The Boob Group
Benefits of Hand Expression and Manual Breast Pumps

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

SUNNY GAULT: You may be breastfeeding your baby. You may be pumping breast milk for your baby on a regular basis. Or perhaps you’re doing both. But what happens if you need to express your breast milk and there’s no pump in sight? Maybe your pump breaks unexpectedly or perhaps you need an alternative if you don’t have a power source? These are just some of the benefits of hand expression and manual breast pumps. We are The Boob Group.

[Intro/Theme Music]

SUNNY GAULT: Welcome to The Boob Group! We are here to support all moms who want to give their babies breastmilk and to respect moms who have chosen to feed their babies another way. I am Sunny Gault. How do you listen to The Boob Group? Our show is available on multiple platforms such as iTunes, Stitchers, Bricker, TuneIn and most recently, we are very proud of this, Google Play Music. So hit that subscribe button if you are on any of those sources today so you can get our episodes on a regular basis. Also just a quick reminder: New Mommy Media has several other podcasts focused on new and expecting parents, so if you like The Boob Group, then please check some of our other shows which are available at www.newmommymedia.com. Or perhaps, if you are an app person, you can download our network app which is available for free wherever you download apps. So let’s meet some of the mammas that are joining our conversation today. Ladies, why don’t you tell us a little bit about yourself, and your family, and your experience with today’s topic, whether you have experience manually expressing breastmilk for your baby or you, know, with hand pumps, things of that sort. So Rebecca, let’s start with you?

REBECCA: My name is Rebecca Jackson-Artis. I am a certified lactation specialist by choice. I am also a trained doula. And I am a mom. And I am also an actor and writer. Yes, I breastfed both of my sons for two and a half year, so that’s a total five years of breastfeeding, and I did it all. I pumped manually, I pumped with a double electric breast pump and I hand-expressed. And I am going to tell you: I preferably liked hand expression.

SUNNY GAULT: Yeah? Oh, good! Good, good, good! I am glad we have a fan of hand expression on here, so we are going to talk about this in just a second. Alright, welcome to the show! Janelle, tell us a little bit about yourself?

JANELLE: Hi, my name is Janelle. I live in Upstate New Your with my three-year-old son and my three-month-old daughter, and my husband. I am an army vet and a stayed-at-home mom now. And I have experience with manual pumps. I actually prefer them over the electric pumps. But I don’t have any experience with hand expression. But I am interested to learn more about it.

SUNNY GAULT: Absolutely! And I love that you said that you like the manual pumps better because I feel like manual pumps get such a bad rep! We think: oh, my Gosh, it is so much work, and we just want the electric pumps to do their thing. And the electric pumps certainly have their place, but I love that you said you love the manual pumps. So we’ll definitely talk about that a little bit more later on. And Paula? Paula, you are mamma as well, tell us more about yourself and your family?

PAULA LARIA-ROSELLO: Hi, Sunny! Hi, Janelle and Rebecca! Yes, I have six and a half years old, Wyatt, I breastfeed him for four years and a half. And Hazel is only three and she is almost weaning at this time. So it is like seven years and a half breastfeeding. I think I am going to wean!

SUNNY GAULT: Right? I know, we do it for so long it is like it becomes a part of us: alright, what are we going to do it we are not breastfeeding or pumping for our kids?

PAULA LARIA-ROSELLO: Exactly!

SUNNY GAULT: Alright! And we will learn a little bit more about your professional experience a little later on. So ladies, thanks do much for being with us. We’ll take a quick break and we’ll be right back.

[Theme Music]

SUNNY GAULT: Alright, so before we kick off our episode and talk more about hand expression and hand pumps, manual pumps, we are going to talk about a news headline. And I love sharing articles from things about breastfeeding, about pumping that are happening across the country. It gives us more of a worldly perspective on things. So this comes from Hong-Kong and it is about a flash mob that actually took place. It says more than a hundred breastfeeding mothers gathered at a train station in Hong-Kong to protest prejudice. And the event was conducted just about the time it was the mother’s day celebration, so we just had mother’s day and kind of goes into more in debt.

They were trying to raise awareness of the challenges they face as mothers who are breastfeeding their children. And they actually formed a group called mamma milk baby alliance. And yeah, they are just trying to raise support for this. And it has some pictures. I will be sure to post this link to our Facebook page if you guys want to check it out. But yeah, they were specifically trying to protest the fact that they need more adequate facilities throughout the country to be able to do this properly and different you know facilities for breastfeeding, childcare, things of that sort. So I wanted to just kind of to see what you ladies, thought of this? I know we struggle with some stuff here in the US, we obviously have nurse-ins and other ways to publicly show our support for breastfeeding. And this shows that is happening in other countries as well. So Rebecca, any thoughts on this article?

REBECCA: You know, I am one for…I consider myself an advocate for community organizing, and anything dealing with a desperate or a gap in community relations and society, and the natural, or the more realistic way to approach things. And if it is blithered I really believe that coming together and having community organizing, and getting women to come together…women, we are some powerful people. And we come together, and we organize, and we know how to do it, and we are strategic, we can get anything done.

