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Once you have your breastfeeding routine well established - typically between four and six weeks after the birth - you may want to introduce an occasional cup or bottle of breast milk.  

That will mean you have to either hand express or pump your milk.

Here's some advice on what to consider.

Watch a video on how to express breast milk.Mothers usually decide to use a manual or electric pump for one of two reasons:

1. Essential: A mother must pump because her baby cannot breastfeed or cannot breastfeed well enough. Examples include preterm or sick babies or when mother and baby are separated.
2. Optional: A mother chooses to pump because she wants some additional milk 'just in case' or because her baby will miss a feeding or she'll be away from her baby for a short time. 

You don't need to buy a pump before your baby's is born. It’s probably best to wait until after birth to see what you will need. Like many mothers, you may find that once you learn to hand express, you will prefer that method. If there's a temporary problem where you must pump, a rental electric pump may be your best choice.

It's important to express breast milk if you miss a feeding. However, keep in mind that babies who get several bottles a day on a regular basis may start to refuse the breast. 

Electric pumps

• Some electric pumps allow you to pump both breasts at the same time using two collection kits - one on each breast. If you're pumping for a sick or preterm baby it's helpful to double pump.
• If you're expressing your milk for every feeding because your baby can't feed well enough at the breast, you can rent or buy a good electric pump. Renting a pump is suitable if you are expressing milk for a few days or weeks. If your baby is born very early, you may need to pump for a few months. It's cheaper to buy a pump if you need it for three months or more.
• The cost of pumps varies, mostly because of the type of carrying case.
• Combine electric pumping with hand expression to stimulate your breasts into producing the most milk.
• With some cheaper pumps, you create suction by using your finger to open and close a hole. These electric pumps do not work well for many women.

When pumping milk, try not to compare yourself to other women! Some mothers can express several ounces of milk each time they try. However most women will need to express or pump several times to produce enough milk for one feeding.

Under Pressure

Sometimes mothers turn pump pressure up high to try to get more milk. Pumping at a high pressure can cause pain and may damage your nipples. If you gave birth very recently, your milk may not be in yet. Keep pumping and use some hand expression to stimulate your breasts and spur milk production.

Cleaning Pumps

If you choose to express milk with a pump be sure that all bottles, containers, and pump pieces are washed daily before use until your baby is three months old:

• Wash your hands.
• Take the pump pieces apart.
• Rinse milk off pump pieces with cold water.
• Wash with hot, soapy water and rinse well.
• Air dry on a clean towel.
• Check the manufacturer’s instructions - most tubing does not need to be washed and will not work if water is in it. If the tubing gets wet inside, try using a hair dryer to dry it.
• If pumping very frequently, some mothers will put the parts in the fridge between uses (perhaps during the night) and then wash them well.
• If you're using an electric pump, do not immerse the motor in water. Wipe the outside casing well with a damp cloth.

If your baby is preterm or ill, check with the hospital. Some hospitals will ask you to disinfect the parts once a day.

Here's how:

• Put the pump parts in a pot, cover with water, and boil on the stove for five to 10 minutes. Air dry on a clean towel; or
• Soak the pump parts for 10 minutes in household bleach. Use 250 ml (1 cup) of bleach and 2.25 litres (10 cups) of water. Rinse well with boiled water. Air dry on a clean towel; or
• Use the sani cycle on your dishwasher. Place pump parts on the top rack. 

Helpful Hint

If you need to use a pump in the hospital, you will be loaned one during your stay. If you continue to express your milk when you go home and already have a pump, bring it into the hospital and compare how it works with the hospital pump.

Check with your midwife, nurse or lactation consultant for more information about where you can buy or rent a pump.

Resources & Links:

Breastfeeding

Breast-Feeding - Choosing a Breast Pump 

VIDEO: Admission to Postpartum - Keeping Your Baby Skin-to-Skin

VIDEO: Baby's Feeding Cues and Behaviours

VIDEO: Breastfeeding Positions

VIDEO: Hand Expressing Milk

VIDEO: Latching Your Baby