Here’s to the ladies who pump

Nothing funny here, folks — just some straight-up information that might be useful to those who are facing some heavy-duty pumping. I learned a lot of this late in the game, so I’m posting it in the hope that someone who’s just starting out might benefit early on. It’s mostly Medela-specific, but some of it might apply universally.

Lube it. Grease up your areolae with lanolin before you start. It will help create a good seal within the cones and will reduce irritation from the friction. Do this every time; the difference when you don’t is noticeable.

Soup up your collection kit.
If your cones are uncomfortable you may need a different size. Older collection kits come with only a single-piece unit, so if that’s what you have you might consider switching to a newer set; Medela has now moved to a two-part system that allows you to swap out the cone as necessary.
Speaking of swapping out cones, the Medela SoftFit breast shields, which are made of some kind of flexible space-age polymer — okay, silicone — are infinitely more comfortable for me than the standard hard plastic set.

Go hands-free. I do this by the simple method of pulling up the cups of my nursing bra enough to hold the cones in place. There are more esoteric ways of doing it, ranging from special bras to the rubber band trick. If you want to move around while you pump, these methods are a better bet than mine, but I spend my time pumping in front of the computer, so I don’t need the cones to be all that secure. Note that the SoftFit breast shields are not compatible with Medela’s hands-free pumping rig; you’ll have to engineer your own.

Acquire multiple collection kits. Stock up especially on the membranes, which do wear out eventually, acquiring little tears that will compromise effectiveness. I don’t mean just one extra set, either — I have four and still spend more time cleaning parts than I’d like. Which brings us to…

Throw your rig into the dishwasher. Every part of the Medela system is dishwasher safe except the SoftFit shields and the tubing that connects the collection kit to the pump itself. Even the tiny white membranes are dishwasher safe, but I haven’t come up with a good way to contain them within the dishwasher so that they don’t get lost and mangled. However…

You can use a collection kit more than once before washing it. Some women use the refrigerator trick, where they put their pump parts into a Ziploc full of water then refrigerate; it keeps any remaining droplets of milk from spoiling. I, however, live dangerously: since breast milk keeps at room temperature for up to 10 hours, I don’t bother. I usually use a setup twice before washing. Since I’m pumping every three hours, I stay well within that time limit. Plus…

Reduce the number of parts in play by pumping directly into the bottles you feed with. I’m using Avent bottles, which are incompatible with Medela pumps, but I bought a set of couplers that allow me to pump into Avent bottles, eliminating Medela’s collection bottles entirely. I cap those and refrigerate; when it’s time for a feeding I just clap a nipple on the bottle and go.

A manual pump is probably insufficient for more than just occasional use. While I get my highest yield per pump with the Avent Isis — man, is that thing comfy — it takes much longer than a double electric and makes my hand and shoulder sore to use it more than once a day.

Conventional wisdom says that if you’re going to be pumping exclusively, you’ll need a hospital-grade pump. I don’t know if this is because they’re more efficient and extract more milk, or because they’re heavier duty and won’t wear out like a pump made for occasional use might. I have both, a rented Lactina and a Pump In Style, but have no opinion about which is better for my milk supply. I prefer the Lactina only because it is much, much quieter — you’d be surprised how grating that wheezing noise can be at 4 A.M.

If you have a choice in hospital-grade pumps, the Medela Symphony rocks the motherfucking house. It has two independent pump actions so that if you lose suction on one breast — say your jury-rigged hand-free arrangement slips — the other side keeps pumping unabated. It also has a gentle letdown cycle; on other pumps you can mimic that by manually adjusting the speed and suction, but in the dark of night it’s nice not to have to.

Don’t make yourself suffer with low supply. There are plenty of ways you can increase supply if you notice it’s dwindling — increasing the number of pumps, decreasing the time between pumps, so-called power pumping, herbal supplements, et cetera. For me the biggest increase has come through profligate use of domperidone. It’s not approved for use as a galactagogue in the U.S., but it’s easily available on the Internet without a prescription if you’re feeling bold. With domperidone my supply has doubled, allowing me to keep pumping happily — well, not happily, since this is me you’re talking to — instead of being discouraged by the fact that Charlie’s demand was far outpacing my supply.

Pumping mothers, what other tips do you wish you’d had when you were first starting? Let us give the Internet the rich, nutritious hindmilk of our collective experience.