SUNNY GAULT: Absolutely! Absolutely! And let’s see… Janelle, any ideas? Any thoughts on this article?

JANELLE: Well, I’ve never really experienced any discrimination, or anything, when it comes to breastfeeding in public. I’ve had some challenges with places to breastfeed while I was on drill with the National Guard. But I feel very fortunate that the communities that I’ve been in, haven’t given me dirty looks, or told me to cover up. And I am not the most graceful person when it comes to breastfeeding in public either. So I am sure that I’ve graced them with some visuals that no one was expecting. But yeah, I think it is great, just like Rebecca said, when communities come together to recognize a problem. And hopefully it brings awareness to people who may just be not as informed on the topic as you know other people. So I think anything is good, especially when it comes to something so large as raising healthy children.

SUNNY GAULT: Paula, I am really curious on your take on this? I don’t know what the breastfeeding rates are like over in Hong-Kong, but it sounds like they really need some more support behind them.

PAULA LARIA-ROSELLO: I think it is wonderful. I think that we need to help populations, communities, to be aware of how important is breastfeeding and the fact that we need to feel comfortable to be able to breastfeed wherever we are, wherever we go. So I think that’s wonderful that they are getting together and they are trying to get more help to be able to breastfeed in public. We need to do that! We need to do that in every single place! I know here now we have laws to protect us to breastfeed in public in most, and this is sad that we are saying in most of the States in this country. But at the same time I wish we won’t need any law. I wish we could do it without anything and do it freely, and nobody saying anything about it. We should be proud of being a mothers who are breastfeeding instead of looking for ways to, you know, stop all people from saying things to those mothers. But we need to help.

SUNNY GAULT: Yeah! And I agree with you. It seems kind of strange that we need to have a law that protects us from allowing us to feed our babies. I am like: this is a basic human need and we need a law that says we can do this when we need to do this. It seems really silly, right?

REBECCA: You know, I mean, one thing, I am kind of on the fence about…especially in the article… The article it talks about the women of Hong-Kong, they want more facilities to feel safe and comfortable to breastfeed. Now, I am kind of on the fence with that, because… And I’ve been hearing a lot. And I know in the State of Illinois at O’Hare airport the representative there… Unfortunately I am forgetting her name. She advocated for a breastfeeding room, because she is a new mom. That’s great, but why are we promoting putting breastfeeding in a room? And I understand that people are uncomfortable. I understand there’s a gradual; you know…we have to do step by step. But we are starting off kind of in a way still hiding breastfeeding in a room. And then we have to work our way out. Why don’t we just say: look, there are some women, we’d like to breastfeed, we don’t want to go in a room! And I don’t want my daughter to think she has to go in a room. So that’s why I am on the fence with all this.

PAULA LARIA-ROSELLO: I feel exactly the same way! I don’t get happy when I see… Ok, I understand exactly what Rebecca says. You don’t feel, you personally don’t feel comfortable breastfeeding in front of other people? Then you go to a room. It is nice to have a place designated for you to be able to feel comfortable yourself. But the rest of us who feel that we can do it in from of everybody and say: hey, I am breastfeeding my baby, look how wonderful this is, just do it outdoors, everybody can see you. The more we expose ourselves to something that is absolutely natural and everybody should take it like it is, the easier will be for the community to understand how important it is. And we should be able to, you know, walk in the street like nothing happened. She is breastfeeding her baby, good for her! That’s it, you know!

SUNNY GAULT: Yeah! And one of the things that the article does say is I think it says something about childcare facilities, and I wonder… I am not saying that that’s like, you know, like a daycare kind of facility. But I am wondering if Hong-Kong is even missing, you know, places to change your baby’s diaper, or, you know what I mean, I wonder if… I don’t know and I don’t know if the article really goes into a lot of debt about that, but like they might not be just talking about breastfeeding facilities, like go-cover-up or go into a separate room where people don’t have to see you. I think it is just about carrying for your child in general. So that can include, you know, bunch of different things. More like a mother’s room.

So it is not necessary, you know, that is just for breastfeeding. But it sounds like they do need some support over there for moms in general, you know. And so these ladies definitely made some noise with this. I can only imagine walking into, you know, a train station and seeing a hundred mother breastfeeding. That in an image that is going to stick in a lot of people’s heads. So I think, you know, from that standpoint, I think they accomplished what they wanted to accomplished.

[Theme Music]

SUNNY GAULT: Alright, so today we are giving to two options for expressing breastmilk that I personally feel are underrated, but extremely useful, and that’s hand pumps and manual expression. So our expert today is Paula Laria-Rosello and she is an international board certified lactation consultant. She also teaches breastfeeding classes online. She has some great video tutorials on techniques, such as manual expression, that are posted to YouTube. We’ll be sure to put a link to all of these on the episode’s page for this episode. Paula, welcome to The Boob Group, it is great to have you!

