For whatever reason (going back to work, increasing your supply, letting dad feed baby while you get a massage...), you need to express breastmilk. How can you make sure you get the most out of the precious time you sacrifice to the pump? Follow these evidence-based suggestions to maximize your output:
Warm up your boobs. Yup, you read that right. A study from Turkey showed that when women applied a warm compress to one breast for 20 minutes before pumping, they expressed significantly more milk (~15 ml) from the warmed breast compared to the non-warmed breast (Yiğit et al., 2012).
Relax. A study from the University of New Mexico found that progressive relaxation techniques (tensing and relaxing muscle groups while taking deep breaths) lead to a 63% increase in milk expression (Feher et al., 1989).
Pump both breasts at the same time. This saves time and increases yield of higher fat content milk (Prime, Garbin, Hartmann, & Kent, 2010).
Massage breasts while pumping. This increases output of fat-rich, calorie-dense milk (Morton et al., 2009; Morton et al., 2012).
When pumping, follow a pattern of alternating frequency/intensity (Kent et al., 2012).
Start pumping at a higher frequency with low-moderate intensity (~120 cycles/minute, 70 cycle on Spectra pump) to simulate baby's sucking. This will stimulate let down.
After let down is detected (milk starts flowing), switch to a lower cycle frequency (54 cycle on Spectra pump) with higher intensity to more efficiently remove milk.
Return to higher frequency once milk stops to stimulate let down again. Repeat cycle for 10-20 minutes depending on breast capacity.
Figure out what pumping duration work best for you. "A mother who has only early milk ejections may have removed most of the milk within 10 minutes and will not increase her milk yield even if she pumps for 15 minutes or longer. Conversely, a mother who has many milk ejections or who has a late milk ejection may want to pump for 15 minutes or longer to drain the breast thoroughly" (Kent et al., 2012).
If sitting with a warm compress on your chest for 20 minutes fits into your schedule, go for it! If you don't have time, maybe try massaging your chest while simultaneously pumping both boobs (tricky with only two hands, but not impossible! a pumping bra might help). In the end, figure out what works best for you and adopt the strategies that benefit you the most.
Sources:
Yiğit F, Çiğdem Z, Temizsoy E, Cingi ME, Korel Ö, Yıldırım E, Ovalı F. Does warming the breasts affect the amount of breastmilk production? Breastfeed Med. 2012 Dec;7(6):487-8.
Feher SD, Berger LR, Johnson JD, Wilde JB. Increasing breast milk production for premature infants with a relaxation/imagery audiotape. Pediatrics. 1989 Jan;83(1):57-60.
Prime, D. K., Garbin, C. P., Hartmann, P. E., & Kent, J. C. (2010). A comparison of simultaneous and sequential breast expression in women. Journal of Human Lactation, 26(4), 433.
Morton J, Hall JY, Wong RJ, Thairu L, Benitz WE, Rhine WD. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol. 2009 Nov;29(11):757-64.
Morton J, Wong RJ, Hall JY, Pang WW, Lai CT, Lui J, Hartmann PE, Rhine WD. Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants. J Perinatol. 2012 Oct;32(10):791-6.
Kent JC, Prime DK, Garbin CP. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs. 2012 Jan-Feb;41(1):114-121.
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