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How to tell your breastshields (flanges) fit you properly (May 2022)

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How to tell your breastshields (flanges) fit you properly (May 2022)

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Breastfeeding without pumping or bottle feeding is possible and can make life easier

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Breastfeeding without pumping or bottle feeding is possible and can make life easier

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Because of the way breastmilk production works: https://www.cordeliauys.co.uk/how-breastmilk-production-works , in the early months, if a mother goes longer than roughly 3 or 4 hours without breastfeeding or pumping, unless she has a very large breast storage capacity: https://www.instagram.com/p/CLXTEvlsZXv/?utm_source=ig_web_copy_link , her breasts will get the message to reduce milk production, and she could be at risk of developing blocked ducts and mastitis. Therefore, contrary to what is commonly believed, someone else giving a bottle at night doesn't tend to mean mothers get more sleep because most mothers would need to wake up and pump at some point close to when their baby needs to feed.
Bed sharing and using the side-lying position are game-changers for most nursing mothers
Many women find direct breastfeeding at night allows them to get more sleep. Mastering the side-lying position tends to make night feeds much less exhausting: https://www.cordeliauys.co.uk/in-praise-of-the-sidelying-position
Lots of women struggle to produce milk when pumping
When a mother breastfeeds, feeling, seeing, and smelling her baby helps her release oxytocin, the hormone which makes the muscles around the milk producing cells inside her breasts contract and push the milk out. This process is known as the let-down reflex (or the milk ejection reflex). But when a mother expresses her milk, especially if she is doing so when away from her baby, it can be harder to get the milk flowing:

https://www.ardobreastpumps.co.uk/the-let-down-reflex-by-cordelia-uys/#:~:text=The%20anatomy%20of%20your%20breasts,and%20turn%20them%20into%20milk.
Expressing can put mums at risk of oversupply
If a woman is exclusively breastfeeding without doing any pumping, her baby programmes her breasts to make exactly the right amount of milk. It's blissfully simple. Pumping can interfere with the delicate balance that happens when a mother and baby are perfectly in tune with each other. As well as putting a mother at risk of reduced milk supply, pumping can also put a mother at risk of the opposite, that's to say creating more milk than her baby needs, which increases her chances of getting blocked ducts and mastitis. Oversupply can also make babies uncomfortable and fussy.
Bottle feeding can lead to breast rejection and nursing strikes
When babies are bottle-fed on a regular basis, they can start to refuse to suckle at the breast, because breastfeeding is harder work for a baby, and it takes longer for the milk to start to flow.

If a baby is having a fussy period, and a mother is solely breastfeeding, she has to find ways of managing, but if there is the option, it's not uncommon for mothers to offer a bottle, which can lead to a baby refusing to breastfeed, and therefore being given more and more bottles.

I regularly hear from mothers whose babies have been given bottles and who then start to reject the breast occasionally or all the time. These mothers will then need to pump to protect their milk supply. In many cases this results in a breastfeeding journey ending sooner than the mother wanted.
Of course, pumping and bottle feeding can be incredibly useful...
I need to emphasise that I am not at all against pumping and giving bottles. I was a volunteer pump agent for a leading pump manufacturer for many years. I know pumping works well for many women and can allow mothers who need to go back to work earlier than 6 months, or who will regularly need to be away from their young babies for longer than 2 or 3 hours, to continue breastfeeding. If a baby is born premature, unwell or is unable to latch, or if a mother needs to stop breastfeeding temporarily, pumping with a hospital grade double pump can enable her to establish and maintain her milk supply. Pumping can also be very helpful if a mother needs to increase her milk supply.

When parents practise paced bottle feeding, it helps to protect against overfeeding and breast rejection:

https://www.youtube.com/watch?v=OGPm5SpLxXY
...However, it is possible to breastfeed without pumping or using bottles, and some women find this much easier and more enjoyable
I am keen to raise awareness of the fact that if a mother is lucky enough to be able to take at least 6 months maternity leave, it is very much possible to breastfeed without doing any pumping and without ever using bottles. What's more, this can make her experience of breastfeeding easier, simpler and more enjoyable.

I suspect many people assume that all babies will need to be bottle fed at some point, but that really isn't the case. From around 6 months, babies can drink water or milk out of a cup or beaker if their mother is not around.

It is also worth bearing in mind that the early introduction of a bottle is no guarantee that a baby will continue taking one. It is not uncommon for a baby to take a bottle early on, and then one day suddenly refuse to.
What mothers say about their experiences of breastfeeding without pumping
To find out why some women choose not to give any bottles, and to hear about their experiences, I posted the following question on NWL Breastfeeding, a Facebook group for London-based breastfeeding mothers:
"I'm writing an article about how it's possible and feasible, if one is lucky enough not to need to go back to work earlier than 6 months, to breastfeed without ever using bottles. If that's been your experience, I'd be grateful if you could post below about what it was like for you."
Over 80 members responded, and I have compiled their comments below.
The idea that fathers need to bottle feed to bond with their babies can affect a mother's breastfeeding journey & make her life stressful
Some mothers feel obliged to pump because their partner believes this is the only way he can bond with their baby. This can lead to a very miserable and stressful experience for the mother:

Anonymous: " My husband wanted to give our daughter a bottle in the evening, so he could bond better with her, which meant I couldn't refuse. But I wished I didn't have to do it, because I needed three or four pumping sessions to get him that one bottle of milk. It was so stressful for me, and I was always worried that I wouldn't be able to get enough milk. I also had to pump while he was giving her the bottle, so half of my day was centred around that one bottle of milk.

I know it's not the question that was asked but it's another side of "giving a bottle". The day I packed my pump for storage was the day I exhaled. Removing that pressure and focusing on our breastfeeding journey was such a relief! I was able to work from home so lots of times I would latch her in a sling or on a very carefully propped feeding pillow at my desk and she could feed while I did my calls and worked on my laptop. While I managed to create a little supply of frozen milk, we ended up disposing of it as we never used it. My daughter is still breastfeeding at 26 months...it has been such a blessing for us after such a rough start that we are enjoying it every day it lasts."
There are many ways dads can bond with their babies that don't involve feeding
Becky: " Breastfeeding is very special and my partner, her father, is very supportive and hands on. He has never voiced a desire to feed our baby. He has never felt 'left out' by not being able to feed her. They have a very wonderful bond and spend a huge amount of time together in other ways. He always tells people: ' I do everything Becky does, except breastfeed.'"

Cameron: " Ellen is in charge of the input and I'm in charge of the output."

Alex: " There's a lot of guilt that gets placed on mothers to do certain things and one of those that irks me the most is "You should let dad feed the baby so he can bond properly". What does that even mean!? And why can that bonding only happen during a feed? We play different roles in our girls' lives and they are both special in different ways."
Pumping is boring, exhausting, stressful and time consuming
Sophie: " I decided not to pump at all with my youngest having had a miserable time having to pump and bottle supplement with her big brother. I had no appetite to deal with the faff of it all again."

Joanne: " With my second (now 7 months old) I've never bothered expressing as I realised that first time round it just caused me stress with no benefit!"

Flora: " I have been thinking a lot about this recently as I have never used bottles or expressed with my second baby - I just haven't had the energy to even get my pump out and my baby had a dairy allergy so can't give normal formula. I've enjoyed how simple things have been (no sterilising, no equipment)."

Alex: " I've never used bottles - I have an almost 3-year-old who still breastfeeds and also a 6-month-old. I think when our older daughter was born, we just assumed we would use bottles for some feeds as we thought that's what everyone did! And that it might give more flexibility if my husband could help on the feeding front. So we bought a pump, storage bags, etc... But I never found the time nor had the inclination to express - the less on my to-do list the better I felt about my day!"

Becky: " I have personally not wanted to introduce a bottle because I have thought that the whole pumping and sterilising regime seems like such a faff and hard work. All mums I speak to seem to hate pumping."

Cina: " With my first I tried bottles of expressed milk and she just wasn't keen and it seemed like an extra faff and unnecessary stress seeing as I didn't actually need to be away from her. Second time round I could not be bothered so just didn't as there was no reason for us to be apart for a significant amount of time. I'm glad we didn't as it took out the extra stress of trying to get her to take a bottle, that we just didn't need!"

Dina: " I wanted to avoid the hassle of sterilising, pumping, worrying about how much my baby is getting and was worried about 'nipple confusion', 'when I should pump'. I was particularly confused about needing to pump while baby has the bottle and how this would help me rest more while also keep up my supply, so that was a major factor in not bothering with bottles.
I managed to also avoid mastitis completely which was very lucky, but I think might have been down to always having baby be the one to remove milk."
Maya: " My son didn't take a bottle and I'm so glad because pumping was so exhausting! "

Lucy: "With my first baby I had to go to a wedding when she was 4 months old to which she was not invited. Cue much stress, tears and worry about getting her to take a bottle...The upshot of all that was that I found the process of expressing, sterilising, trying to encourage a baby to take a bottle, then inevitably wasting half the milk stressful, full of faff and incredibly time consuming."
Exclusive breastfeeding is simpler, easier and more convenient
Lucy: " With my second baby I just didn't have time for that faff. I knew she would be with me all the time so I didn't see the need to introduce a bottle and it was such a relief not to have to even think about it. She latched perfectly at 5 minutes old and we were away."

Elle: " From a practical point of view, I love the freedom of having always what my baby needs without the need to remember to take a bottle, wash, sterilise, warm up, check the temperature... I just need to make sure I'm with her at least within 3 hours or so most of time. Also SO convenient when flying! To the question: any liquids? (especially when they see the baby) I always smile and say: no just mummy."