PAULA LARIA-ROSELLO: Hi! Thank you, Sunny! Very happy to be here today!

SUNNY GAULT: Oh, good, good! We are excited to have you! So why do you think hand expression and manual pumps are sometimes overlooked as options for expressing breastmilk?

PAULA LARIA-ROSELLO: Ok, so I think that the main reason for that, that is happening, is because we have…is easy to access to an electric breast pump. There are, in the last years, has been seen a huge increment in the quantity of brands, a variety of colors, sizes, shapes, whatever you want to name about electric pumps. You go to the store; many of them to the point that you get there, you see everything, you are looking for stuff for your baby, maybe you are looking for stuff for your baby shower and you see all those pumps, and you are like: I wonder why is so many pumps here? I think I need one!

SUNNY GAULT: Yeah, it is true!

PAULA LARIA-ROSELLO: And that will be one of the reasons. Also, there is a new law that the medical insurance should be covering for those electric pumps for those mothers who are in need. And what I’ve been seeing is that mothers will ask for it no matter what, just in case. Oh, just in case I got every electric pump! And just in case I am going to get it in my baby shower. So I think easy accessibility that we have here in this country to those things make us buying stuff that will end not needed later or you know, just using a little bit.

SUNNY GAULT: Exactly! Rebecca, I would love to have your take on this too as someone who educated and helps breastfeeding moms. Why do you think that, you know that we don’t really consider these as options?

REBECCA: Well, it doesn’t make a lot of money. And you know, I mean…

SUNNY GAULT: That is true!

REBECCA: Look at some of these top double electric breast pumps. I mean, look at how much money is being shelled out to do it. You know, it is all about marketing, it is all about pretty boxes, you know. We are taught to tell us what’s more convenient for us. We as the majority of people, we never allow to find out for ourselves. We are told: oh, this is more convenient. And then, look what hospitals do. They are dealers of high-price pumps. So you know, they are also a part of the game. I am not saying that there is no room for double electric breast pumps. I am not saying that. I mean, and I know everybody has their options. But what I am saying is we need to understand: we can’t negate certain options for women because it is not cool, or cute, or pretty, or stylish. And so if you really want the quick answer it is because it just doesn’t make that much money. I mean, you buy a $15-$20 manual breast pump compared to some of these $500 breast pumps. I mean, come on! And then you promote hand expression.

I mean, you know, so of course you are going to get this image that hand expression is country ghetto, you know, that crunchy moms who are crazy and barefoot, and walking around with flowers in their hair. You know, you are not going to get this… You know hand expression is actually amazing! And you actually get a lot of results from hand expression! And moms have to touch their breasts. Oh, my God! God forbid you make me touch my own breast for longer than 30 seconds! And you learn your body, you are learning your rhythm. And again, we are also in a society that’s telling us not to be in tune with our rhythm. You know, that’s why, and I will say it, and I know not a lot of people are going to like it, but I mean that even goes to understanding our menses. So we are taught to not touch ourselves, we are taught to not be in tune with ourselves and our rhythm and marketing, marketing, marketing. You need something to substitute. You need to by something to make you better. You know, you need the best of this. And it is garbage in the end.

PAULA LARIA-ROSELLO: So basically, also what Rebecca is saying, it depends on the needs of each mother, what kind of power will be more appropriate for you. Unfortunately, sometimes we go to buy this stuff without learning why we need. Am I going to need a pump? What would be the reason I need a pump? What would be more appropriate for my needs? So depending on the needs of each mother is the kind of pump or technique that she will need to use or more appropriate for that specific case.

SUNNY GAULT: Alright, so let’s go ahead and let’s talk a little bit about hand expression first and we’ll talk more about the manual pumps in the second half of the show. So when it comes to hand expression, Paula, what would you say are some of the main benefits of hand expression?

PAULA LARIA-ROSELLO: Hand expression is a magnificent technique for every single mother. The main reason or the situations where I would be using it the most are during the first three days of the baby’s life or five days, especially for those mothers who need to be separated from their babies. When his happen in the hospital, we have a policy, or at least in my hospital, there is a policy, where we try to tell a mother to try stimulating during the first six hours after the baby is born. And before what we were doing was to give the mother the electric pump, the hospital gave an electric pump for her to start stimulating the breast. What we noticed is that when we ask them, most of them are extremely frustrated because they come out with the fact that they can't get anything out of their breast. Ok, it is very hard to express due to the characteristics of colostrum that is, small in quantity and it is thick.

It is very difficult to remove with an electric pump. And also, when we are able to get some, we lost that drop inside the flanges, it doesn’t way all the way to the bottle. We end up losing whatever we get. So for those cases hand expression is the best way to express breastmilk from the breast. It is very easy. It is a technique that once we learn, is very efficient. And it is the best way to remove colostrum from the breast. Other situations where we use hand expression will be for babies who have very difficult time to start breastfeeding, to initiate the flow of milk. When we are engorged, during those days, sometimes the breast get really hard and it is more challenging for our babies to latch and get a good latch or avoid mother feeling some, a little bit of discomfort. So applying hand expression a couple of minutes before breastfeeding will help mother to soften the area and that way mother will be able to held that baby to get a better grab.

