To establish milk supply and help your baby learn how to breastfeed, it is recommended that you place baby to the breast for the first 2 – 4 weeks after birth!
Collecting Your Milk
You can collect (express) your breast milk when you are unable to nurse your baby.
Relax and think about your baby. This will help with let down and increase the amount that you are able to express. Relax and think about your baby. This will allow milk produced in your breast to flow to your nipple, also known as “let down,” and will increase the amount that you are able to express. “Let down” is necessary at each feeding.
To help your milk flow, place a warm washcloth on your breasts or massage your breasts for a few minutes. Massage from several starting points, always working from your chest towards your nipple.
Why Pump Breast Milk?
Allows you to offer your baby the benefits of breastmilk even when you are apart
Allows other caregivers to help in feeding & offers you a little freedom
Relieves and prevents breast fullness, engorgement, and infection
Provides nutrition for premature babies or babies that are can’t breastfeed
Increases milk supply
Provides all the nutrients and antibodies of breastfeeding even if you do not feel comfortable putting your baby to your breast or nursing in public
Three Ways to Express Breast Milk
Hand expression is cheapest and helps ease fullness, but if you are going to be pumping often, a good electric pump will probably be more efficient.
Keep in mind that any type of pumping is not as good at removing milk as actual breastfeeding. Your baby will receive more milk when he or she nurses than you will be able to pump!
Tip: Some women find it helpful to nurse on one breast while they pump on the other.
Begin by washing your hands and use a clean wide mouthed container to collect your milk.
To begin, gently massage your breasts for a short time to encourage the let down or flow of milk.
Position your thumb on one side of your breast and 2 to 3 fingers on the other side, about 1 to 2 inches back from the nipple.
Press your breast gently inward towards the wall of your chest.
Compress your thumb and fingers together.
Release and repeat; catch drops of milk in the container as they appear .
When milk flow stops, rotate thumb and fingers to another position around the nipple and repeat the process until the breast is drained.
Express milk the same way from the other breast.
When done expressing, pour breast milk in a clean bottle or storage container.
Practice in the shower with hot water running on your breast — this works well if trying to soften engorged breasts.
Begin by washing your hands.
Pick out the correct nipple adapter for your breast size and put it in the end of the pump. Nipple should be centered and move freely in breast shield with no excessive areola being pulled into the tunnel.
Center the breast shield over your nipple and hold the pump in place. Caution: pushing shield too firmly into breast may actually reduce milk flow.
Start pumping in the stimulation mode by pressing down on the milk drops symbol. Press and release quickly until milk flow begins.
As your milk flow increases, switch the expression mode by pressing the bottom of the pump handle.
When milk flow slows down, switch to your other breast. Then massage both breasts again and pump some more.
Expressing your milk gets easier with practice and works best when your milk supply is built up.
Don’t be discouraged if you can only express an ounce at first.
Wash the manual pump and containers after each use in hot soapy water. Rinse well and air dry.
It usually takes about 20 minutes to express milk from both breasts.
Ask your WIC dietitian or nurse if you qualify for an electric breast pump! You may be eligible to get a pump through Medicaid if you qualify.
There are many types of electric pumps available. The WIC Offices in South Dakota offer Medela Symphony hospital grade pumps. These pumps mimic a baby’s nursing rhythm and have been known to generate more milk in less time. Hospital grade pumps are good for moms that depend exclusively on pumping to bring in and maintain milk supply (for example, if you are the mother of a premature infant).
If you are planning on returning to work or school and have a long-term breastfeeding goal, the WIC Clinics in South Dakota offer Medela breast pumps that are more portable and are single-use (meaning you get to keep it!).
Picking what kind of breast pump you want to use can be a big decision. Consider cost, quality, portability, and how you plan to use it. Your health provider, lactation consultant, or WIC dietitian or nurse can help you make the decision. No matter which pump you pick, remember that it is very important to follow the instructions provided with your pump! If you are able to receive a pump through the WIC Office, staff will teach you how to use and care for your breast pump.
Medicaid Breast Pump Issuance
As of July 1, 2019, South Dakota Medicaid now covers manual and personal electric breast pumps when ordered by a physician, physicians assistant, nurse practitioner, or certified nurse midwife for any lactating mother wishing to nurse her newborn. The breast pumps should be used to promote lactation and to provide lactation support when natural feeding is not possible. These items are available for purchase only and do not require prior authorization.
Breast pumps are covered under the child’s Medicaid coverage. Coverage is limited to one manual breast pump per year, per family or one personal electric breast pump per family every 3 years.
NOTE: Breast pumps are required to be billed under the infant’s Medicaid ID number so the date of service cannot be before the infant’s date of birth.
Storing Breast Milk
Store your milk in a sterile bottle (hard plastic or glass) or disposable breast milk freezer bag.
Put enough milk for 1 feeding in each bag/bottle. Do not overfill. Consider freezing various amounts (1oz, 2oz, 4oz) to accommodate larger feedings as well as any snacking your baby might do. Leave an inch or so of space at the top of the container because milk will expand as it freezes.