Courtney: " With Teddy, we never used bottles and it was a completely different experience for us from our daughter, who was bottle fed from day three...I found that breastfeeding just simplified everything for me. Night feeding was easier because I didn't have to get up and make a bottle, I could leave the house with very little (whereas I felt I was carrying a massive load of bottles/formula/sterilising tablets/water/etc with my daughter); overall I felt I could be more flexible. Breastfeeding was also the answer for everything, Teddy being overwhelmed/hurt/hungry/tired/angry/overexcited/sick. I felt that I was able to get more sleep and that had a huge impact on those early days and months. It was (and continues to be), the most important tool in my toolbox."

Joanna: " I love the simplicity of it including feeding to sleep in a recovery position (both for bedtime and for naps) without having to move or reposition the baby plus of course the connection. I feel it is our time but in a way my time too - it's a great opportunity to catch up on sleep/ rest / reflection/ reading / extra connection when I finally got back to work after 12 months etc."

Laura:" It's soooooo much easier. No sterilising, no pumping - if I'm very honest, laziness and searching for the easiest path (especially when taking care of a baby, sleepless nights etc) were definite factors for me."

Suzanne: "I exclusively breastfed Henry without a bottle etc until he eventually started to take water additionally from an open top little cup at about 8 months old. We were travelling for over half of my maternity leave and it was so much easier to just feed him directly."

Maggie: " My plan with my second was to try and introduce a bottle earlier as an option, but then you know, there was COVID, so we weren't going anywhere anyways! As others have said, once you make that decision it takes the stress out of the situation."
It is possible to be productive while breastfeeding
Kirsti: "I love to read while feeding (a Kindle is easier than an actual book), listen to a podcast, or call a friend, and I've even written blog posts and brainstormed work ideas on my phone. That way I find I'm grateful for the time because it's either productive or a form of self-care.
Young babies can be taken almost everywhere
Lots of women believe that they will need to pump so they can leave their baby with a carer if they need to go out, but in fact, it's possible to take a young baby almost anywhere. Having them in a sling or baby carrier tends to help. An architect friend of mine took her young baby to all her meetings with English Heritage and she says no one batted an eyelid when she breastfed him. I took my youngest son to a talk by the author Amanda Foreman when he was just a few months old. Under the Equality Act 2010, it is illegal to prevent a woman from breastfeeding her child (of any age) wherever she is legally allowed to be.

Sophie: " She went to the hairdressers with me, to leg wax appointments (fed during both!), KIT days, weddings, funerals and all sorts."

Becky: "I've not had any occasions I've needed to go to where my baby couldn't come along with the support of her dad helping out. As she has grown, and time in between feeds lengthened, I've also had time to myself. Introducing a bottle has just not ever seemed necessary."

Gwyneth: " I have found it easier than I thought to just take my baby with me everywhere I go."

Varsha: " Baby just goes with me everywhere now and she gets milk when she wants it."

Joanne: " I tried to offer my first baby a bottle for a while but he never took it so I gave up as I got so sick of throwing out my expressed milk! After a while I realised I had no need to be away from him for long enough that he would need a bottle anyway! I still went to the hairdresser (my husband would bring baby midway through for a feed)."

Kirsti: " Recently I attended a mum & baby yoga class where I could take my baby. Mums just fed and soothed their babies freely in the class when necessary (we still got a decent amount of exercise done!), and it was a great way to make new mum friends. I feel so happy knowing that I can consistently attend yoga now and won't have that background tension of wanting my me time but feeling anxious about being needed!

Another part of it I think is about getting more comfortable breastfeeding in public or having the baby cry while out. One thing I really enjoyed pre-baby was attending author events, and now that they're open again post-covid I've been frustrated that I can't go... but perhaps it's not so much that I "can't" go as that I'm anxious she cries in that situation or feeding doesn't go as well as it does at home. I suppose if I turn up early and begin feeding her in the sling just before the event starts, she'll probably fall asleep for the rest of it and I can still enjoy the talk - and if I sit at the back, I can quickly slip out if she cries. I think the more I practice bringing my baby with me to the things I want to do, the more confident I'll become. "

Consuela: " It means I can leave the house very quickly - so long as baby is in the sling, her food and drink is on tap. Friends have commented that they're up for meeting up a lot as I can get out and there aren't loads of baby related delays! Also means I can get on with all sorts, be it enjoying a lunch out or just sorting out more mundane things like laundry or ordering shopping."

Alexandra: " I never felt the need to be out without my baby and tended to just take him everywhere with me."
The time babies are tiny and need to be fed really frequently doesn't last that long
Elle: " I only tried the bottle twice just to see if it could work and neither of us seemed really excited about it. I didn't enjoy expressing and she didn't enjoy the bottle. It's a tough journey at times due to the need for mom to always be around, but I accepted that, knowing it's for a relative short time. I personally enjoy this moment so much!"

Gery: " Yes, there wasn't the option to be away for more than a couple of hours when the girls were very little, but those first few months fly by so quickly and I wouldn't change a thing."

Cogs: " With my first I did my socialising in the day, managed to fit in gym, walks, lunches out etc and knew one day I'd get back to going to the pub in the evening and out for dinner."
Some mothers don't want to spend time away from their young babies
Emma: " My first had maybe two or three bottles of expressed milk ever, my second maybe one which he didn't take and my third is currently 11 months and yet to meet a bottle. I've been lucky enough to be able to keep working from home flexibly with the kids around and have never really wanted to be away from them so haven't really expressed. I'm also rubbish at expressing despite a great milk supply, so it just seems like such an effort that I've not really bothered!"

Cogs: " People were desperate to get me using a bottle [with my first baby] "just in case"! And so I could go out in the evening. But I didn't want to go out in the evening because I knew even if we went through the rigmarole of getting him to accept a bottle, he wouldn't be happy without me there. It wasn't just about the boob - it was about our relationship.
With my second...I'm all the surer that I won't introduce a bottle or pump because I really do know how short these years are now. I had an inkling that they would be and really did try to cherish every feed and every moment with my firstborn, but now with additional hindsight I absolutely know that the days and weeks fly by, and my baby girl will never be this little again. I don't want to be separated from her."
Kylie: "My baby has never taken a bottle and I will be going back to work part time in a few months when he will be 9 1/2 months old. We are currently experimenting with a Doidy cup. Until now, I haven't been away from him for more than an hour. I feel breastfeeding is an excellent excuse/reason to stay super close and I am so grateful to have had this uninterrupted time with him. "

Amelia: " I am lucky that I have a year of maternity leave and no need to be apart from her and if I want to do anything I just take her with me."
Older babies can go longer between feeds and cope with solids and water, or milk, from a cup
Older babies are also much more predictable, so it's easier to plan around their schedule.

Jessica: " My son has never drunk from a bottle and very happily started to use a cup easily [now he has started solids]."

Sophie: " When she was older, I could intuit her feeding patterns a bit more so I'd know if I needed to go somewhere how long she could go without feeding eg physio appointments etc."

Varsha: " My little one is just over a year and has never taken a bottle, even when I was admitted to hospital as an emergency, and she couldn't breastfeed for >24 hours. I can only say that she found her way with having food and water from dad and then when she saw me, attached herself."

Joanne: " After about 8 months he was taking water from a cup and eating lots of food, so his dad just gave him food and water while I was gone, and I was able to go to drinks with friends."

Maya: " My son wouldn't take a bottle. At around 5 months, it got much easier to leave him for an hour or so as he was very happy exploring the world and also got better at sleeping a bit longer. Then when he was ready for solids at 6 months, it got even easier and now at 11 months, he's settling into nursery and with grandparents."

Alexandra: " I exclusively breastfed my son until introducing solids at around 8 months and am still nursing him now at 2.5 years old. We tried a couple of times to introduce a bottle of expressed milk, but he would never take it - looking back I shouldn't have bothered, I think "getting him to take a bottle" was more about the expectations of others. I never felt the need to be out without my baby and tended to just take him everywhere with me. I went back to work at 10 months. I expressed for a short time so he could have my milk in a sippy cup, but he wasn't too interested in that either, and was happy to wait until pickup for a breastfeed! I am glad at how it all worked out and proud of our breastfeeding journey."

Kim: " I have had two children and have been in the incredibly fortunate position of never needing to use bottles for either. With my oldest, she was offered breastmilk in a doidy cup by my husband at 7 months when I was out and she happily took it."

Julia: " My son never used a bottle and I went back to work when he was 9 months old. It's mainly because expressing and sterilising is such a pain! I was lucky he took to solids well. "
In an emergency, babies can be fed with a syringe
Gwyneth: "I've pumped a bit for the freezer and in an emergency my husband could syringe feed if I was in A & E or something, but otherwise we'll just wait until he can use a cup."

Trying to get a baby to take a bottle can be very stressful!

