My Pump Isn't Working!

1. Rule out a weak or ineffective pump.

• Try putting the flange against your cheek and using the pump.  You should feel a very strong, almost painful pinch.
• Test it, using a vacuum gauge.  (Your lactation consultant may have one.)  A baby uses pressures of 100-250 lbs. Your pump should get to at least 100 lb. pressure in 1-2 seconds.
• If the pump is too weak and it's a new pump, return it to where you purchased it.  Get a more effective one.  Learn to hand-express.  Expect to pay around $50 for a manual pump and around $150-200 for an electric pump.

2. If your pump WAS working well and this is a NEW problem:

• Clean all parts that touch the milk with warm soapy water.  If a part is gummy with dried milk, soak it in vinegar for several hours then wash and rinse well.
• Check all parts for cracks and looseness.  Hairline cracks will affect suction.  If there is a white filter between the tubing and motor, it must be bone-dry and clean. Double-check pressure settings.
• If you have recently started using hormonal contraceptives, these drugs may quickly effect supply.  Call your doctor and a lactation consultant.

3. It matters when you are pumping, and what your expectations are.

• If you pump right after your baby nurses, you'll only get a small volume of milk (1/4 to 1/2 oz).  Wait about an hour after nursing.  Or, pump halfway through a predictably longer stretch.  Or, pump one side while the baby nurses the other and try in the morning.
• If you pump instead of nursing, and your baby is effectively nursing during some of the day, you may collect anywhere from 2 to 8 ounces per breast.
• Pump long enough: 10-20 minutes of steady pumping per breast.  Some breasts release milk more quickly than others. Thorough emptying will signal the breast to make more milk faster.
• Research shows that mothers make from 1/2 to 2 ounces per hour per breast.  The breasts make milk fastest when they are "emptiest."  Milk left in the breast signals the breasts to make less milk.  Do not go longer than 5-6 hours without nursing or pumping.
• Stop all pacifier use.  Mom, you should never give a bottle.. that's for someone else to do.  Replace bottles with small cups.  All sucking should be at the breast.  If the baby "needs" a pacifier, she really needs to be fed and held more often.  Pacifiers are often at the root of milk supply problems.

4. Consider why you are pumping.  Pumping is a substitute for directly nursing your baby.  Your feelings about being away from your baby may have a significant affect on how much milk you are able to pump.  ONCE YOU'VE RULED OUT PUMP PROBLEMS, CONSIDER:

• If your baby is ill or premature, pumping just after a visit may increase volume.  Spend as much time as possible with your baby.  This is a major stress - don't try to keep up with "life as usual."
• If nursing was not going well, your baby may have a poor suck.  Pumping may help increase supply.  Have your lactation consultant evaluate the entire situation.
• Babies can tolerate shorter separations better than longer ones, even if that means there are more of them.  (Working five 2-hour days is easier on your baby than working two 5-hour days.)  Negotiate with your employer about bringing the baby to work for a few weeks, working reduced hours, job-sharing, on-site child care, part-time work, work at home, etc.  DON'T ASSUME ANYTHING... ASK for what you want.  You probably aren't the first person who has faced this issue, and you won't be the last.  Companies are trying to be more family-friendly.
• Be very clear why you are at work.  Leaving your baby is hard.  By their very nature, mothers and babies are meant to be together.  Babies need their mothers as much as they need their mothers' milk.  If you can't adjust your work setting, think through this decision even more carefully. There may be more options than you first considered.
• As a mother, you are doing a full-time job.  You absolutely must reduce the other non-baby work you do.  If you are adding paid work to raising your baby, you must reduce non-paid work or something will suffer, usually you.  This is a time for serious negotiation with your partner and others over chores, or paying for help with cleaning, laundry, meals, etc.
• You must be able to completely trust your care provider.  If you feel uncomfortable about leaving your baby with the person you've selected, drop in unannounced several times. If you sense anything wrong at any time, take your baby and leave and never go back.  This applies even to friends and relatives.
• Realize you will probably get resistance from some people no matter what you do.  Someone will say you're a bad mother for leaving your baby to go to work.  Someone will say you're wasting your career on full-time baby-raising. FIND SUPPORTERS, FAST!  Confront anyone you can't ignore, such as family members.  Also, find people who can listen to your problems without telling you what to do with quick answers.  Some LLL groups have many working mothers... try an evening group or a Saturday morning group.
• AND FINALLY:  Call for help! For ANYTHING!  Your lactation consultant has faced these issues before and can help you identify your options.  This is what we do for a living.