If we are using pump, if we are pumping for any situation, what we found out in different research, is that when we combine pumping and hand expression at the same time, mothers can get more quantity of breastmilk. They can express even double of what they express sometimes when combine both techniques. I think hand expression is a technique that every single mother should learn before they leave the hospital. It could be very helpful. There are also researches that have shown that healthy mother with healthy pregnancies if there is a specific reason that they are going to be separated from their babies after the baby is born and they know that during their pregnancy, they can also do hand expression before the baby is born. And to do that, please, make sure that you have the confirmation of your doctor. You need to OB if you can it. But you can apply hand expression and start colostrum for your baby if you already know that your baby will be separated from you before your baby is born. I think those are the main reasons that we can use hand expression.

SUNNY GAULT: Okay, so moms why did you decide and actually this is a question more for Rebecca, because, you know, Janelle I don’t think you have the experience doing that, so Rebecca why did you decide to manually express? Why was that something that was important to you?

REBECCA: I grew up in a formula feeding family and I was blessed to have certain people who would kind of tap me on the shoulder and say “You know you have an option to breastfeed?” and I breastfed and my family out of all my relatives I had very few that actually breastfed in one being my grandmother, my maternal grandmother, who happened to live with my mother. And when I would go over to my mom’s house, you know, my mom would say “Oh you know you can leave the baby with me” or my grandmother would say “You know, Becky, you can leave the baby with me” we’re in Mississippi, dial it, and I would say “Well, grandma, you know I don’t pump, you know, I don’t have any pumping, I didn’t pump any milk” and I don’t know may be after the third time my grandma said “Becky, you can put your hand on your breast and expr…” she didn’t say express, but she said “You can get your milk from your breast, Becky! You don’t need no pump! What do you think I did? What do you think I did back in the 40s and the 50s?

I never used no pump!” and so I realized I was like “Oh, okay” and honestly like she says “You better grab your breast and massage those breasts” and as soon as I did and again I kind of knew what my grandmother meant, so it wasn’t a completely foreign concept to me, but, you know, I just, no one, again we live in a society that doesn’t educate women about the power of our bodies and just the limitless things that we can do, so and I like, I hand expressed that day, now of course my hand got a little tired and my grandmother said “The more you do it the more milk you’re going to get out” and that what she told me.

I would actually get more milk from hand expression the more I learned how to do it , I started to learn how to get that rhythm. I started to learn the certain sports on my breasts to kind of get a better flow, it was amazing and I was like “Why to use a pump?” So I went months without using a pump. I would, you know, get a good, sometimes I would get two bottles out and I know what people think that’s crazy, but I would and we’re using double electric breast I’m going to, I need to stress, I’m not saying that double electric breast pumps are not needed. So I wanted to stress that, so what I’m saying is we can’t negate the options that mothers have.

And so I started doing that to the point that I may be by the time my son was probably nine or ten months old, I decided “Let me pull out this double electric breast pump and try to use it” and it was almost like my breasts were like “Uhm, uhm I don’t like that thing” and so I just went back to use a hand expression. With my second son I used the pump only at work, because I knew it will freak people out, if I’m sitting … and I worked, you know I’m an actress, so I worked at a theatre company and another mom at the time was pumping too, so we were, and it was a very small office, so we were just pumping at our desks.

I really, you know with the mothers I work with in the breastfeeding class I do and the mothers I talk to on internet and all this and I really promote mothers to hand express and I’m telling you, I tell mothers “After you do the pump, the double electric breast pump, take that pump off when you don’t see any more milk come out and hand express more and more and I bet you’ll get two or three more ounces”
Every time women always call me back and say “You know, Rebecca, you were right, this is amazing! You know why more people, why hasn’t a woman told me this the last six months I’ve been working, you know, at work and struggling and crying because I got only four ounces and I could’ve gotten three more and I’ve gotten seven. And it’s all about education, it’s all about support and it’s all about again allowing women to get educated decision for themselves.

SUNNY GAULT: So Rebecca, when you manual, I’m saying hand expression, manual expression, kind of using these terms interchangeably but when you were hand expressing, what would you typically do? I’m just curious about the process. Would you express the milk into a cup or I mean how did you do it?

REBECCA: Well, when I first started I would say, I started hand expressing into a bottle, because, you know, why, you know, lets skip a step, just put it into the bottle and I wasn’t all … I was, I really stayed at home most of my first son’s first year, so I did have the blessing to, to not have to have storage, so when, you know, when my husband did say “Oh, Rebecca lets go to a movie together” you know, “Leave the baby with your grandmother or your mom” you know then I was able to just grab a bottle and sit there and hand express.

