Inducing lactation requires two things: first, the nipples must be frequently and vigorously stimulated to tell the brain “There is someone hungry here”, and second, any milk which is produced must be completely removed at every feeding so the breast doesn’t get the idea that there’s plenty and shut off. Any stimulation method that does both these things without hurting the breast will bring in milk and any method that does not, will fail.
The best nipple stimulation is the sucking of a partner. This is not the flicking or teasing of the nipple which is often part of sex, but actual sucking and squeezing of the nipple and the dark area around the nipple called the areola’. Since it is the squeezing which sends the signals to the brain the woman should coach her partner if necessary.
A few women can suckle their own breasts. Those who can may find this almost as effective as a partner at the start. Once her milk comes in it can’t really be just as good because some ducts are usually closed off meaning that the breast can’t be completely emptied. Moreover, many women find this uncomfortable and others don’t like the idea or don’t like the taste of their milk.
Second best is the woman’s hand ( manual stimulation’), rolling and squeezing the nipples themselves. This is tiring; she may get cramps and sore muscles in her hand at first if she uses it a lot. Manual stimulation, however, is an effective method, the equipment costs nothing, and it is always with you — very convenient if you aren’t always at home.
Although many women try to induce with electric breast pumps, they are actually not very effective, in fact we don’t know of anyone who has induced using mainly or only a pump.
The inexpensive pumps found in department stores (Gerber and Evenflo are two brands) are useless for inducing because they don’t give correct or strong enough stimulation and can’t completely empty a breast. Also they’re hard to use because you must work the suction by hand. The hospital’, rental’ or professional’ grade electric pumps made by companies like Medela and Ameda all have automatic cycling’ and can mostly empty a breast but they’re much more expensive to buy — $150 and up, often $250 or more. They can, however, be rented from medical supply or larger drugstores in most towns. Even these pumps do not provide as strong stimulation as a partner’s mouth and they should be used as little as possible when inducing. Some manual breast pumps (but usually not the cheapest ones) work fairly well; you will have to experiment. No matter what method or equipment you use, don’t do anything that hurts. Sore nipples and bruises are a lot easier to avoid than cure.