by Susan Greenbank, ABA Breastfeeding Counsellor
Many breastfeeding mothers will need to express their breastmilk at some time.
The reasons for expressing are many and varied, but can generally be grouped into short-term (less than 4 weeks) or longer-term.
Short-term reasons can include temporary breastfeeding difficulties such as engorgement, poor attachment, breast refusal, nipple soreness and the like; or short-term separations of mother and baby.
Longer-term reasons can include a mother who needs to be separated from her baby during her working hours; or a baby with permanent attachment difficulties (e.g. cleft lip or palate), or breast refusal.
The need to express due to a premature birth, or illness in either mother or baby, could be either short-term or longer-term. Some mothers also choose to express breastmilk for their own personal reasons, on either a short-term or a longer-term basis. Many mothers also like to keep a small store of breastmilk in the freezer for emergencies.
Whatever your reason for expressing, it can be confusing working out the best way to express and what breast pump is best to use (if any).
The most important thing to consider is how often you will be using the pump. Each breast pump is designed for a specific level of usage and you will get the most benefit from a pump that closely matches your personal circumstances.
If you have decided to use a breast pump, it is a good idea to carefully consider what the best pump is for you before purchasing or hiring. With breast pumps you really 'get what you pay for' so it is worthwhile buying or hiring a good quality pump designed for the need you have.
The following table may be useful in making your choice.
Most preferable choice Next preferable choice Least preferable choice X Not recommended
Breast shield size
Different size breast shields allow mothers to choose the breast shield that is the right size for them, to ensure maximum comfort and efficiency while pumping.
The Medela PersonalFit Breastshields are available in the following sizes:
Small — 21 mm
Medium — 24 mm
Large — 27 mm
XL — 30 mm
XXL — 36 mm
The Medium (24 mm) is the standard breast shield size included with Medela breast pumps.
If double pumping, two kits need to be purchased.
The easiest way for a mother to check if she is using the correct sized breast shield is to look at how her nipple fits into the breast shield funnel when pumping. It should move freely and easily, without rubbing on the sides.
If the breast shield is too small, the nipple will rub against the sides. Pumping may be painful and cause nipple soreness.
If the breast shield is too large, the areola will be pulled into the tunnel. This may cause impaired milk flow and soreness. Air may also get into the pump and affect suction strength.
If you would like more information on choosing a breast pump talk to your local breastfeeding counsellor. Australian Breastfeeding Association subscribers hire at half price. Breast pump hire is available through many local groups of the Australian Breastfeeding Association.
There is some more information on expressing and storing breastmilk, and an information sheet Suggestions On Using An Electric Breast Pump, available on this website. The comprehensive booklet 'Breastfeeding: expressing and storing breastmilk' can also be purchased from the Australian Breastfeeding Association by calling 03 9885 0855 or emailing email@example.com.
Instead of using a pump some mothers express breastmilk by hand, or combine hand expressing and pumping. Hand expressing is also useful for the times when a pump is not available.
Hand expressing is relatively easy to learn and may be sufficient for short-term or occasional expressing. Some mothers also use this method on a longer-term basis.
Some mothers find hand expressing an easier way to remove the smaller amounts of colostrum in their first few days of breastfeeding. Other mothers have found that hand expressing will continue to remove milk from their breasts after a pumping, or when a pump is not able to do so.
Combining hand expressing with electric pumping has also been found to increase milk production in mothers of premature babies. (See the videos 'Hand Expression of Breastmilk (Premature Babies)' and 'Maximizing Milk Production with Hands On Pumping (Premature Babies)' on the links page. Other videos about pumping, hand expressing, and also returning to work can also be found on the same links page.
Once you get the hang of it, hand expressing can be a quick and efficient method. To learn more talk to your local Australian Breastfeeding Association counsellor or contact our National Breastfeeding Helpline on 1800 686 268.
Hand expressing is also described well, with accompanying photos, in the Australian Breastfeeding Association booklet 'Breastfeeding: expressing and storing breastmilk. This booklet is available from the Australian Breastfeeding Association by calling 03 9885 0855 or emailing firstname.lastname@example.org.
For further information on using an electric breast pump, see the Suggestions on using an electric breast pump article on this website.
© Australian Breastfeeding Association May 2015