Now that I did, I have, now I want to tell people, because I have very large breasts and another due to breastfeeding, my grandmother had them, my mother had them, I just come from a family, we are chest blessed and I’m telling you I scare people with my breasts, that’s why that hole movement when people were like “Go, go braless!” I’m like “I’m going to end up in jail if I go braless”. So I’m going to hurt somebody or hurt myself, I was like “I can’t do that” so what I did is, you know, when I’ve heard people with larger breasts say “Rebecca I can’t hand express..” I was like “Why not?” But I would start at the top the part of my breast near my chest and I would do the C cup, the C positioning and I would squeeze with my four fingers at the bottom and I would take my thumb and I’d push it down toward my nipple.

I do that and then I would even kind of push the milk from the, the breast from the more the inside, because I was, of course, doing it from the outside of my breast, but I would go inside, where my two breasts come together and I would rotate because I would want to also use those milk ducts and those that tubing and so I massage that and then again work my way, work that thumb down toward my areola and my nipple, it would be like a waterfall and I would hear that (waterfall sound) and then you get a rhythm and you just get the output, I mean, I hope people can kind of get a visual from what I’m saying.

SUNNY GAULT: Yeah, no, absolutely and I think you actually have a great description of how it works. Paula would you add anything else to that as far as how do you actually hand express, I mean, I thought that was a pretty good description, anything else you would add to that?

PAULA LARIA-ROSELLO: That is a very good description. Actually, I would like to add a couple of things … in many of the things Rebecca said … regarding these – yes. First – always wash your hands; a step-by-step would be washing hands first. The second thing that helps a lot to initiate hand expression, also I am thinking … based on what Rebecca said, I can imagine that his happen like once the milk was increased after lactogenesis happens.

When we have colostrum during the first three days or five days, for some mothers it is a little bit more challenge … we may now see that [sound] which is … it happens later on but during the first days, it takes a little bit more than that. So, washing hands; after that you can either do some warm compresses or a little bit of very gentle massage, massage would be very soft like a caress and all around the areola and also it can go all the way under the armpit because we have mammary glands around the whole breast but also under the armpit or axilla. So when we are engorged and we need to release that … before the engorgement, sorry, that colostrum you can massage all that area. That would take a couple of minutes and when you do that massage, you help your body to release a hormone called oxytocin and oxytocin is the hormone that would help for the ejection of the milk, it is going to prepare to flow easier out of the breast, applying a couple of minutes of hand massage can be very beneficial.

For the next step, that would be hand expression. Yes, we use the hand in the U or in a C position. What I found out is that if we use the whole finger and then we press a lot of points at the same time, it doesn’t work as well then when we use only tip of the index finger and the tip of the thumb. We are going to imagine there is a line crossing the nipple and the areola in any direction we want and then we are going to position our hand in either a U or a C hole, only the tip of the index finger and the thumb at the same height of the nipple imagining that line and then we are going to do these three movements – press towards mother breast, compress fingers together and release – press, compress, release; press, compress, release.

When we have colostrum, we may not need a bottle, we are not going to be able to … we may lose those drop off colostrum so we can use a spoon under the breast or the nipple and collect drop by drop those golden drops of colostrum that can be extremely helpful for those babies that may be separated from their mothers too. And then after the milk increase, three or five days after delivery, we can either use a bottle or for some mothers bowl, like a glass bowl, will be easier because if milk flashes out of the breast – sprays – the bowl would be able to contain all that milk that is coming out. So that would be what I want to add about the technique. The other thing that I love is … Rebecca’s story, I wish … I don’t know if you are going to have enough time for this but I have another story. My sister is in a different country so remember that these wonderful options that are being used for many years in other countries where things are not that accessible. So, she is in another country and she had her baby and I was pretty new in the breastfeeding area and I wanted to help her and she said she was back to work, she was breastfeeding and she was using a manual pump for maybe two months and I was like “oh my gosh, breast pumps, electric pumps are so accessible here, I am going to buy one and I am going to send it to you.”

It wasn’t a good idea … being very difficult, I sent it to her, then she … they returned the package because it was coming from another country and it was an electric thing and they ended charging her extra money because she was receiving something that they didn’t have there. And then she finally got it and started using it, she was extremely disappointed. She was so used to using that manual pump and she was so efficient at using it that she did not get the same quantity using the double electric pump. So isn’t that funny after all the things … yeah.

SUNNY GAULT: Yeah, so it goes back to technique and experience like what Rebecca was talking about – like the more she did it, the easier it got, the more comfortable she got with the whole process and that is just a testament to a lot of times we just psych ourselves out, right. We are just like – oh, we can’t do it, we have to have this electric thing that attaches to us, that is the only way to pump milk and that is not, right?

PAULA LARIA-ROSELLO: Yes, definitely.

REBECCA: I mean … what did women do back in … why do you think women sat there and just said – well, I guess I just always have to be with my baby, you know, in 1901. Women did have lives back then and they did have time of separation from their infants and they might not have had access to that pedal pump so they hand expressed. So this is not … again, we are coming from this concept of going back to nature, going back to understanding yourself is now called alternative. That is something we did for centuries and centuries and this whole technology thing, this has only been in the last 50 years, this is what is really alternative.