Reena: " My older son refused a bottle from about 10 days old even though the midwife gave him a bottle on day 4. It was quite stressful trying to express and offer feeds because he *must* drink from a bottle. I didn't even try with second son, and he breastfed until he was 4 years old."
Older babies can 'reverse cycle' and get the breastmilk they need when they're reunited with their mother
Kathryn: " My babies number 3 and 4 never had a bottle despite my going back to work at 6 months both times.
Baby 3 refused any expressed milk from any vessel. My child minder tried them all. Eventually she made mash potato with it so it wasn't wasted. Baby 3 very quickly got good at eating and would drink some water form a sippy cup. When I picked him up he had a big old cluster feeding session to make up for it. Then a bedtime feed, night feeds and a morning feed. On our days together we breastfed as normal and he went back to be pretty much exclusively breastfed with just a little food, as you would expect from a 6 month old baby! After a couple of weeks I decided I wasn't going to express for mash potato, so I stopped. I sometimes needed to hand express a little for comfort. But my boobs soon adjusted. They absolutely knew which day of the week it was. Baby no 4 was not quite as extreme. He would have a small cup of expressed milk. But only 30-60ml and then the rest of the time had food and water. So I expressed a bit longer for him. Both children we breastfed for over 3 years." External pressure to express and give bottles
I remember a new mother calling me several years ago to ask about how to manage pumping and bottle feeding. During the conversation it became apparent that she didn't want to spend time away from her baby, but friends and relatives had been trying to encourage her to 'get her life back' and she felt ashamed and embarrassed about not wanting to be separated from her baby. She felt as if she were somehow being 'weak'. If a mother is keen to have some time to herself, that should, of course, be respected. But mothers who would rather not spend time away from their baby should also be respected and not put under pressure.

Joanne: " Looking back, I think I only became interested in the idea of baby being able to take bottles because I felt pressure from my mother-in-law, as well as friends who were doing it!"

Gwyneth: " It's not 'resigning' to just exclusively nurse at this stage, probably society puts a lot of pressure on us to use bottles or sees bottles as the norm. I was getting pressure from my MIL to introduce a bottle as SHE found it irritating that my husband wouldn't take one as a baby, but that was her experience, not mine."

Courtney: " Unfortunately, there was pressure from every angle that I should offer a bottle now and then, to give myself a break or give others a chance to feed. But I very quickly realised that it said more about those applying the pressure than me, so I ignored it and eventually the comments stopped."

Laura: " I think friends felt pressure to pump even when it wasn't necessary. There is so much talk...about which pump, what bottles, it makes it at the fore of your mind before the baby arrives (if I want to ebf, I must pump...)."

Maggie: " With my first I think I felt under some pressure after a few months that he should take a bottle of expressed milk (1) for top ups as there was concern on weight gain (2) because of this message that seemed to be coming from some family, and that seemed to be generally out there in society, that I needed to make sure he could also take the bottle so he 'wasn't totally dependent on me' and others could feed him/I could leave him with others. It then became quite stressful when he wouldn't take a bottle no matter what we tried. I was told as I hadn't introduced a bottle early enough I had missed 'that window'! I felt then I had almost done something wrong."
Worry about breast rejection
Gwyneth: "I've got a 12 week-old who won't take a bottle, which I'm actually relieved about as I was worried about breast rejection. I will just wait until the weaning stage for him to use a cup. I'm lucky to take so much time off work and it's just easier and less stressful to take him places."

Amelia: " I am so weary of bottles and eventual breast rejection from my first. I therefore have completely avoided introducing a bottle at all to my second. I've actually found it far easier than the feeding, pumping and top up regime I went through with my first."
Some women do feel trapped, or overwhelmed, but find it gets easier as their baby gets older
Emma: "I felt trapped at times when my first born would not take a bottle - I dreamed of having an hour to go to a yoga class without worrying about filling him with milk beforehand and then worrying during the class that he would be hungry whilst I wasn't there! I found that around 5 months it got a lot easier to leave my son for longer than an hour. He fed a little less often, he decided that feeding during the day was boring and he'd rather look around - my husband could distract him if I wasn't there by taking him for a walk outside or putting him forward-facing in a sling, and then shortly afterwards he started solids. Second time around I have twins who have just turned 5 months. I'm not pumping at all as I don't have time. I can feed one before I go, take my eldest and the other twin out for 2.5 hours whilst my husband looks after the other. "

Melissa:" I think the prospect of only being able to feed her myself was quite overwhelming when it dawned on me that she wasn't going to take a bottle - but now it seems like the easiest option really, in contrast to a daily bottle battle and chucking away all that precious milk. The time is certainly flying, and I can definitely feel the breastfeeding becoming much easier than it was - think I will just try and enjoy the ride of the next couple of months until she can try a cup. Goodness me, I can't imagine how it will feel not to have her with me all the time!"

Helen: "My son rejected bottle at 10 weeks and I tried literally every day, every kind of bottle, every technique to get him to take it. I was desperate as I did need the space to be able to leave him with someone and have a break for my mental health. I'd say at 6 months it gets less essential as they can have water from a sippy cup and food and you know they aren't going to starve."
Pumping can bring back the trauma of a previous experience
Amelia: "With my second daughter who is 10 weeks old I have managed to exclusively breastfeed and she's gaining weight well and she's never even seen a bottle. It's been such a healing experience for me and i would not want to be apart from her anyway. I did get my pump out once and using it brought back many memories of feeding troubles from my first and it was not an enjoyable experience at all."

Suzanne: "I had exclusively pumped for my first son and had found that quite emotionally hard towards the end and so I was also reluctant to pump until I returned to work this time, so I put it off as long as possible!"
In conclusion
If you are lucky enough not to need to spend much time away from your baby for at least the first 6 months of their life, and breastfeeding is going well, you might want to wait and see how things go before doing any pumping, because not pumping might make your breastfeeding journey considerably easier and more relaxing. Your baby will programme your breasts to make exactly the right amount of milk for his or her needs; you are less likely to get blocked ducts and mastitis, and much less likely to have a baby who starts to reject the breast or goes on a nursing strike. Six months is a relatively short period, and before you know it, your baby will be able to cope without your presence for quite long stretches.

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Because of the way breastmilk production works: https://www.cordeliauys.co.uk/how-breastmilk-production-works , in the early months, if a mother goes longer than roughly 3 or 4 hours without breastfeeding or pumping, unless she has a very large breast storage capacity: https://www.instagram.com/p/CLXTEvlsZXv/?utm_source=ig_web_copy_link , her breasts will get the message to reduce milk production, and she could be at risk of developing blocked ducts and mastitis.

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Antenatal harvesting of colostrum article

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Antenatal harvesting of colostrum article

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Press both your thumb and your index finger straight back towards your ribs. Then squeeze your finger and thumb, slowly and firmly, behind your areola. Imagine you are trying to join your thumb and index finger together. You will probably have to press quite hard. Initially this can be uncomfortable.

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by Cordelia Uys

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The anatomy of your breasts.
There are several ducts on the inside of your nipples which branch out into your breasts; at the end of the ducts are a multitude of alveoli containing milk producing cells. These cells take nutrients from your blood and turn them into milk. The milk ducts then transport milk to the tip of your nipples, where milk is released from several openings called milk duct orifices. This network of ducts looks similar to a tree, with the trunk being the nipple, the branches the milk ducts and the leaves the alveoli.

Oxytocin and Prolactin

The two main hormones involved in milk production are oxytocin and prolactin. Oxytocin, often called the hormone of love, causes the contractions of orgasm, birth and lactation. It promotes feelings of love, bonding, calm and well-being in both you and your baby. Prolactin is the hormone that creates milk; it induces calmness and mothering behaviours. Prolactin levels are highest in your body between 2am and 4am, which is why mothers often notice they produce more milk at night, and why breastfeeding (or pumping) at night in the early months is so crucial to establishing and maintaining your milk supply.
The let-down reflex:
When your baby suckles at your breasts, your brain releases oxytocin, which travels in your blood down to your breasts, where it makes the muscles surrounding the milk producing cells contract and push the milk out. This process is called the milk ejection reflex, or the let-down reflex, as milk is 'let-down' from the breasts. The removal of milk from your breasts - by your baby or by pumping - then tells your body to make more prolactin. Milk production is reliant on supply and demand: the more often your baby feeds (or the more often you pump), and the more milk is removed, the more milk you will make.
The Feedback Inhibitor of Lactation (FIL) and the importance of frequent milk removal:
Whenever your breasts get hard and full, a whey protein, known as the Feedback Inhibitor of Lactation, builds up in your breasts, telling them to stop making milk. This means milk production slows down when your breasts are fuller and speeds up when your breasts are softer. This is why regular milk removal is so important for maintaining a good milk supply. A baby will typically breastfeed at least 8-12 times in 24 hours; in fact, many babies will breastfeed more than 12 times in 24 hours. A mother who is exclusively pumping should aim to pump at least 8 times in 24 hours because regular milk removal helps promote good milk production and protect her milk supply. If milk is not removed very regularly either by breastfeeding or pumping, a mother's breasts will get the message to gradually produce less and less milk.
What does the let-down reflex feel like?
Some women don't feel the let-down reflex at all, others feel a tingling or tightening sensation in their breasts, or a sudden feeling of fullness, and a few women actually find the let-down reflex quite uncomfortable or even painful. Women usually experience two let-downs during a feed, but many are only aware of the first one. This tends to occur after the baby has been suckling for a minute or two. If you are one of those mothers who don't feel their let-down, the way you'll know it's happening is that you will see, and possibly hear, your baby swallowing faster, and you may notice milk dripping from your other breast.

Uterine contractions

In the first week or so of your baby's life, you will often feel uterine contractions at the same time as the let-down reflex. This is because the oxytocin causing the muscles around your milk producing cells to contract also causes your uterus to contract back down to its pre-pregnancy size. This is one of the beneficial effects of breastfeeding: your uterus shrinks back down faster. These contractions can feel quite painful, especially with second and subsequent babies, and some women choose to take paracetamol to help with the pain. Paracetamol is compatible with breastfeeding. Breathing in through your nose and blowing long breaths out through your mouth, as during birth contractions, can also work well.
Oxytocin - the 'shy' hormone
When you're breastfeeding your baby, having a let-down reflex is rarely something you need to think about, as your baby's presence is all your brain needs to release oxytocin, but when mothers are pumping, and especially if they're doing so when away from their baby, or when they are anxious about their milk production, or indeed feeling worried about anything else, it can be harder to get the milk flowing.

