Pumping breast milk for your premature or ill baby

You can start to use a breast pump from around day 3. This is generally when your body starts to produce more breast milk. The colour changes from yellow colostrum to more white-coloured breast milk.

You can use a hospital-grade double electric pump depending on you and your baby’s situation. Your nurse or midwife will guide you.

In the hospital, electric breast pumps are available in the maternity and neonatal units.

Your nurse or midwife will:

  • show you how to use the pump
  • give you sterile containers for your milk
  • help you to pump beside your baby or in the expressing rooms

Continue breast massage and hand expressing a few minutes before and after pumping.

Make sure that your nurse or midwife is there to support you the first time you use the breast pump.

They'll check that the:

  • fit of the attachment is comfortable for you
  • suction of the pump is correct

Read more about types of breast pumps

How often to pump

Use the pump to express milk at least 8 times in 24 hours.

This may seem like a lot but newborn babies feed this often.

It can take about 20 to 30 minutes to massage and express your milk in the early days.

Do not express for more than 20 minutes at each breast.

A woman uses two breast pumps to express milk from both breasts
Pumping from both breasts at the same time is called ‘double pumping

You can pump milk from both breasts at the same time. This is called double pumping.

Double pumping stimulates the hormone prolactin. Prolactin helps increase and keep your milk supply.

When you have the hang of pumping, try double pumping your milk:

  • every 2 to 3 hours
  • at least one time between midnight and 6am

You also need to continue to massage and express often. This helps to establish your milk supply.

The amount of milk you make depends on how often you express. It helps to keep a log of the amount of milk you express.

Read more about managing your milk supply when expressing

Hands-on pumping (HOP)

The best way to establish your milk supply is to combine hand expressing and pumping using a double hospital-grade breast pump.

This is called hands-on pumping (HOP). It helps drain your breasts more fully. Drained breasts make milk faster.

It also helps to pump from both breasts at the same time.

Pumping both breasts together:

  • is quicker
  • expresses more milk

The milk expressed also has a higher fat content. This is important for ill and premature babies.

When you express milk, there is often a drop in milk supply around week 3. Doing HOP means your milk supply continues to increase gradually. This is usually by 5 to 6 weeks.

Preparing to pump

  1. Wash your hands.
  2. Wipe the pump and tubes with a sterile disposable wipe.
  3. Wash your hands again.
  4. Connect the sterilised expressing set to the tubing and the pump.

You will need a comfortable chair with your back supported.

Doing hands-on pumping

Information:

High suction pressure can cause nipple damage. It does not help you to get any more milk. If the pressure feels uncomfortable, turn it down and gradually increase as you get used to the sensation.

  1. Check that the suction pressure is on the minimum setting.
  2. Support your breast with your hand and place your nipple in the centre of the funnel.
  3. Hold the funnel so that the pump can maintain a vacuum. Do not press the funnel too firmly into the breast tissue - this can stop the milk flow.
  4. Turn on the breast pump. After 2 minutes on the stimulation phase, the pump will change to the expression phase.
  5. Gradually increase the suction pressure. If the pressure becomes uncomfortable, reduce the setting.
  6. Apply gentle pressure on the breasts or gently compress the breasts with your hand. See the following picture.
  7. When the flow of milk slows down, turn off the pump.
  8. When the suction stops, remove the funnel.
  9. Massage your breasts for a few minutes and do some hand expression.
  10. Repeat steps 1 to 6.
  11. When the flow of milk stops, turn off the pump. Do not express for more than 20 minutes in total.
  12. When the suction stops, remove the funnel.
Illustration of a woman using a breast pump. The pump is attached to both breasts. She is applying pressure to one breast with her hand.
Doing hands on pumping

Adapting your bra

You can adapt your bra for pumping by cutting a small hole in each cup. This makes it easier to place the pump funnels and attach them to the bottles. It also helps when you do hands-on pumping.

A woman attaches a pump funnel to her breast using a small hole in her bra
Cut a hole in your bra big enough for a pump funnel
A woman has both hands free as her bra holds two pump funnels and bottles
Attaching a pump funnel using holes in your bra means you do not need to hold breast milk containers or pump parts

Dealing with sore breasts or nipples

Expressing milk should not hurt.

There are things you can do if your nipples are sore while you use the breast pump.

Do

    • talk to your midwife or the nurse caring for your baby
    • try using a nipple balm or cream to ease any tenderness
    • rub some of your breast milk on your nipple
    • check the size of the funnel on the breast pump - you may need a different size
    • reduce the suction pressure on the pump
    • turn off the suction pressure before you remove the funnel from your breast

Cleaning and sterilising expressing sets

Staff at the hospital will give you information and guidelines on cleaning and sterilising breast pump equipment. They will tell you how to store your milk.

There may be a place in the hospital unit for you to clean and sterilise your equipment. Some units provide sterilised disposable kits. You may need to return the used kits for sterilisation.

Ask the hospital staff for help and information about breast pump equipment.

Pumping at home

You will need a hospital-grade electric pump at home.

The staff in the maternity or neonatal unit can give you information about renting a hospital-grade electric pump. Your partner or support person could do this for you.

You could also buy a hospital-grade pump. Hospital-grade pumps can cost over 1,000 Euro. But it can cost less if you buy a second-hand pump.

You may be able to claim tax relief on the cost of breast pumps you rent or buy.

Read more about claiming health expenses on revenue.ie

Learn more about hospital grade pumps

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 10 November 2021
Next review due: 10 November 2024