SUNNY GAULT: Yeah, it is true, it is so true. And the thing is you just never know, I mean, you always have your hands with you, you know what I am saying, so like you don’t have to worry about … like if you are away from your baby, I know – this just happened to me recently as we had some company, my parents came into town for a while so my twins who I am still breastfeeding were very distracted and they weren’t nursing as much. And I found myself needing to manually, you know, hand expresses the breastmilk not using a pump or anything because I was more full than I normally was. I didn’t have a pump around, I mean, this was not … that is not part of our life.

REBECCA: Exactly and I am going to add just one thing because and that is true … I have been on date nights and you know, my husband and I, my husband said “Rebecca, let’s go to this one extra play” and I look down and I am like “oh my gosh” and what I do, I remember one time I grabbed a cup that my husband had I guess he stopped at a restaurant and I dumped that stuff. But it was just because I needed to relieve myself. Also, just this morning I was helping a mom out of Dallas, Texas and she was asking me that, you know, her baby is sleeping a lot through the night and he is getting older and he is fine, it is just that he is gaining weight, he is pooping and peeing, doing wonderful things and she said she wakes up engorged and I said “well, you can pump” and she said “but I don’t want to wake him, I don’t want to wake my other son”. I said “what about hand expression” and she said “you know what, I should start doing that”. So I mean it is not a foreign concept.

SUNNY GAULT: Yeah, no motor required, right. Just use your hand. Alright, good impute everybody. Okay, we are going to take a quick break. When we come back, we are going to learn more about the benefits of using a manual pump. I know we kind of talked about it, kind of intermittently throughout the first half but we are going to dive into that a little bit more. So we will be right back.

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SUNNY GAULT: Welcome back. We are continuing our discussion on hand expression and manual breast pumps and Paula Laria-Rosello is our expert. So Paula, let’s now turn the conversation a little bit. Let’s talk more about manual pumps. What are some of the benefits of using a manual pump?

PAULA LARIA-ROSELLO: Manual pumps are easy to bring with you any place you go, especially for those mothers who don’t feel comfortable trying to do hand expression. So manual pump would be a cheaper option, it is less expensive; you can put it in almost any handbag, bring it with you any place you go; you don’t need electricity to make it work; it could be very efficient as any other technique. You just need to practice, practice, practice … we were saying before … that would be the main benefit of manual pumps. And also for those mothers who need to pump maybe once a week or once a day, they don’t need any other thing than a manual pump to be able to do it.

SUNNY GAULT: Yeah, you know, I am glad you brought that up because that was actually my situation I really didn’t need … once my twins started tandem breastfeeding, I really didn’t need anything else besides manual pump but it wasn’t even something that I had thought of as an option. Isn’t that crazy? I was thinking that I was going to have to buy this double-electric or whatever and I didn’t even think about a manual pump.
I had just heard horror stories, in fact, I am going to blame my mom on this because she is the one that said “oh, they only had hand pumps or manual pumps when …” whatever I was a baby and “oh, it hurt your hand” and like throwing all these negative stuff. So I had already had this perception of it being like far below electric pumps which isn’t fare. And what happened for me was my twins were born right before their Affordable Care Act took effect and I just missed the cut off and so for my insurance, they were giving out electric pumps now but not for me because my babies were born in November as opposed to January, right.

And so the lactation consultant that I was talking to said “you know, we have all of these manual pumps, why don’t you just … you are not going to be pumping a lot, you are primarily tandem breastfeeding” but I just wanted to incorporate one pumping session after my girls went to bed so I could store up some milk in the freezer. So I could be away from them and somebody be able to feed them some expressed breast milk. And so she is like “this could be perfect for you” and so I was very hesitant but I got it in the mail and I am looking it like “there is no way this thing is going to do anything” and I am a really hands-on pumper meaning I don’t just kind of set it and forget it even if it is an electric pump; I massage the breast with one hand and I pump with the other. I am just very involved in the pumping process and so this wasn’t that much different for me.

One hand was kind of squeezing but I felt like I actually had more control over the whole process and it turned out to be a really great thing for me. So, this is one of the reasons I wanted to do episodes is because I feel like there is so much negative information out there about these methods and it could really be depending on your situation, the very best thing for you so I don’t want anyone to overlook it. Janelle, I know … we haven’t been ignoring you but we have been talking so much about hand expression, I know you don’t have a lot of experience with that. So manual pumps – tell us a little bit about those and how you use them and how it helped you.

JANELLE: Sure! Well, with my first son I used the electric pump at first and I hated it because I thought that is what I was supposed to be doing, I was a new mom, everyone told me I had to pump and here is my electric pump. And so I kept on doing it and I think I generalized it to pumping in general, I just hated pumping until I had a drill weekend with the Army National Guard here in New York state and where we were training just wasn’t going to allow me to take my huge machine set up and plug it in and do the pumping and so I got a hand pump. And all my friends said I was going to hate it because my hand was going to cramp up or whatever but I had no choice. I actually ended up pumping in a supply closet next to the k-cups and printer ink. And so this is where I had to do it and then it turned out that I liked the manual pump way better. It hurt me less, I got more milk from it and it was way more convenient and easier to clean, this 15$ pump compared to the 200$ electric pump which I ended up just throwing in the closet. And now I use a manual pump with my daughter; I have a toddler and so I couldn’t be strapped to an outlet so now if I am pumping and I need to go check on my son in his room, I can just walk with the pump right on my boob and not miss a beep. So now there is the convenience of the pump on the go and all my friends were totally shocked when I told them that I prefer the manual pump, they can’t believe it but I do so there you have it.