Oxytocin is linked to loving feelings, and although a mother might like her pump and be pleased to have it, few women actually love their pump. In addition, oxytocin is often called the 'shy' hormone, as it's harder to get a release of oxytocin if you aren't feeling safe, calm and unobserved. Imagine being told you needed to have an orgasm within a set amount of time, especially if you weren't in the mood. It would be even harder if someone you didn't feel comfortable with were sitting there watching you!

Once mothers are used to pumping, and especially when mums are pumping at the same time, or times, every day, their breasts become accustomed to the process and having a let-down isn't usually a problem, but if you are new to pumping, there are some steps you can take to help with the process.
How to encourage the let-down reflex.
- Warmth and massage

Firstly, apply warmth to your breasts - pouring comfortably hot water into a clean nappy makes a great warm compress - and then gently massage or stroke your breasts. It's even better if someone you feel comfortable with can rub your shoulders and/or feet. If your baby isn't in front of you, have a photo of him or her to look at, and a piece of clothing or muslin that smells of them to sniff.

- Try to relax

Try to relax as much as possible, for example by listening to music you enjoy, or some hypnobirthing tapes. Some mothers find practising mindfulness or imagining their favourite place really helpful. Watching a TV programme that puts you in a good mood can work wonders. One mother who had to do a lot of double pumping at the beginning of her breastfeeding journey used to watch an episode of Friends during each of her pumping sessions.

- Pain prevents oxytocin release

Please remember that pain impedes the release of oxytocin, so it's essential that your breast shields fit comfortably, and that the vacuum on your pump isn't set too high. Start with the vacuum low and the cycles high, then once the milk starts to flow, turn the cycles halfway down, and the vacuum up so that the suction is firm but totally comfortable. If you put the vacuum up too high, you'll produce less milk and you might also cause nipple damage.

- Try not to stare at the pump sets

Rather than sitting and staring at the pump sets, some mothers choose to cover the pump sets with baby socks, so that they can't see how much milk is coming, and therefore don't obsess about whether or not they're producing enough milk.

- Pumping bra

When double pumping, it's recommended to either buy or make yourself a pumping bra that will hold the pump sets in place. You can customise an old exercise bra you don't mind sacrificing, by cutting holes in it where the pump sets need to go. Make sure the bra is comfortable and doesn't dig in anywhere or push the pump sets too tightly into your breasts as this can cause blocked ducts. A pumping bra will also allow you to massage and compress your breasts while you pump. This is known as hands-on pumping and it helps both with the let-down reflex and also in removing more milk from your breasts.
Oxytocin is triggered in many ways:
* By having your baby in skin to skin
* By seeing, hearing and smelling your baby
* Sometimes by hearing someone else's baby
* By thinking of your baby
* By breastfeeding
* By pumping

Things that help oxytocin to flow:

* Feeling warm
* Feeling calm, safe and relaxed
* Not feeling observed
* Not feeling pressured or anxious
* Not being in pain
* Gently stroking or massaging your breasts and nipples
* Having your shoulders and/or feet massaged
* Seeing a photo of your baby
* Practising mindfulness
* Listening to hypnobirthing tapes
* Listening to music you enjoy
* Watching a TV programme or film that is fun and light-hearted
Imprinting on your pump
One last thing to point out, is that over the years we have noticed that when a mother has become used to a particular brand of pump, it can sometimes be hard for her to get a let-down reflex for a different brand. It's as if her brain has imprinted on that brand and she's bonded with it. In fact, if a mother has been exclusively pumping for a while, and has been separated from her baby while pumping, sometimes she might need to think about her pump to get a let-down when she starts breastfeeding her baby. This is another reason why it's a good idea to look at a photo of your baby while pumping, rather than staring at your pump. If you would like or need, to change the brand of pump you're using, it can help to spend a week alternating between the two types of pumps so that your brain learns to accept the new brand.

For further information please watch the Let-down video
Cordelia Uys has been a NCT Breastfeeding Counsellor since 2009. Cordelia runs a weekly breastfeeding drop-in at her home and helps countless mums with feeding and expressing.

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THE LET-DOWN REFLEX by Cordelia Uys | Ardo Breast Pumps

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THE LET-DOWN REFLEX by Cordelia Uys The anatomy of your breasts. There are several ducts on the inside of your nipples which branch out into your breasts; at the end of the ducts are a multitude of alveoli containing milk producing cells. These cells ...

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This is a very good article about choosing a pump

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This is a very good article about choosing a pump

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I decided to write this blog after seeing a mum post on a Facebook breastfeeding group asking for pump recommendations. The Admin for that group directed her to a link on the American Kellymom.com breastfeeding website on buying new and used breast pumps which really is not particularly helpful. I did a quick google and really could not find anything useful to help a mum select an appropriate breast pump from the vast array on offer. This reaffirmed to me the difficulties mothers in this situation face. I see families daily who are using a breast pump that is not appropriate to meet their needs or who have spent hundreds of pounds on a pump that remains in its box unused.

Why do you need to express?

So, as a parent how do you choose a breast pump? There are many reasons why you may need to or want to express. The reason for expressing will also dictate how often you will be pumping. This is key to choosing a suitable breast pump.

In the early days after birth you may find you need to pump frequently to provide milk for your baby who, for whatever reason, is not able to latch and feed directly at the breast. Or your baby may be struggling to drain the breast effectively. Frequent expressing will be needed to stimulate milk production and manage engorgement as the milk starts to come in. Later, you may need to express because of inefficient feeding and/or slow weight gain to provide top ups and/or boost a low supply. As baby gets older you may want the flexibility of being able to leave her baby in the care of someone else so you can have a break, go to bed early or attend appointments. You may be returning to work and need to leave milk for your baby.

There may also be situations where a mother wishes to re-establish a milk supply after a break from breastfeeding ( relactation). More parents are now inducing lactation in situations where they are adopting a baby, or in same sex couples where the non-birthing parent wishes to share in the breastfeeding, or where a parent is transgender. Both these situations usually necessitate frequent expressing.

Not all breast pumps are the same

Not all breast pumps are equal, and some are designed for frequent use, whereas others are more suited to occasional use.

When a baby cannot latch and suckle effectively at the breast immediately after birth due, for example to prematurity, illness in the baby or mother, other additional needs, an oral abnormality such as a cleft palate or tongue-tie or simply because of a difficult birth then it is vital that expressing starts early. This will ensure a good milk supply is established and provide colostrum for the baby. Early stimulation and drainage of the breast helps to further develop the glandular tissue (the milk factory) within the breast.

Furthermore, once the milk comes in at day 3-6 milk production begins to switch from endocrine control (driven by hormones) to autocrine control (driven by the frequent and effective removal of milk from the breast).

Hospital grade pumps

So which type of pump is most suited to this situation? Expression of colostrum in the first few days is best done by hand expression due to the small amounts of colostrum produced. However, once the milk starts to come in then a double electric breast pump is recommended. Preferably a hospital grade pump as these are designed to be used by multiple mothers, multiple times per day. They are powerful, robust, and durable and offer smoother cycling curves than personal use double pumps. Double pumping not only reduces the time required to express, as both breasts can be expressed simultaneously, it also tends to stimulate more milk production (Jones et al, 2001) .

Hospital grade pumps are expensive so are usually hired, rather than purchased. In the UK there are two companies who provide pump hire services:
https://www.ardobreastpumps.co.uk/shop/products/rent-a-breastpump/ https://www.medela-rental.co.uk/
Cost for hire of these pumps is £47 for the first 14 days and then £47 for each subsequent 30 days thereafter.

Some Children's Centres loan out breast pumps for free. This happens in my local area. However, the pumps which are loaned out in my area are 'personal use' double pumps, not hospital grade. They are also loaned out with just one collection set meaning they can only be used to pump one breast at a time. Parents are sometimes placed on a waiting list. So, they are not suitable in the situations previously described. It is important to check that what you are being offered is right for the purpose you intend to use it.

Personal use double electric pumps

Personal use electric pumps come in double and single options. All double personal use pumps can be used as a single pump. However, most single electric pumps cannot be converted to double. Double personal use pumps are good for maintaining supply, returning to work or for boosting supply if for any reason it has dipped. Many mums will switch to a personal use pump, after the first month or so, when they have established a good supply with a hospital grade pump, if they are in a situation where ongoing frequent expressing is needed.

Sometimes, mothers experience a drop in supply after the early weeks due to illness, the use of formula, certain medications, an undiagnosed latching or sucking issue (commonly a tongue-tie), or because they have implemented scheduled feeding to get baby into a routine. Double personal use pumps can be extremely helpful in boosting supply in these situations. Generally supply recovers more quickly and efficiently than with a single electric pump. Double personal use pumps are also helpful when returning to work as pumping sessions at work will take less time.

Single electric pumps

Single electric pumps can be used for the same purposes as the double personal use pumps, but pumping will be less effective and more time consuming. They are more suited to mothers who only need to pump once or twice a day to stock the freezer or provide milk so someone else can feed the baby. Some single electric pumps, such as the Medela Swing Flex, retail for the same price as personal use double pumps, such as the Ardo Calypso, so this is something to be aware of.

Electric pumps, whether single or double, can be helpful in effectively draining breasts affected by engorgement, blocked ducts, or mastitis when a baby is struggling to do this, or the nipples are too sore for breastfeeding.

