People might be surprised to learn how much time I spend helping mothers with pumping. After all, I'm a lactation consultant, so isn't my job all about helping moms and babies with positioning and latch? Sure, we work on those things, but based on personal experience and observation, a lot of the mechanics of breastfeeding get ironed out as mom and baby get to know each other. I like to tell moms that there are no rules when it comes to positioning as long as everyone is comfortable and baby is feeding well.

Pumping is a different story. It involves a machine that operates one way, with the same assembly and basic function for all users. Not everyone responds the same way to every pump, though, and thus some tweaking is often helpful to make pumping more effective and efficient. At consults, I'm able to assess a mom and baby's unique needs and tailor my suggestions accordingly. However, there are several tips that all breast pump users should know.

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• ​Make sure that your pump is in good working order. If you inherited a pump from someone else, it may be worn out, but even a brand-new pump can be defective. I have a pressure gauge that measures the vacuum of pumps, and many stores that sell pumps will do a vacuum test for free as well.
• Regularly inspect your pump kit. I'm talking about the flanges, membranes, bottles, tubing, and other plastic bits that you assemble and attach to your pump. Anything that is chipped, cracked, or worn has the potential to negatively affect the whole system and needs to be replaced.
• Make sure you are assembling your kit correctly. Is everything screwed on straight and pushed in tightly? This makes a difference! I know a mom who discovered that her pump worked much better when she pushed the tubing flush into the pump. Another mom removed the little white membranes from her Medela Pump in Style because she thought they were part of the packaging. Turns out, they're essential for the pump to work!
• Wash your pump kit just once a day! This is music to the ears of moms who exclusively pump or work outside the home. After you pump and store your milk, put your pump kit into a gallon zippered bag and stick it in the fridge. Wash everything at the end of the day.

I had the good fortune to attend a talk at UCSF last week by Jessica Shortall, author of Work. Pump. Repeat. I highly recommend this book to anyone going back to work. Jessica includes a number of awesome pumping hacks that she's discovered over the years, and her book also addresses the emotional issues faced by working parents.

Need help with pumping? Book an appointment.

This question came up over the weekend when I was teaching a breastfeeding class at Kaiser San Francisco. A sweet dad-to-be approached me during the break and said that he was under the impression that breastfeeding wasn't really possible unless a mom had access to a pump. I talked him through some of the common uses of a breast pump:

• ​​stimulating milk supply when baby can't breastfeed or transfer milk well
• engorgement relief
• drawing out inverted nipples
• mom returning to work
• other situations of mama-baby separation
• inducing lactation or relactation
• breast milk donation

All of these scenarios made sense to the dad, and then I talked about how in many cases, pumping isn't necessary. If mom and baby are mostly together and breastfeeding is going well, there might not be a reason to ever pump. And from the standpoint of human history and worldwide resources, only a small number of humans have actually had access to breast pumps. As a species, we wouldn't have lasted this long if we'd had to rely on a machine to feed our babies! The dad nodded and started laughing. "Well, of course!" he said. "Now I feel kind of silly that I didn't think of that."

I didn't think he was silly. We live in a culture dominated by technology and commercialism. Reliance on electronics has become second nature for most of us. New parents are marketed so many new products: breastfeeding apps, seats and swings that can be programmed to bounce and make noise, baby monitors with cameras, forehead scanning thermometers, and on and on. How are we supposed to know what we really need?

A lot of people see the breast pump as a must-have, and it goes on the baby gift registry automatically. I learned this a few years ago when a dear friend was expecting her first baby. Her registry included a heavy-duty electric double pump, as well as sets of bottles, several packages of milk storage bags, extra flanges, and pump cleaning supplies. We hadn't been in touch for much of her pregnancy, so looking at her registry, I assumed she was planning to return to work. Turns out, she wasn't! But all of her mama friends had told her that she needed those items, so on to the registry list they went. She ended up pumping a few times for date nights, but most of the supplies went unused and were passed along to a mom who worked outside the home. My friend probably could have gotten by with hand expression (or using an inexpensive hand pump) and a couple of bottles.

I devote a good portion of my breastfeeding classes to talking about hand expression. There are many good videos, and I show this one by Maya Bolman. It's always fun to see the reactions of the students, many of whom didn't even know that it was possible to remove milk this way! In my private practice, I teach hand expression to every mom who doesn't already know how to do it. In many cases, skilled hand expression is as effective as a high-quality pump, and it's certainly cheaper. Perhaps this is why hand expression is still not widely trusted as a good way to remove milk; there isn't much money to be made in telling people to use their hands.

A parting thought that I share with all breastfeeding families: a breast pump is not an accurate gauge of milk supply. Many moms worry that if they don't pump out a certain amount of milk that they are not making enough. Or perhaps they have been pumping for a while and notice a decrease in their output. It may appear as though their supply as dropped. Yikes! But as my wise lactation consultant mother once said to me, "Before you doubt your body, doubt the machine." Our bodies are very well designed to make milk, and our babies are good at getting it out. Pumps, however, can vary in quality. They can wear out. They can be defective. And yet new parents continue to put their trust in electronics to help them navigate the uncertain waters of infant care and feeding. I invite them to turn that notion on its head, and trust themselves instead.

Need help with pumping? Book an appointment.