SUNNY GAULT: That’s good. I love to hear that. So Paula, can you explain to us logistically what are some of the differences that moms would experience between a manual pump and an electric pump? If moms are trying to think “I don’t know which one to get”, what would you explain are some of the differences between the two?

PAULA LARIA-ROSELLO: Janelle said a lot of the stuff already. One of the wonderful things with a manual pump is that you control with your hand the strength and the speed of the pumping so it feels more natural in that matter because you are in control of everything all the time. Even though the new electric pumps, you can press a button but it is still this extra thing out of your body making all the suction and everything on your body feels weird. So when you use the manual pump, you are holding the pump, sometimes you hold it with … some hold it with both hands, the most of them the new ones, you can hold them with only one hand and as you also said in some cases you can pump and compress the breast or massage the breast at the same time to get it more efficient. So it is nice you can control the strength of the pump use. What I think makes mothers frustrated is when they think that at the first time that they are going to use it, they are going to get a lot. Link that with any single pump that you use – the first time is something new – and we have some feelings that make us thing that “oh, I don’t feel like this is going to work” or “I feel like this is going to feel painful” or we expect that the manual pump would be able to get a lot the first time.

It is the same thing with the electric pump. So what I notice is that when they use it the first time they don’t think what they expect; they have two options – they either think that the pump doesn’t work or their body is not producing enough breastmilk. My message would be – give yourself a chance to try several times until you get comfortable with any technique that you want to use and you will see how you are going to be able to modify the technique to the point that you can get as much as you can give. Remember, the more you remove, the more you remove from your breast, the more milk you are going to be producing so with more experience, you are going to be able to get better results.

SUNNY GAULT: And Rebecca, I would love to get your take on … since you did so much of the hand expression, like how you compare hand expression to using a manual pump because you have experience with both, right?

REBECCA: Yeah, I remember coming home from the hospital and I was given a manual breast pump and again, I had no idea what this thing was and I kind of understood it like I think these big wide circles part you put on the breast and so I put it because nobody showed me like “oh yeah, you are breastfeeding, that’s great. Here is a manual breast pump and here is a whole case of formula.” But anyway, so I took it home and I used it and I … like Paula said, I didn’t get that much output from it so I was like – oh, this thing doesn’t work.

And so I just kind of put it to the side. It was only my friend who had been breastfeeding at that time for about six months and I told her about this but she was like "oh, I love my manual pump” and by the way we are both actors, we have to be very overdramatic and use our hands and fall into each other and so she was like “oh I love my breast pump. It is the best! I can’t stand my electric pump. I get a way more out of my manual pump”.
And when she said that I said “let me try this thing again” and I tried it for a few more times and I looked up and I was like “oh, this actually works” so I always have my manual pump in my car for those times I was driving in traffic and I just have to, you know, put it on there to relieve myself.

SUNNY GAULT: And then compared to just the hand expression part. Like, which one did you prefer I guess this is what I am wondering?

REBECCA: Hand expression.

SUNNY GAULT: You did, okay. And why?

REBECCA: I don’t know. Maybe I felt more in control when I had my own hand. I don’t know. Maybe I didn’t like that barrier between me and my own body, I don’t know. You know, that is something I need to explore, Sunny. That is a good question.

SUNNY GAULT: Because that is actually felt between an electric and a hand is I felt is once I filled up my manual pump, I felt like more of a sense of accomplishment than I did with an electric pump. But maybe that sounds really strange but … and to Paula’s point, it was because I felt like I was in control. I was like “okay, so my hands are doing all the work here even though there is a hand pump involved, I am still able to do this” and so I … yeah, I actually just felt like I was accomplishing more when I was using a manual pump as opposed to an electric. So I was wondering if you felt that way with the hand, you know, using your hand as opposed to a manual pump.

REBECCA: I think you are right and overall Sunny, breastfeeding is a very empowering thing and however you fit your narrative into that lactation journey, like when you accept – I like this – and you become so like – this has my name on it – and it feels good. And that is when you are like, that is what empowered me.

SUNNY GAULT: And Paula, I know we have been talking a lot about pumps and certainly we don’t want to give electric pumps a bad rep because there is certainly a time and a place for it and a lot of women greatly benefit from them. Would it be helpful, do you think, for moms who need to pump and they need to pump at a regular basis to have both and we talked about manual pumps not being that expensive, you know, maybe an extra 15 or 20 bucks on top of the 500$ you are paying for an electric pump. So, would you recommend that pumping moms have both just as a backup?