Hands free pumping

What about hands free pumps like the Elvie? These are relatively new to the market. They can be useful for mothers who need to pump on the go or discreetly and my feeling is that working mothers with established milk supplies are the ones who may benefit most from this type of pump. I have had a few mothers use the Elvie in the early days of their breastfeeding journey, but supply has been slow to pick up. This is probably because we know that double pumping is most effective at this stage. Plus, the design of hands-free pumps necessitates the use of a very small motor which is not likely to be as powerful as the much larger motors found in the hospital grade pumps. For a single pump hands free designs are comparatively expensive.

There are other ways to achieve hands free pumping. The simplest way is to use a 'pumping bra' or, if you have basic sewing skills, convert a standard nursing bra or close-fitting crop top for the purpose. Freemie cups are cups that can be worn inside your bra and in place of the flange and collection bottle on your usual pump. They are compatible with the major brands of pumps. Some pump companies, such as Spectra, make their own hands-free pumping kits.

Manual and silicone pumps

But what about manual pumps and the all-in-one silicone pumps? These are useful for the occasional pumping session for the occasional bottle feed or for softening up engorged breasts for making latching easier. Many mums get in to the habit of using the silicone pumps for collecting the milk that is ejected when the baby is feeding on the opposite breast, rather than allowing this milk to soak into a breast pad and be wasted. However, caution is needed when doing this. Unlike breast shells which are designed to simply collect 'drip' milk from the 'let down', the silicone pumps actually create suction at the breast and draw milk so frequent use can result in an oversupply. Over supply can be associated with engorgement, blocked ducts and mastitis for mum and latching difficulties, gulping and choking, wind and reflux for baby.

Flange fit

When choosing a breast pump correct flange fit is vital. An ill-fitting flange will affect pumping efficiency and can cause damage to your nipples and breast tissue. Not all makes and model of pump come with the option of different flange sizes. The cheaper pumps tend to come with just one flange size and if this does not fit there is no option to buy a different size. Some pump flanges have soft silicone inserts which can be removed to create a larger flange and some pumps are supplied with more than one flange size. But in most cases if the flange supplied with your pump does not fit then you will need to buy a different size. Manufacturers have fitting guides on their websites but as a rule you will need a flange that is about 4mm larger than the diameter of your nipple. One nipple may be much larger than the other, so some mums find they need a different size flange on each breast.

Spare parts

The availability and cost of spare parts is also something to investigate before you buy. With cheaper pumps it is unlikely you will be able to obtain spares in a situation that a part gets lost or damaged. The cost of spare parts for some brands of pump are higher than for others.

Portability

Some electric pumps work just off the mains. But others have the option to work off a battery, making them more portable, or can be powered via the 12-volt socket in a car which means you can pump in locations away from home and mains electricity.

Quality

The quality of a pump is something to consider too. Generally speaking pumps made by companies whose core business is the manufacture of breast pumps are better in terms of reliability, efficiency and durability and they often offer better after sales service. They dedicate a lot of resources to research and development of their products. Pumps made by bottle manufacturers, such as Tommee Tippee, in my experience do not compare well. Why would they? Bottle manufacturers make their money from families who formula feed and the breast pump in their range is purely a complement to their other products, not their core business or main source of income.

Second hand pumps

Finally, a word about second-hand pumps. These may seem like a good idea as they are cheaper than a new pump and many mums are given second-hand pumps by friends and relatives. However, in my experience there can be problems with this. Some second-hand pumps have been very well used and may be third or fourth hand. Even if they have only had one previous owner, she may have used the pump for more than one baby. I have seen many situations where a mum has complained that she cannot pump much milk or her supply is not increasing and upon investigation I have found that she has been using a second-hand pump with a worn out motor or defective parts.

Parts, particularly the crucial but delicate valves, can easily get damaged during use and plastic can deteriorate with repeated cleaning and sterilising, and storage meaning that seal and therefore suction is compromised. For these reasons and for reasons of hygiene it is recommended that collection sets are replaced and not handed on. Furthermore, not all pumps are 'closed systems', notably personal use pumps in the Medela range. This means that it is possible for milk to be drawn up the tubing and into the motor housing and this poses a theoretical risk of cross infection. So, if you do opt for a second-hand pump ensure that it has not been overused, replace the collection sets and check that it is a 'closed system' pump.

Sarah Oakley Independent Nurse, Health Visitor and International Board Certified Lactation Consultant 25/10/20

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Choosing a breast pump - Sarah Oakley Lactation

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I decided to write this blog after seeing a mum post on a Facebook breastfeeding group asking for pump recommendations. The Admin for that group directed her to a link on the American Kellymom.com breastfeeding website on buying new and used breast pumps which really is not particularly helpful.

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Breastfeeding Network info on milk storage:

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Breastfeeding Network info on milk storage:

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Providing breast milk is one of the best things you can do for your baby's health and development. Pumping your milk is one way to provide breast milk to your baby. However, germs can grow quickly in breast milk or breast milk residue that remains on pump parts. Following these steps can keep your breast pump clean and help protect your baby from these germs. If your baby was born prematurely or has other health concerns, your baby's health care providers may have more recommendations for pumping breast milk safely.

1. Wash hands. Wash your hands well with soap and water for 20 seconds.

2. Assemble. Assemble clean pump kit. Inspect whether the pump kit or tubing has become moldy or soiled during storage. If your tubing is moldy, discard and replace immediately.

3. Clean if using a shared pump.Clean pump dials, power switch, and countertop with disinfectant wipe.

1. Store milk safely. Cap milk collection bottle or seal milk collection bag, label with date and time, and immediately place in a refrigerator, freezer, or cooler bag with ice packs.

If milk collection container will be stored at a hospital or childcare facility, add name to the label

2. Clean pumping area. Especially if using a shared pump, clean the dials, power switch, and countertop with disinfectant wipes.

3. Take apart and inspect pump kit. Take apart breast pump tubing and separate all parts that come in contact with breast/breast milk (for example, flanges, valves, membranes, connectors, and milk collection bottles).

4. Rinse pump kit. Rinse breast pump parts that come into contact with breast/breast milk under running water to remove remaining milk

5. Clean pump kit. As soon as possible after pumping, clean pump parts that come into contact with breast/breast milk in one of the following ways.

6. Clean wash basin and bottle brush. If you use a wash basin or bottle brush when cleaning your pump parts, rinse them well and allow them to air-dry after each use. Consider washing them every few days, either in a dishwasher with hot water and a heated drying cycle, if they are dishwasher-safe, or by hand with soap and warm water.

For extra germ removal, sanitize pump parts at least once daily. Sanitizing is especially important if your baby is less than 3 months old, was born prematurely, or has a weakened immune system due to illness or medical treatment (such as chemotherapy for cancer). Daily sanitizing of pump parts may not be necessary for older, healthy babies, if the parts are cleaned carefully after each use. Sanitize all items (even the bottle brush and wash basin!) by using one of the following options.

Note: If you use a dishwasher with hot water and a heating drying cycle (or sanitizing setting) to clean infant feeding items, a separate sanitizing step is not necessary.

1. Clean first. Pump parts, bottle brushes, and wash basins should be sanitized only after they have been cleaned.

2. Sanitize. Sanitize the pump kit, bottle brushes, and wash basins using one of the following options. Check manufacturer's instructions about whether items may be steamed or boiled.

1. Steam:
Use a microwave or plug-in steam system according to the manufacturer's directions.

2. Boil:

Place disassembled items that are safe to boil into a pot and cover with water.

Put the pot over heat and bring to a boil.

Boil for 5 minutes.

Remove items with clean tongs.

3. Allow to air-dry thoroughly. Place sanitized pump parts, wash basin, and bottle brush on a clean, unused dish towel or paper towel in an area protected from dirt and dust. Do not use a dish towel to rub or pat items dry because doing so may transfer germs to the items.

Allow the clean pump parts, bottle brushes, and wash basins to air-dry thoroughly before storing to help prevent germs and mold from growing. Once completely dry, the items should be stored in a clean, protected area to prevent contamination during storage.

Wash hands. Wash hands well with soap and water.

Reassemble. Put together the clean, dry pump parts.

Store safely. Place reassembled pump kit in a clean, protected area such as inside an unused, sealable food storage bag. Store wash basins and bottle brushes in a clean area.

When used correctly, breast pump tubing does not touch the pumped milk and does not need to be cleaned routinely.

Keep a spare set of tubing on hand in case the set you are using gets soiled or damaged.

If your tubing has water droplets in it at the end of a pumping session, disconnect the tubing from the flange/pump kit, but leave it attached to the pump. Run the pump for a few more minutes until the tubing is dry.

If your tubing has milk or mold in it, throw it away immediately because it is difficult to clean properly. Replace it with a new set of tubing, and check to see if the problem happened because

The valves or membranes need to be replaced.

The tubing was attached to the pump incorrectly.

If the outside of your tubing is soiled, wipe it with a damp cloth or disinfectant wipe.

Page last reviewed:

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centers for disease control and prevention

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How to Keep Your Breast Pump Kit Clean: The Essentials

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Providing breast milk is one of the best things you can do for your baby's health and development. Pumping your milk is one way to provide breast milk to your baby. However, germs can grow quickly in breast milk or breast milk residue that remains on pump parts.

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What should I know about buying a new or used breastpump? • KellyMom.com

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Are used pumps safe and effective? Several things you should consider when buying a used or new pump.

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What to know about buying a new or second hand breast pump:  

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What to know about buying a new or second hand breast pump:  

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Closed system versus open system pumps:

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What should I know about buying a new or used breastpump? • KellyMom.com

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Are used pumps safe and effective? Several things you should consider when buying a used or new pump.

