Why isn’t milk coming out when i pump

Breastfeeding may be a natural process, but it doesn’t always come naturally and can take some time to perfect. Pumping breast milk is much the same — an activity that, on the surface, seems pretty straightforward (put on cups, flip the switch, milk comes out), yet it’s not always so easy for every woman to hook herself up and produce a bunch of bottles.

And even once you get the hang of pumping breast milk, it’s normal to have questions or concerns — about your milk supply, getting your baby to take a bottle, the cost of breast pump equipment or any anxiety you may feel about the task as a whole.

The good news? Once you conquer these pumping bumps in the road, many moms find the experience to be surprisingly satisfying: After all, you’re providing your baby with nutrition even when you’re not around to nurse her.

Here are some fixes for common pumping predicaments, which should hopefully help keep your supply up and your frustration level down. And remember, you can always reach out to a board-certified lactation consultant for questions, concerns or support.

Common pumping problems

The problem: Your milk supply is low

Why it happens: Low milk supply can be the result of not pumping enough, pumping too soon after a feeding or not nursing between sessions. You may also have a low supply if you’re not pumping long enough, if you’re using the wrong type of pump or you’re not drinking enough liquids.

How to fix it: Strive to pump at a minimum of once every three to four hours (or more if your baby is still a newborn) and be sure to wait to pump again until at least an hour after your last feeding or pumping session. As for nursing between pumping sessions, plan to pump at least an hour before nursing time to make sure that baby will get what she needs at the breast.

Keep in mind that you’ll need a solid 15 to 20 minutes on the pump to net a good amount of milk (some women will need 30 to 45 minutes, especially in the early days). For the most efficient sessions, use a double-electric pump, which pumps both breasts at the same time and ramps up let-down. Finally, remember to drink lots of water and other non-caffeinated beverages as dehydration can cause your supply to dwindle.

The problem: You have to miss sessions

Why it happens: Your boss calls you into a meeting just as you’re starting to pump. Or you’re stuck in traffic taking an older child to her piano lesson and suddenly your whole schedule is thrown for a loop. Yup — life can sometimes get in the way of your carefully crafted pumping timetable.

How to fix it: Block pumping time on a shared calendar or hang a sign on the door of the room where you’re pumping so coworkers are aware. And while meetings or travel delays are inevitable, talk with your employer if it’s common (under provisions in the Affordable Care Act, employers must provide mothers with reasonable break time and a private, non-bathroom space to express their milk). Lastly, a short pumping session is better than none, so don’t skip it. Even five minutes can help with your supply — just avoid too many days like that in a row.

The problem: Pumping feels painful

Why it happens: Pumping can feel kind of funny at first, but it shouldn’t cause pain. If it does, you may be using the wrong sized breast flange, the suction may be too strong or your nipples could be sore.

How to fix it: When sizing the flange, aim to place your nipple in the tunnel’s center so that it moves freely during pumping without too much of the areola being sucked into the tunnel. As for suction settings, the highest one doesn’t always yield the most milk — and it may even slow your flow — along with causing significant pain. Instead, set your pump to the suction level that feels best for you.

And if your nipples are sore, red or cracked, take steps to heal them. Rubbing pure lanolin or expressed milk on your nipples, avoiding soap in the shower (it’s drying) and letting your nipples air-dry after each feeding may help. If you still can’t find relief, seek support from a certified lactation consultant to help pinpoint the issue.

The problem: You struggle with let-down

Why it happens: If your breasts feel full but you’re not getting much milk when you pump, you may be struggling with your let-down reflex. As nifty as your pump is, there’s no comparing it to the smell and feel of your sweet baby in your arms. In fact, when you hold your baby to nurse, oxytocin (the love hormone) is released, which triggers your let-down response. Oh — and your mother’s texts and co-workers’ Slack messages that that pop up on your phone probably don’t help either (ditto the cold, hard folding chair in the pumping room).

How to fix it: It may sound cliché, but try to relax with a quick meditation, soothing music or a few deep breaths or stretches. And try to consider the pump like a friend and a way to connect with your baby. If you’re pumping away from home, keep a few baby items in your bag (photos, an unwashed shirt) that remind you of your cutie or play a recording of her coos or cries.

The problem: There’s no place to store your breast milk

Why it happens: If you’re pumping at work, you may find that not every workplace offers a fridge for milk storage — or the fridge you do have may be jam-packed with lunches and office catering for meetings.

How to fix it: No fridge? The Centers for Disease Control and Prevention (CDC) says it’s fine to leave breast milk at room temperature for four hours. But for longer days, bring in a small cooler or insulated bag with an ice pack to keep your milk fresh. You can keep your breast milk safely stored in an insulated bag with ice packs for 24 hours. When you get home, transfer your milk to the refrigerator or freezer right away.

The problem: Your baby rejects your pumped milk

Why it happens: Babies are smart — if you’re pumping at work but generally nursing at home, some breastfed babies may reject the bottle hold out for the “real thing” until you get home. Other bottle complaints from wee ones can include the way they’re held by other caregivers, nipple size, shape or flow level — or how the nipple is placed in their mouths.

How to fix it: Keep pumping and don’t get discouraged! Try different nipple types until you find the size, shape and flow that clicks with your baby. You can also leave your T-shirt with the sitter as the scent may encourage her to drink up. And if your baby has a high palate, her suck reflex might not be stimulated. By pointing the bottle at the palate and then gently moving it to a horizontal position, it may help.

The problem: You feel anxiety about pumping

Why it happens: Many factors conspire to cause anxiety around using a breast pump, including worries about supply, pain and the pressure some women feel to keep it up month after month. Social media, family and friends may also play a role in undermining a woman’s confidence when pumping.

How to fix it: Sure, you have lots in common with your fellow nursing moms, but it’s wise to remind yourself that each person’s pump experience is different and to refrain from comparing your situation with what you see on social media or hear about in your mommy-and-me classes. Your best bet? Ignore the negative energy and surround yourself with supportive people.

If you find that you often experience negative feelings (which may range from sadness to irritation to panic to depression or anxiety) right before your letdown, you may be experiencing a condition called dysphoric milk ejection reflex, or D-MER. This condition affects lactating women and causes dysphoria, or a state of feeling unhappy, right before your breasts release milk. Speak to your practitioner if these symptoms sound familiar.

The problem: Pumping accessories are expensive

Why it happens: These powerful machines can be costly, with hospital-grade pumps renting at $50-$85 (or more) a month, not including the tubing, flanges and bottles. And buying your own electric pump can run you between $150 and $500 (though most pumps hover on the high end of the price scale).

How to fix it: Talk to your insurance provider as most plans cover the cost of breast-pump rentals or purchases in part or in full. And a Flexible Spending Account (FSA) at work can be used for lots of breastfeeding items, from the pump parts to lanolin nipple cream.

Pumping is time-intensive and requires dedication. No matter how long your pumping journey lasts, be kind to yourself and remember that you’re doing a great job.

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