PAULA LARIA-ROSELLO: That is a wonderful question. My recommendation would be if they have the opportunity to meet a lactation consultant in the hospital before they go home; talk to the lactation consultant about what is your situation – are you going to stay home, are you going to go back to work. Depending on your situation, the lactation consultant would be able to give you an idea of what would be the best option. I always say breastfeeding – the simple you do it, the easier. Having an electric pump when you are not going to use it is a waste of money.
So no, I don’t think you need to buy an electric pump unless there is a specific situation for which you need like going back to work. I would like to give like a small classification of the different pumps and what would be the main reason that you need one of these pumps. So hand expression we talked about a lot and it is more natural and it can be as efficient as any other pump and sometimes even more efficient for mothers who don’t feel comfortable using something that is not natural.

Manual pumps – perfect for bringing with you any place in case that you don’t like to do hand expression of breastmilk; for occasional use when you need to pump maybe once a day or three times per week for occasional use or like Rebecca said, I hope everybody is not driving and pumping at the same time. Definitely, if you are doing something else and you cannot use hand expression, a manual pump can be a very good option in those situations.

Personal pumps are excellent options for mothers who already established their milk supply; they have been breastfeeding for one or two months; breastfeeding is well established; baby learnt to breastfeed, mother is producing the quantity of breastmilk that the baby is needing and now she is going back to work and she needs to be pumping three or four times per day. So for those situations, remember, the breastmilk is well established, then if you need to skip some feedings, a personal electric pump would be a perfect option for you because they are also small and you can bring it anyplace you go.

Some of them, they also have an internal batteries that would help in case you don’t have electricity available. Hospital-grade pumps … we don’t buy hospital-grade pumps at home. You may feel that would help that is the best option ever that is the bigger pump, the best one. We only need hospital-grade pumps when there is a complete separation from the baby and we need to help mother to build her milk supply; this mother is separated from the baby for such amount of time and she needs to be pumping at least 8 times in 24 hours to be able to build her milk supply. So I think that would be the main difference for the different types of pumps.

SUNNY GAULT: Yeah and I actually used a hospital grade immediately after my twins are born because they were a little bit preemie, not too bad, but they were having trouble latching so for the first two months I used a hospital-grade pump and what I will say about that is that it is so easy to fall in love with the hospital-grade pumps because I had so much milk, you guys should have seen me, like every 3 hours I was pumping, it didn’t matter at day or night, I was like a pumping rock star so I can definitely vouch for the hospital-grade pumps.

But I think it also goes to show that throughout your breastfeeding journey, you may use a bunch of there … you may start out with a hospital-grade, you may find that you don’t need that, at certain point you may go to a personal pump and then you may go to a hand pump after that and then you may throw it all out the windows and say “I’m just using my hands.” So you could go through the whole game I guess it depends on your needs. So, everyone thanks so much for being with us today; it was a lot of fun chatting with you. I really appreciate everyone sharing their personal experiences with this. If you are a member of the Boob Group Club, then please be sure to check out our bonus content for this episode. We are going to talk more about the benefits of hand expression and manual pumps even before your baby is born so we can actually get a jump start on all of this. So, for more information about our club, visit our website at www.newmommymedia.com .

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SUNNY GAULT: Alright, before we wrap up our show, we do have a quick question from one of our listeners. This comes from Sarah and Sarah says:
Hi! I love your podcast and I need some help. My son is 7 months old and has thrush. In turn, I got it and my nipple is cracked so badly on the underside. When it latches it burns and it hurts so badly. I am in no way stopping breastfeeding so my question is what can I do to ease or help with this nipple pain?

MICHELE STALBERGER: Hi, this is Michele Stalberger. I am an IBCLS in the Washington DC area. Hi, Sarah, thanks for your question. I am sorry to hear you have been dealing with thrush, it can definitely be persistent because you and baby will pass it back and forth. Make sure that you wash your bras really well and that you are not leaving any bra pads against your skin for too long while they are wet. You want to keep you area nice and dry so that you don’t continue to gather bacteria. I think it is time to call in the big guns and break out the all-purpose nipple ointment.
This is a prescription cream that includes an anti-fungal and it will help heal the cracks and prevent re-occurrence of the thrush. You can find the ingredients on Dr. Jack Newman’s website and contact your OB about getting a prescription. Make sure that you and your baby are both getting treated to prevent further transmission of the thrush. And as always – contact an IBCLC if you have further questions. I hope this helps.

SUNNY GAULT: That wraps up our show for today. I know it was a longer one. Thanks so much for hanging in there with me.

Don’t forget to check out our sister shows:
∞ Preggie Pals for expecting parents
∞ Newbies for newly postpartum moms
∞ Parent Savers for moms and dads with toddlers and
∞ Twin Talks for parents with multiples.

This is The Boob Group where moms know breast!

[Disclaimer]
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. While such information and materials are believed to be accurate, it is not intended to replace or substitute for professional, medical advice or care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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