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When a woman is still producing colostrum, the best way to collect it is by HAND EXPRESSING. Here's an excellent film by Stanford Medical School on how to hand express: 

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When a woman is still producing colostrum, the best way to collect it is by HAND EXPRESSING. Here's an excellent film by Stanford Medical School on how to hand express: 

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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If everything is going well with breastfeeding, the recommendation is to wait until a baby is around 6 weeks old before expressing and introducing a bottle, if that’s what you’d like to do. If you are having breastfeeding difficulties, expressing is a great way of maintaining a milk supply, but expressing before the prolactin receptors have settled down, which happens at 6 weeks, can cause complications, and needs to be managed very carefully. Here's my article "Expressing after 6 weeks when breastfeeding is going well."

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If everything is going well with breastfeeding, the recommendation is to wait until a baby is around 6 weeks old before expressing and introducing a bottle, if that’s what you’d like to do. If you are having breastfeeding difficulties, expressing is a great way of maintaining a milk supply, but expressing before the prolactin receptors have settled down, which happens at 6 weeks, can cause complications, and needs to be managed very carefully. Here's my article "Expressing after 6 weeks when breastfeeding is going well."

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If your baby is full-term and is in good health, you only need to sterilise the pumping equipment once in 24 hours. After each usage, wash the pumping equipment and bottle carefully with hot water and washing up liquid, then rinse well and put to dry on some clean kitchen paper.

N.B. Bottles used to give formula need to be sterilised after each usage.

Storing breastmilk:

Breastmilk is safe at room temperature for approximately 6 hours.

Here is detailed information on storing breastmilk:
https://abm.me.uk/breastfeeding-information/expressing-breast-milk/
You can add newly pumped milk to milk already stored in the fridge on the same day, but only after it has cooled down in the fridge for at least 30 minutes. Never add warm milk to cold milk, as this encourages the growth of bacteria.
Breastmilk storage bags
You can store breastmilk in the fridge in bottles, but when freezing it, you might want to use storage bags, as these take up less space. Many companies make breastmilk storage bags.

Make sure to allow some space at the top of bags or bottles for the expansion that happens when milk is frozen.
Labelling expressed breastmilk
When storing your breastmilk in the fridge or freezer, make sure to always label it with the date so that if there are several batches, you can use the 'oldest' first.
When to pump?
If you would like to pump in order for your baby to have a daily bottle of expressed milk, the recommendation is to pump once a day, on both breasts, at roughly the same time each day, shortly after having breastfed your baby.

Many women choose to pump in the morning, as they tend to produce greater volumes at that time, but it is fine to pump whenever works best for you.

When you first start expressing after your baby has nursed, you might not be able to pump very much, but after a few days, your breasts will get the message that they need to produce more milk at that time.

Alternatively, several times a day, you could do a short amount of pumping after breastfeeding your baby.

By pumping immediately after a feed, there is a better chance of your breasts having time to produce more milk before your baby's next feed.
Do I pump from one breast or both?
It is usually a good idea to pump from both breasts, as this will allow you to collect more milk, and to stimulate both breasts equally.
Pumping from one breast while your baby feeds on the other
Rather than pumping after a feed, some women find it convenient to pump from one breast while their baby nurses on the other side. This tends to allow them to collect milk more easily, since the baby's suckling stimulates the let-down reflex more effectively than a pump. (This is because oxytocin, the hormone that causes the let-down reflex, is stimulated most powerfully by love, and although many women find their pump useful, few love their pump).

The concern about pumping while nursing is that your baby might then want to feed from the second breast, in which case, there won't be much milk left for them. Pumping while nursing tends to work best for women whose babies usually only take one breast per feed.
How long to pump for?
How long to pump for depends very much on your supply and how efficient your pump is; most women pump for somewhere between 10 and 30 minutes. It is not recommended to pump non-stop for longer than 30 minutes as this can cause nipple soreness.
How much will milk will I get?
Women vary enormously in the volumes they can pump. Some women can get 60ml in 5 minutes from one breast, whereas others will need to double pump for 30 minutes in order to get 60ml from both breasts. It is important to bear in mind that the volumes you can pump are not an accurate reflection of the volumes your baby gets at the breast, as babies are much more effective at removing milk than a pump.

N.B. As babies get older (6 months plus), some women find that the volumes they can pump decrease. This is not usually because their supply has decreased, it is just that some women become less responsive to pumping over time.
Feeding your baby The critical importance of paced bottle feeding
When a baby is held in the traditional, reclined bottle feeding position, a combination of gravity and the baby's sucking reflex means it is easy to persuade them to drink more milk than their tummy can comfortably fit. This puts them at risk of overfeeding, and gets them used to a fast flow, which in turn means they are likely, sooner or later, to reject the breast, which usually has a much slower flow.

Therefore, whenever giving a baby a bottle, it is crucially important to use the paced bottle feeding method, as this will protect your breastfeeding journey.

This film explains paced bottle feeding:
https://www.youtube.com/watch?v=OGPm5SpLxXY What type of bottle?
The type of bottle and teat you use is not as important as making sure that whoever is feeding your baby always practises paced bottle feeding. However, it is easier to practise paced bottle feeding with a bottle that is not too big or too fat. Look for a bottle that has around a 150ml maximum capacity, and one that resembles Kate Moss in shape, rather than Beyoncé. Here's an article about which bottles to use for breastfed babies:
https://breastfeeding.support/best-bottle-breastfed-baby/ Volumes of milk
Here is a page from the website kellymom.com with some guidance on how much expressed milk a baby might need: http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

Please bear in mind that between 4 weeks and 6 months, your baby's maximum stomach capacity is around 120ml - 150ml.
Responsive feeding - be guided by your baby
The beauty of paced bottle feeding is that your baby will be able to indicate when they are full much more easily. It is normal for babies to drink different amounts at each feed. It is very important not to try to coax your baby to drink more than they can comfortably fit, or their ability to self-regulate might be impacted, putting them at risk of future overweight and obesity.
When to give the bottle?
It is important to think carefully about when your baby is going to be given the bottle, because at first, your breasts probably won't be used to going much longer than 3 or 4 hours between breastfeeds.
The Feedback Inhibitor of Lactation (FIL)
Whenever breasts get hard and full, a negative feedback mechanism kicks in, telling them to stop making milk. This means milk production slows down when breasts are full and speeds up when breasts are emptier.

In the early weeks, if a mother goes longer than 3 or 4 hours without breastfeeding or pumping, unless she has a very large breast storage capacity http://www.nancymohrbacher.com/articles/2014/1/17/infographic-on-breast-storage-capacity.html the FIL will kick in, giving her breasts the message to reduce milk production. You want to avoid this happening, or your milk supply could be affected.

In addition, when breasts get very full, mothers are at risk of developing blocked ducts and mastitis.
Don't let your breasts get uncomfortably full
If you experience uncomfortable fullness and cannot breastfeed or pump, to avoid getting blocked ducts, it is a good idea to hand express just enough to stop that 'bursting' feeling.
One mother's experience
Here is an article a new mother called Jemma wrote for me about how she managed expressing after 6 weeks.
I started expressing milk when our baby Alexander was nearly 7 weeks old. I express at around 9pm every evening from both breasts and my husband, Jeremy, feeds Alexander from the bottle at 11pm. Alexander then sleeps to between 3 and 4am, when I breastfeed him and he then wakes again between 6 and 7am. Sometimes I also express after I have fed him first thing in the morning and this milk goes towards filling our freezer! We had several reasons for deciding to start expressing: the first and most pressing was to give me a bit more sleep! I am able to go to bed after expressing in the evening and sleep through till Alexander wakes for his middle of the night feed. As Alexander got bigger, it also gave me a bit of flexibility to be able to pop out for a couple of hours, dipping into the freezer supply to keep him going until my return. Jeremy usually comes home after Alexander has gone to bed so the 11pm feed has become a precious time for the two of them to spend together each evening. Sometimes Alexander is awake and sometimes it is a 'dream feed' but either way Jeremy gets to give him a cuddle! Of course, dads have plenty of other ways than feeding to bond with their babies, but we have found this, given Jeremy's working hours, to be an added bonus.
It wasn't easy at first to get Alexander to accept the bottle. It took Jeremy a couple of weeks of gentle persuasion and perseverance, but we got there in the end. (Please see Wendy Lever's article ' Help - my breastfed baby won't take a bottle' in the links below).
I waited until almost 7 weeks before starting to express because I wanted my milk supply to be well established, and I wanted Alexander and me to get used to breastfeeding, hopefully reducing the risk of nipple confusion. However, we didn't want to wait too long in case Alexander then refused to take a bottle. I did have some concern that I might cause my breasts to become engorged through expressing. To avoid this, when I first started, I would actually express at 10pm rather than 9pm so that there was less of a gap between when I was pumping and next breastfeeding Alexander. As I got more used to it, I gradually brought that time back to 9pm so I could have an earlier night if I wanted to. In the mornings I have always had lots of milk, so this is why I am able to express after Alexander finishes feeding. As he has got bigger, I have found that I am not always able to express as much milk in the evening as he could drink. Expressing in the morning has therefore been a useful way to 'top up' his evening bottle. Expressing is boring! I can't say that I look forward to doing it each day but the benefits it brings have really benefited our new little family. The importance of increasing gaps between breastfeeds and/or expressing gradually
Please note that Jemma made sure to increase the length of time she was going between expressing and breastfeeding gradually. It is generally recommended to increase the gaps by no more than 15 minutes each day or two, in order to avoid getting blocked ducts and mastitis.

Similarly, if you decide to stop expressing, you will need to do so gradually, in order to avoid getting blocked ducts.

