MANUAL EXPRESSION OR BREASTPUMP?
This depends on your needs. If you are expressing for a premature baby, rent a hospital-grade electric pump with a double collection kit in order to properly stimulate your milk supply. You can rent this from a lactation consultant or directly from the hospital. Many hospitals have pumps in the NICU that moms can use on the premises, but if you are discharged before baby, you will need to rent or buy your own to use at home. Hospital-grade pumps have a closed vacuum system, and are safe for reuse. Each mom buys her own collection kit, which is basically the flange and tubes (you can opt for a single collection set, or a double, which means both breasts can be pumped at the same time – which saves time and increases supply). If you will be expressing two or more feeds per day once you return to work, a store-bought double electric breast pump is ideal and time efficient. And if you only plan to express once in a blue moon? In that case a manual pump or hand expressing will do the job.
YOUR LET-DOWN REFLEX
Breastmilk is produced by and stored in special milk-making cells in the alveoli (hollow structures in the breast resembling clusters of grapes). Around each alveolus is a basket-like network of muscle cells. When the nerve endings in your areola (the dark area around your nipple) are stimulated, your brain releases oxytocin. This hormone contracts the muscle cells around the alveoli, squeezing the milk into the ducts that lead to the holes in your nipples. This process is called the let-down or the milk ejection reflex, and without it no milk is available. The let-down is a conditioned reflex. It occurs when baby suckles, but can also be triggered by other stimuli. Any breastfeeding mom knows that her milk often starts flowing when she hears baby cry or merely thinks about him. In order to express milk, you will need to condition your breasts to respond to hand expression or a breast pump. For this reason, most moms only get a few millilitres – or even a few drops, the first time they express. Don’t be discouraged, practice makes perfect.