dripping, it is empty. The breast can let down more than one time, but we often stop pumping after the first letdown is complete. Try turning the pump back to the stimulation mode to see if you can trigger additional letdowns. Also, compression of the back and upper part of the breast during pumping (called hands-on pumping) can help bring milk down the ducts where it can be pulled out easier. Once you believe the breast is as empty as possible, push the flange in a little deeper for about 20 seconds to remove any remaining milk at the ends of the ducts.

Tip No. 4: Making sure the flange (plastic horn that rests on the breast) fits well. Although flange sizing beforehand is important, recognize that nipples elongate when stimulated. Most manufacturers recommend you measure the base of the nipple (not areola) and round up to the closest flange size. Some women have super stretchy nipples (referred to as elastic nipples) and mistakenly size up instead of buying soft silicone adapters and/or a smaller size flange. Read your pump manufacturer’s instructions for sizing.

Tip No. 5: Remember that stress can derail the milk ejection reflex (let down). You can have a lot of milk in the breast, but if you are stressed, worried, anxious, etc. — which is easy to be in a busy workplace setting — you may not let down efficiently. If you are fixated on how much you are might release, put a sock over the bottle so you can’t obsess about it visually. When you are pumping, think about your baby and relax. Have a “letdown photo” with you to trigger oxytocin release. For many women, pumping needs to be the only thing they are doing — not trying to read emails or make phone calls at the same time. 

Above all, breast pumping should be comfortable. Many women think the higher the suction, the more the pump will pull out, and that is not always the case. Experiment with different settings to find the one that works best for you. And remember what a great job you are doing by pumping and providing amazing breastmilk to your baby or babies. Every dripped drop counts! If you are struggling with breastfeeding, contact your local outpatient lactation unit or a Board-Certified Lactation Consultant (IBCLC) for help.

Mindy Cockeram has been educating women and their partners about childbirth and breastfeeding for 20 years. She certified with the National Childbirth Trust’s (NCT) Teacher Training College in the United Kingdom before relocating with her family to Southern California in 2010 where she certified with Lamaze International. She is also a Board-Certified Lactation Consultant (IBCLC). She teaches childbirth, breastfeeding, and baby care classes for a large Southern California hospital.

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