As your baby gets older, your breasts will be able to go longer between breastfeeds (or pumping sessions) without putting your supply at risk, or causing blocked ducts, but it is still safest to increase the gaps gradually.
Night feeds and prolactin (the hormone that makes milk)
Jemma was still breastfeeding sometime between 3am and 4am, which is good, because a nursing mother's prolactin levels are highest between 2am and 4am, and therefore breastfeeding in the middle of the night is particularly important for maintaining milk supply.
Expressing is tedious and can be stressful
Before having their babies, parents-to-be tend to think that expressing will make life easier. In particular, many believe that if partners can give a bottle of expressed milk at night, the nursing mother will be able to get more sleep. However, many women find pumping hard work, and decide that direct breastfeeding, both at night and during the day, is easier and more convenient. Mastering the side-lying position tends to make night feeds much less exhausting.

One mother's experience of pumping:
My husband wanted to give our daughter a bottle of expressed milk in the evening (so he could bond better with her, so I couldn't refuse). But for my own sake, I wished I didn't have to do it because I needed three or four pumping sessions to get him that one bottle of milk. It was so stressful to me and I was always worried that I wouldn't be able to get it. Plus I had to pump while he was giving her the bottle, so half of my day was centred around that one bottle of milk. The day I packed my pump for storage was the day I exhaled. Removing that pressure and focusing on our breastfeeding journey was such a relief! I was able to work from home, so lots of times I would latch her in a sling or on a very carefully propped feeding pillow at my desk and she would be feeding there while I did my calls and worked on my laptop. While I managed to create a little supply of frozen milk, we ended up disposing of it as we never used it. At 26 months we still breastfeed - it has been such a blessing for us after such a rough start that we are enjoying it every day it lasts. The side-lying position for breastfeeding at night
I encourage all new mothers to learn how to breastfeed in the side-lying position. In this position, many women find breastfeeding at night is not as exhausting as they anticipated, especially if their baby falls back to sleep while breastfeeding next to them.

You can also use the side-lying position if you'd like to nap with your baby during the day.

Here's my article on the side-lying position:

https://www.cordeliauys.co.uk/in-praise-of-the-sidelying-position

This video explains how to achieve side-lying position: Side lying Breastfeeding How To - YouTube

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If your baby is full-term and is in good health, you only need to sterilise the pumping equipment once in 24 hours. After each usage, wash the pumping equipment and bottle carefully with hot water and washing up liquid, then rinse well and put to dry on some clean kitchen paper.

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Comparing the Medela Swing with the Medela Freestyle pump

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Comparing the Medela Swing with the Medela Freestyle pump

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For most working moms, having a baby while having to go to work can be tricky to perform. In such cases, a decent and reliable breast pump becomes a necessity. With a breast pump, you will be able to prepare your baby's milk every before you go to work. There are several breast pump products available on the market, but Medela is one notable brand, for sure. In the following article, we are going to see the comparisons between two Medela's products, Medela Swing and Medela Freestyle. Between the two, Medela Freestyle is quite more expensive than Medela Swing. Which one makes the fullest value for the money?

Medela Swing
Medela Swing is a very compact, lightweight, and portable breast pump, making it an excellent choice for travels. It is a single electric breast pump that features the Two-Phase Expression Technology to produce more milk in less time than most other breast pumps on the market, at the same time ensuring the user's comfort with the Maximum Comfort Vacuum Technology in the expression phase. You never have to worry about the pump being too harsh or too strong; it is very comfortable to use. In addition, Medela Swing has been equipped as well with a belt clip and a neck/shoulder strap, both of which make mobile and tabletop pumping much easier and more practical to perform. The powering options are quite versatile; Medela Swing can work with an AC adaptor, or with four AA batteries for portable operation.

Medela Freestyle
On the other hand, Medela Freestyle is a double electric breast pump that also features the Two-Phase Expression Technology. Unlike Medela Swing, which is only a single electric pump, Medela Freestyle has two parts that will allow you pump both breasts simultaneously. Of course, this allows for faster milk accumulation. The pump power is also more powerful than Medela Swing, but it is still very comfortable to use. Medela Freestyle has been equipped with a backlit digital display, timer, and memory so that you can customize and personalize the pump. In addition, Medela Freestyle works with a rechargeable Lithium-ion battery, so it is very portable and cost-efficient. The AC adaptor also functions as the charger. (See also : Medela Symphony Vs Freestyle)

Medela Swing Vs Freestyle

Key features

- Single-electric breast pump designed for moms who pump occasionally - Compact, lightweight motor fits into purse or tote bag - Convenient AC adaptor or battery power options for charging and mobile pumping

- Digital display features a memory button, timer and backlight - Two sizes of Personal Fit breast shields for comfort - Portable microfiber carry bag designed specifically for your Freestyle breast pump parts

Customer ratings*

4.5 out of 5.0 stars

4.1 out of 5.0 stars

Best deal*

Save Money Please click here

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NOTE : Product prices, availability, ratings and save money information are accurate as of the date/time indicated on post time (as seen right bellow the tittle) and are subject to change. Any price, ratings, availability and save money information displayed on Amazon Site at the time of purchase will apply to the purchase of this product.

Conclusion
For usage at home or before work, Medela Freestyle makes the best way to go. It is much more powerful that it can collect more milk in a shorter time than Medela Swing. The rechargeable battery is also a very nice feature. However, for travels, you may prefer Medela Swing, which is more compact and lightweight.

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Medela Swing Vs Freestyle - VersusHost.com

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For most working moms, having a baby while having to go to work can be tricky to perform. In such cases, a decent and reliable breast pump becomes a necessity. With a breast pump, you will be able to prepare your baby's milk every before you go to work.

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Here's an excellent film on double pumping made by Stanford Medical School: 

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Here's an excellent film on double pumping made by Stanford Medical School: 

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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This material was developed by Jane Morton, MD and produced for educational purposes only. Reproduction for commercial purposes is prohibited. Utilization of the materials to improve care of pregnant women and their newborns is encouraged with proper citation of source.

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If you have a double pump, you can buy (link below) or make for yourself (see photo) a self-expressing bra which will make double pumping easier for you:

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If you have a double pump, you can buy (link below) or make for yourself (see photo) a self-expressing bra which will make double pumping easier for you:

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http://www.amazon.co.uk/Simple-Wishes-Double-Pumping-Bustier/dp/B004S8MGGQ/ref=sr_1_1?ie=UTF8&qid=1411768890&sr=8-1&keywords=expressing+bra

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This bra from John-Lewis holds the pumpsets of a double pump in place while you pump: 

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This bra from John-Lewis holds the pumpsets of a double pump in place while you pump: 

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How to tell if an Ardo Medical breastshield fits properly: 

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How to tell if an Ardo Medical breastshield fits properly: 

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Kanari Pharmacy hire out Medela Symphony double pumps:

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Kanari Pharmacy hire out Medela Symphony double pumps:

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Electronic Prescription Service

This pharmacy offers the Electronic Prescription Service, which allows you to choose or "nominate" a pharmacy to get your medicines or appliances from. Your GP then sends your prescription electronically to the place you have nominated, this means:

If you collect your repeat prescriptions from your GP you will not have to visit your GP practice to pick up your paper prescription, saving you time.

You will have more choice about where to get your medicines from because they can be collected from a pharmacy near to where you live, work or shop.

You may not have to wait as long at the pharmacy as your repeat prescriptions could be prepared before you arrive.

Find out more

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This pharmacy offers the Electronic Prescription Service, which allows you to choose or "nominate" a pharmacy to get your medicines or appliances from. Your GP then sends your prescription electronically to the place you have nominated, this means: If you collect your repeat prescriptions from your GP you will not have to visit your GP practice to pick up your paper prescription, saving you time.

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Here’s an NHS leaflet on how to safely prepare infant formula milk:

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Here’s an NHS leaflet on how to safely prepare infant formula milk:

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Good hygiene is very important when making up a formula feed.
Your baby's immune system is not as strong as an adult's. That's why bottles, teats and any other feeding equipment need to be washed and sterilised before each feed.

This will reduce the chance of your baby getting an infection, in particular diarrhoea and vomiting.

Step-by-step guide to preparing a formula feed

Step 1: Fill the kettle with at least 1 litre of fresh tap water (do not use water that has been boiled before).

Step 2: Boil the water. Then leave the water to cool for no more than 30 minutes, so that it remains at a temperature of at least 70C.

Step 3: Clean and disinfect the surface you are going to use.

Step 4: It's important that you wash your hands.

Step 5: If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse them with cooled boiled water from the kettle (not tap water).

Step 6: Stand the bottle on the cleaned, disinfected surface.

Step 7: Follow the manufacturer's instructions and pour the amount of water you need into the bottle. Double check that the water level is correct. Always put the water in the bottle first, while it is still hot, before adding the powdered formula.

Step 8:

Credit:

Pete Titmuss / Alamy Stock Photo

https://www.alamy.com/stock-photo-young-mothers-hands-preparing-powdered-milk-drink-for-her-baby-54213147.html?pv=1&stamp=2&imageid=5FDDEEA6-841C-4900-8A1D-277900301545&p=78384&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dD45HBR%26qt_raw%3dD45HBR%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d788068%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

Loosely fill the scoop with formula powder, according to the manufacturer's instructions, then level it using either the flat edge of a clean, dry knife or the leveller provided. Different tins of formula come with different scoops. Make sure you only use the scoop that comes with the formula.

Step 9: Holding the edge of the teat, put it into the retaining ring, check it is secure, then screw the ring onto the bottle.

Step 10: Cover the teat with the cap and shake the bottle until the powder is dissolved.

Step 11: It's important to cool the formula so it's not too hot to drink. Do this by holding the bottle (with the lid on) under cold running water.

