By Stella Dao, M.D.
Sustaining lactation is one of the most important things new moms are doing. But as with anything new, there are new tricks to figure out. Since new moms are dealing with so much, and so many new gadgets all at once (while being sleep-deprived!) I’ve put together some pointers to help you learn to use your Freemie breast milk collection cups. Because the pumping experience with the Freemie cups can be different for a variety of reasons, if you keep the following tips in mind, I’m sure they will help as you adapt to more freedom in your pumping routine.
When troubleshooting the Freemie system you should first check that all the connections between the pump and the Freemie cups are correctly and securely put together. You should also check the duck bill valve to ensure that it is in the location and orientation that allows it to open and close properly during pumping.
Next, there is a very important seal to be made between the Freemie cups and the breasts.This seal is maintained by your bra, so the bra style and fit you choose plays an important role.Traditional devices require you to hold the collection bottles over the breasts, so you are necessarily pressing those funnels against your breasts with your hands in order to make a good seal with the funnels. But the Freemie cups rely on your bra to hold the collection system in place while you pump hands free. Because of their design, our cups have a reputation for being very comfortable. So it is easy to overlook how important the bra fit is in achieving a good seal and a consistent vacuum. You need to be sure your bra creates a secure seal between the funnels and your breasts even though you are not holding them.This will ensure the vacuum and consistency you need for a good pumping session.
The bra you use must hold the Freemie cups comfortably and not so tightly that it doesn’t allow the milk ducts to open and empty. (This is also a concern with the traditional funnels, if you press them too tightly against your breasts.) At the same time, the bra must hold the Freemie cups without allowing air or fabric to get between the Freemies’ funnels and your skin. (For example, adjust the back straps on bras with underwires so they don’t interfere with positioning the cups.) If air is drawn into the system as the pump is cycling vacuum strength may be inconsistent or lost.
Keep in mind, the amount of pressure needed at the beginning of a pumping session may be different from the pressure needed at the end of the pumping session because the breasts may be measurably smaller by the end of the pumping session.The elasticity of most bras will accommodate this variable, however, pay particular attention to this when selecting the bras you use.
Lastly, the style or fit of the bra must not tip the Freemie cups in such a way that the seal is broken, or pushes the Freemie cups off of center, or pinches the nipples. We women come in all different shapes and sizes, and you will find that you can get very creative with the Freemie cups. I encourage you to experiment with all your bras at home. You probably already have several bras that will work very well, and sometimes you don’t know which ones will work best until you try!
Since you can now multitask while pumping, you still need to remember that you are pumping. Be careful not to bend over to pick things up, or jostle the milk around as it’s collecting. I encourage you to look at the diagrams in the user manual (http://www.freemie.com/support.html) that show positioning and placement within the bra. The intention is to communicate very clearly that gravity plays a role for the system to operate properly. Milk shouldn’t fall straight down the funnel, but it needs to flow a little bit downhill—just as with the traditional horns—to move through the valve and into the cup. Get familiar with the approximate angle the funnel should be at relative to the ground so that gravity works for you and not against you.
Observe First, Then Replicate What Works
When moms are using the Freemie cups, more likely than not, the system is concealed underneath their clothing. So you will not be able to see your milk letting down. Ultrasound studies that look at lactation have reported that approximately 10% of moms cannot feel when their breasts are emptying. It can be helpful to mothers who cannot feel when their milk is letting down to initially pump while holding the Freemie cups in their hands. This way, they can get used to the feel of the Freemie cups, and see how they work while watching milk letting down.
If you cannot feel your letdown, you may also try to carefully wiggle the Freemie cups against the breasts to check for any sensation of fullness, when the breasts should be empty. (Be careful not to break the seal and lose suction!) With a little wiggle, you may be able to tell how far along you are in your pumping session without having to watch the milk as it comes out.
Getting Used To The True Hands-Free Experience
It is important to remember that the release of breast milk is a conditioned response. This means that there are many factors that affect the release of milk. The medical literature has shown that mothers of babies in intensive care units make more milk during or after holding their babies against their skin than when pumping in adjacent rooms, or at home. Stress, fatigue, dehydration, feeling hurried or self-conscious can affect the pumping session. Some breastfeeding professionals recommend bringing a photo of your baby or a piece of clothing from your baby to help stimulate your senses and help your body release your milk while pumping.
“Conditioned responses” may also include factors like the specific rhythm of the pump you have become used to. Different pumps may all pull the same peak amount of vacuum, but their mechanisms can be different. So the pattern of the suction cycles may vary. For two pumps that both measure the same maximum vacuum strength, one’s suction pattern may increase rapidly while the other’s suction pattern may rise more slowly. The Freemie cups are designed and tested to transmit very similar vacuum as the traditional collection bottles and horns when used with your compatible pump. And the Freemie Freedom pump pulls up to 250mm-Hg peak vacuum, which also is very similar to the strongest pumps on the market. If you’re changing from one pump setup to another, it may take a little time to get used to the rhythm and suction characteristics of a new pump—or simply the feeling of being hands free with your clothes on—to be able to fully appreciate and benefit from the revolutionary experience of the Freemie system.
Change Your World
Lastly, lactation is a very personal endeavor, and only you can decide which tools work best for you. It is important to understand that the Freemie system is just one tool—but it is the tool that is compatible with mothers’ modern day lives. It may not be right for every woman in every setting, every time she is pumping. However, it is certainly the right tool if your circumstances (no time and/or place to undress) would otherwise cause you to skip a much needed pumping session.
You may worry that you can’t pump around others, because you think you will feel too self-conscious. But let me share a little secret with you; most of the people around you will probably be completely unaware of what is happening. And even if they do know, so what? You have a new baby at home that needs you. Additionally, society is changing. The importance of breast milk is now widely understood. You will probably find that you have the support of your friends, family, and co-workers if you are willing to make the extra effort to continue providing breast milk for your baby, while you also keep up with the rest of your world. So just do what you need to do.
 Mitoulas LR, et al. Effect of Vacuum Profile on Breast Milk Expression Using an Electric Breast Pump J Hum Lact 18(4), 2002.
 Acuna-Muga J, et al. Volume of Milk Obtained in Relation to Location and Circumstances of Expression in Mothers of Very Low Birth Weight Infants J of Hum Lact 30(1), 2014