Label the bag or bottle with the date and your baby’s name if you are providing milk for daycare. Talk with your daycare provider about storage guidelines for human milk.
If you don’t have a refrigerator or freezer close by when you collect your milk, store your pumped/expressed milk in an insulated cooler bag with frozen ice packs. Breastmilk can be stored in a cooler with ice packs for approximately 24 hrs before freezing or using.
Breast milk changes with the age of your baby to meet his or her needs! Try to use fresh breast milk when possible because it best meets your baby’s needs; when using frozen milk, rotate the milk so that you use the oldest breast milk first.
Milk can be safely thawed:
In the refrigerator overnight
Under running warm water
In a container of warm water
When thawing your milk, gently swirl the milk (don’t shake) to mix. Thaw by placing in the refrigerator overnight or running under warm water.
Do not boil or microwave breast milk. Microwaving breaks down nutrients and creates hot spots which can burn your baby’s mouth.
Do not refreeze thawed breast milk.
Do not add fresh, warm breast milk to frozen breast milk.
Discard unused milk left in the bottle within 1—2 hours after baby is finished feeding.
Store milk in the back of the refrigerator and freezer where temperatures remain more constant, NOT in the door.
Milk pumped on the same day can be combined before freezing
Always wash your hands with soap and water before pumping and/or preparing bottles.
It is normal for breastmilk to separate or to look slightly blue, yellow, or brown. This does not mean it has gone bad
Sometimes breastmilk that has been stored in the freezer or refrigerator will have a “soapy” smell or strange taste. The is due to changes to the fats in the milk and flavors from nearby foods. These changes are not harmful to your baby.
USDA Breast Milk Storage Guidelines
Room temp (77º F)
Up to 4 hours
1 – 2 hours
Refrigerator (40º F or less)
Up to 4 days
Up to 1 day (24 hours)
Freezer in refrigerator, with separate door (0º F or less)
Up to 6 months
Never re-freeze thawed breast milk
Separate deep freezer (-4º F or less)
Up to 12 months
Never re-freeze thawed breast milk
Storage times and temperatures may vary for premature or sick infants; check with your doctor.
Clean & Disinfect Your Pump
Pumping your milk is one way to provide breast milk to your baby. However, germs can grow quickly in breast milk or breast milk residue that remains on pump parts. Following these steps can keep your breast pump clean and help protect your baby from these germs. If your baby was born prematurely or has other health concerns, your baby’s health care providers may have more recommendations for pumping breast milk safely.
Before Every Use
Wash your hands well with soap and water for 20 seconds.
Inspect and assemble clean pump kit. If your tubing is moldy, discard and replace immediately.
Clean pump dials, power switch, and countertop with disinfectant wipes, especially if using a shared pump.
After Every Use
Store milk safely. Cap milk collection bottle or seal milk collection bag, label with date and time, and immediately place in a refrigerator, freezer, or cooler bag with ice packs.
Clean pumping area, especially if using a shared pump. Clean the dials, power switch, and countertop with disinfectant wipes.
Take apart breast pump tubing and separate all parts that come in contact with breast/breast milk.
Rinse breast pump parts that come into contact with breast/breast milk by holding under running water to remove remaining milk. Do not place parts in sink to rinse.
Clean pump parts that come into contact with breast/breast milk as soon as possible after pumping. You can clean your pump parts in a dishwasher or by hand in a wash basin used only for cleaning the pump kit and infant feeding items.
Cleaning Pump Parts
Place pump parts in a clean wash basin used only for infant feeding items.
Do not place pump parts directly in the sink!
Add soap and hot water to basin.
Scrub items according to pump kit manufacturer’s guidance. If using a brush, use a clean one that is used only to clean infant feeding items.
Rinse by holding items under running water, or by submerging in fresh water in a separate basin.
Air-dry thoroughly. Place pump parts, wash basin, and bottle brush on a clean, unused dish towel or paper towel in an area protected from dirt and dust. Do not use a dish towel to rub or pat items dry!
Clean wash basin and bottle brush. Rinse them well and allow them to air-dry after each use. Wash them by hand or in a dishwasher at least every few days.
Clean pump parts in a dishwasher, if they are dishwasher-safe. Be sure to place small items into a closed-top basket or mesh laundry bag. Add soap and, if possible, run the dishwasher using hot water and a heated drying cycle (or sanitizing setting).’
Remove from dishwasher with clean hands. If items are not completely dry, place items on a clean, unused dish towel or paper towel to air-dry thoroughly before storing. Do not use a dish towel to rub or pat items dry!
For extra germ removal, sanitize pump parts, wash basin, and bottle brush at least once daily after they have been cleaned. Items can be sanitized using steam, boiling water, or a dishwasher with a sanitize setting. Sanitizing is especially important if your baby is less than 3 months old, was born prematurely, or has a weakened immune system due to illness or medical treatment.
Sanitize all items (even the bottle brush and wash basin!) by using one of the following options. Check with the item’s manufacturer about which method to use.
Place disassembled feeding items into a pot and cover with water.