Step 12: Test the temperature of the formula on the inside of your wrist before giving it to your baby. It should be body temperature, which means it should feel warm or cool, but not hot.

Step 13: If there is any made-up formula left in the bottle after a feed, throw it away.

Dos and don'ts of making up formula feeds

Do follow the manufacturers' instructions very carefully, as they vary as to how much water and powder to use.

Do not add extra formula powder when making up a feed. This can make your baby constipated or dehydrated. Too little powder may not give your baby enough nourishment.

Do not add sugar or cereals to your baby's formula.

Never warm up formula in a microwave, as it may heat the feed unevenly and burn your baby's mouth.

Reducing the risk of infection

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain bacteria.

Bacteria multiply very fast at room temperature. Even when a feed is kept in a fridge, bacteria can still survive and multiply, although more slowly.

To reduce the risk of infection, it's best to make up feeds 1 at a time, as your baby needs them.

Use freshly boiled drinking water from the tap to make up a feed. Do not use artificially softened water or water that has been boiled before.

Leave the water to cool in the kettle for no more than 30 minutes. Then it will stay at a temperature of at least 70C. Water at this temperature will kill any harmful bacteria.

Remember to let the feed cool before you give it to your baby. Or you can hold the bottle (with the lid on) under cold water from the tap.

Do not use bottled water to make up formula feeds

Bottled water is not recommended for making up feeds, as it's not sterile and may contain too much salt (sodium) or sulphate.

More information

Find out more about bottle feeding and answers to common questions about formula feeds.

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Good hygiene is very important when making up a formula feed. Your baby's immune system is not as strong as an adult's. That's why bottles, teats and any other feeding equipment need to be washed and sterilised before each feed. This will reduce the chance of your baby getting an infection, in particular diarrhoea and vomiting.

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How much expressed milk will my baby need:

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How much expressed milk will my baby need:

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By Kelly Bonyata, BS, IBCLC

How much milk do babies need?

Many mothers wonder how much expressed breastmilk they need to have available if they are away from baby.

In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby's age or weight between one and six months. After six months, breastmilk intake will continue at this same level until - sometime after six months, depending in baby's intake from other foods - baby's milk intake begins to decrease gradually ( see below).

Now infants can get
all their vitamin D
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The research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. Different babies take in different amounts of milk; a typical range of milk intakes is 19-30 oz per day (570-900 mL per day).

We can use this information to estimate the average amount of milk baby will need at a feeding:

Estimate the number of times that baby nurses per day (24 hours).

Then divide 25 oz by the number of nursings.

This gives you a "ballpark" figure for the amount of expressed milk your exclusively breastfed baby will need at one feeding.

Example: If baby usually nurses around 8 times per day, you can guess that baby might need around 3 ounces per feeding when mom is away. (25/8=3.1).

What if baby is eating solid foods?

Sometime between six months and a year (as solids are introduced and slowly increased) baby's milk intake may begin to decrease, but breastmilk should provide the majority of baby's nutrition through the first year. Because of the great variability in the amount of solids that babies take during the second six months, the amount of milk will vary, too. One study found average breastmilk intake to be 30 oz per day (875 ml/day; 93% of total intake) at 7 months and 19 oz (550 ml/day; 50% of total energy intake) at 11-16 months.

Several studies have measured breastmilk intake for babies between 12 and 24 months and found typical amounts to be 14-19 oz per day (400-550 mL per day). Studies looking at breastmilk intake between 24 and 36 months have found typical amounts to be 10-12 oz per day (300-360 mL per day).

Is baby drinking too much or too little expressed milk?

Keep in mind that the amount of milk that baby takes at a particular feeding will vary, just as the amount of food and drink that an adult takes throughout the day will vary. Baby will probably not drink the same amount of milk at each feeding. Watch baby's cues instead of simply encouraging baby to finish the bottle.

If your baby is taking substantially more than the average amounts, consider the possibility that baby is being given too much milk while you are away. Things that can contribute to overfeeding include:

Fast flow bottles. Always use the lowest flow bottle nipple that baby will tolerate. Even with a slower flowing nipple, it is important to pace the bottle feed to allow baby to better control his intake.

Using bottle feeding as the primary way to comfort baby. Some well-meaning caregivers feed baby the bottle every time he makes a sound. Use the calculator above to estimate the amount of milk that baby needs, and start with that amount. If baby still seems to be hungry, have your caregiver first check to see whether baby will settle with walking, rocking, holding, etc. before offering another ounce or two.

Baby's need to suck. Babies have a very strong need to suck, and the need may be greater while mom is away (sucking is comforting to baby). A baby can control the flow of milk at the breast and will get minimal milk when he mainly needs to suck. When drinking from a bottle, baby gets a larger constant flow of milk as long as he is sucking. If baby is taking large amounts of expressed milk while you are away, you might consider encouraging baby to suck fingers or thumb, or consider using a pacifier for the times when mom is not available, to give baby something besides the bottle to satisfy his sucking needs.

If, after trying these suggestions, you're still having a hard time pumping enough milk, see I'm not pumping enough milk. What can I do?

If baby is taking significantly less expressed milk than the average, it could be that baby is reverse-cycling, where baby takes just enough milk to "take the edge off" his hunger, then waits for mom to return to get the bulk of his calories. Baby will typically nurse more often and/or longer than usual once mom returns. Some mothers encourage reverse cycling so they won't need to pump as much milk. Reverse cycling is common for breastfed babies, especially those just starting out with the bottle.

If your baby is reverse cycling, here are a few tips:

Be patient. Try not to stress about it. Consider it a compliment - baby prefers you!

Use small amounts of expressed milk per bottle so there is less waste.

If you're worrying that baby can't go that long without more milk, keep in mind that some babies sleep through the night for 8 hours or so without mom needing to worry that baby is not eating during that time period. Keep an eye on wet diapers and weight gain to assure yourself that baby is getting enough milk.

Ensure that baby has ample chance to nurse when you're together.

Other ways of estimating milk intake

There are various ways of estimating the amount of milk intake related to the weight of the baby and the age of the baby, based upon formula intake - research has shown that after the early weeks these methods overestimate the amount of milk that baby actually needs. These are the estimates that we used for breastfed babies for years, with the caveat that most breastfed babies don't take as much expressed milk as estimated by these methods. Current research tells us that breastmilk intake is quite constant after the first month and does not appreciably increase with age or weight, so the current findings are validating what moms and lactation counselors have observed all along.

More:

References

Onyango, Adelheid W., Receveur, Olivier and Esrey, Steven A. The contribution of breast milk to toddler diets in western Kenya. Bull World Health Organ, 2002, vol.80 no.4. ISSN 0042-9686.

Salazar G, Vio F, Garcia C, Aguirre E, Coward WA. Energy requirements in Chilean infants. Arch Dis Child Fetal Neonatal Ed. 2000 Sep;83(2):F120-3.

Kent JC, Mitoulas L, Cox DB, Owens RA, Hartmann PE. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999 Mar;84(2):435-47.

Persson V, Greiner T, Islam S, and Gebre-Medhin M. The Helen Keller international food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. Food and Nutrition Bulletin, vol.19 no.4. Tokyo, Japan: United Nations University Press, 1998.

Cox DB, Owens RA, Hartmann PE. Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996 Nov;81(6):1007-20.

Dewey KG, Heinig MJ, Nommsen LA, Lonnerdal B. Maternal versus infant factors related to breast milk intake and residual milk volume: the DARLING study. Pediatrics. 1991 Jun;87(6):829-37.

Neville MC, et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. 1988 Dec;48(6):1375-86.

Dewey KG, Finley DA, Lonnerdal B. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr. 1984 Nov;3(5):713-20.

Butte NF, Garza C, Smith EO, Nichols BL. Human milk intake and growth in exclusively breast-fed infants. J Pediatr. 1984 Feb;104(2):187-95.

Dewey KG, Lonnerdal B. Milk and nutrient intake of breast-fed infants from 1 to 6 months: relation to growth and fatness. J Pediatr Gastroenterol Nutr. 1983;2(3):497-506.

Brown K, Black R, Robertson A, Akhtar N, Ahmed G, Becker S. Clinical and field studies of human lactation: methodological considerations. Am J Clin Nutr 1982;35:745-56.

Jelliffe D, Jelliffe E. The volume and composition of human milk in poorly nourished communities: a review. Am J Clin Nutr 1978;31:492-515.

Summary of Research Data

Baby's Age

Average Milk Intake per 24 hours

Reference

Specific Gravity of Mature Human Milk = 1.031, so Density of Mature Human Milk ~ 1.031 g/ml;1 oz = 29.6 ml;Numbers in gray were derived using the above conversion factors.

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How much expressed milk will my baby need? * KellyMom.com

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Many mothers wonder how much expressed breastmilk they need to have available if they are away from baby. In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts).

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IF YOU DECIDE TO GIVE YOUR BABY A BOTTLE, WHETHER OF BREASTMILK OR FORMULA MILK, IT’S ABSOLUTELY CRUCIAL TO PRACTISE PACED BOTTLE FEEDING, IN ORDER TO PROTECT YOUR BABY’S ABILITY TO SELF-REGULATE: 

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IF YOU DECIDE TO GIVE YOUR BABY A BOTTLE, WHETHER OF BREASTMILK OR FORMULA MILK, IT’S ABSOLUTELY CRUCIAL TO PRACTISE PACED BOTTLE FEEDING, IN ORDER TO PROTECT YOUR BABY’S ABILITY TO SELF-REGULATE: 

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Paced Bottle Feeding For The Breastfed Baby