Photo credit: Selbe Lynn via / CC BY-NC-ND

I think it is safe to say that most women will be pumping when they have a baby. Not because it is necessary, but because it has become the cultural norm in our society. I can say with absolute certainty that for most moms, it is definitely possible to breastfeed a baby without ever pumping. However, most women want the flexibility that pumping allows, to be able to leave their baby with someone else at some point during their breastfeeding journey, or to allow someone else to feed the baby. That’s not a bad thing. I’m sure it has made the difference for a lot of women who would not have breastfed if they didn’t have this option.

Questions about pumping are common for me as a lactation consultant.

            When should I start pumping?

            When is the best time to pump?

            What kind of pump should I get?

            How much should I get when I pump?

            Can I use a borrowed pump?

We will look at each of these questions. The firsttwo question will take the longest to answer, so that will be a post all by itself. I will answer the other questions in subsequent posts.

When Should I Start Pumping?

The short answer to this question is, when you need to. Really, the question should be, Why should I pump? That is the question I am going to answer first.

Reasons for Pumping

You should pump…

  1. If your baby is born and won’t, or can’t breastfeed. Most babies will  breastfeeding if they are placed skin-to-skin

    Photo credit: Alice Chaos via / CC BY-NC-SA

    right after birth, and left there for an hour or two. For a whole variety of reasons, some babies won’t. Depending on where you give birth, you may be able to keep your baby skin-to-skin until he does breastfeed. If you have to be removed, make sure you put your baby back skin-to-skin as soon as you can. Sometime around 12-24 hours after birth, if your baby still hasn’t breastfed, it’s a good idea to start pumping. The stimulation will help your milk come in. If your baby is too premature or too sick to breastfeed, or even go skin-to-skin, you should start pumping no later than 6 hours after birth. This is the recommendation by Baby Friendly USA. You will need to continue pumping regularly, approximately every 3 hours until your baby is well enough to stimulate your milk supply.

  2. If you need to, or choose to supplement your baby in the first 4-6 weeks of breastfeeding. If your baby is getting something other than your breastmilk (this includes your colostrum), then that is stimulation that you are not getting. This can be donor milk, or formula. If it is formula, then it will take longer for your baby to digest it and to want to breastfeed again. Supplementing without pumping, especially if it is with formula, is how moms slide down that slippery slope, and end up formula feeding, or having an inadequate supply. They just don’t get enough stimulation.
  3. If you have an insufficient supply, pumping can help boost your supply, especially because you will be supplementing if you don’t have enough milk to meet your baby’s needs.
  4. If you have enough milk, but your baby can’t get enough out for proper growth. This can happen for a variety of reasons. However, if you’ve got the milk, and your baby needs to be supplemented, pump it and give it to your baby in the most appropriate way. Methods of supplementation will be covered in another post.
  5. If your breasts get engorged and your baby either can’t latch on, sometimes pumping can help soften them. This will only work if it is milk making your breasts firm. If it is swelling, which is often the case when the milk first comes in, pumping is not going to help. A technique called Reverse Pressure Softening will be more effective in that case. (Google this term to find out how you do it)
  6. If you are engorged and your baby doesn’t take enough to soften your breasts. Unrelieved severe engorgement can destroy the cells that make milk. If your baby doesn’t need as much as you are producing, and it’s uncomfortable for you, you should pump until you are more comfortable.
  7. If you miss a feeding in the first 4-6 weeks. You are establishing your milk supply during this time. Missing a feeding, especially if you are missing feedings consistently, can decrease your milk supply. After that, it may be uncomfortable for you to miss a feeding, but your breasts can increase and decrease the supply more easily, according to stimulation and emptying.
  8. If you want someone give your baby a bottle regularly, but you want to keep up a full supply, you will need to pump at those times. That plan you had of your partner giving a bottle in the middle of the night so you can sleep through a feeding? That’s not going to work, especially in the early weeks. This is not to say you can never miss a feeding, but it’s just not a good idea in the early weeks.
  9. If you are going to be separated from your baby regularly, for work or school or any other reason, and you want to have a stash of milk in your freezer. Or, if you just to have some milk in your freezer for emergencies.
  10. If you are going to be separated from your baby regularly and want to provide your baby with your milk, and keep up your milk supply.
  11. Some women who have a sensitive milk supply and their baby starts sleeping long stretches at night may need to pump in the middle of that stretch.
  12. If you have that very rare event when you have to take some medication that is incompatible with breastfeeding and you need to pump and discard the milk (this is called “pump and dump.” Many moms are told to pump and dump when it is not actually necessary. I always recommend getting the second opinion of an LC regarding pumping and dumping. Go ahead and pump, just don’t discard any milk until you’ve talked to an LC.

When to Pump

You can see, there are a lot of different reason WHY to pump, and the reason will affect the WHEN to start pumping. Some of

Photo credit: found_drama via Visualhunt / CC BY-NC-SA

Photo credit: found_drama via Visualhunt / CC BY-NC-S

these I have addressed in the WHY. Here are a couple of answers in terms of WHEN if the answer is not clear in the above list.

  1. If you are pumping to stimulate your supply then you will want to pump within 15-20 minutes of the end of a breastfeeding. You want to tell your body to make more milk. If you wait longer, say an hour, you will probably get more milk in the bottles, but you are also cutting into your baby’s next meal.
  2. If you are wanting to get enough milk for the first bottle you offer, pump right after a feeding, when your milk supply is most abundant. For most moms that is in the morning hours. You just want to take the leftovers and not cut into their next meal. You also don’t need a lot of milk because the first bottle you offer, you just want to see what your baby thinks about it. He may love it, he may hate it. I’ll talk more about this when I talk about introducing a bottle in another post.
  3. If your goal is to build a stash in the freezer, for emergencies or just flexibility, pump in the morning, right after a feeding, until you have the amount you want in the freezer. The amount you will get will vary from mom to mom. Never compare yourself to other moms.
  4. If you are trying to get a stash in the freezer for going back to work or school, you may need to pump after a feeding more than once a day. That will depend on how much you get and how far in advance you start working on it. I recommend that moms start at about 6-8 weeks, just to see how much they are going to get, and this can help them determine how often they will need to pump each day, and how long it will take them to build that stash.
  5. If you have a sensitive milk supply, and your baby is sleeping long stretches, you will need to figure out how long you can go before you need to pump. This will involve some trial and error. If you think your milk supply is going down, try pumping a couple of hours after your baby goes to sleep. If that doesn’t help enough, if your baby sleeps past 7 am try waking at 5 am to pump. This can be one of those times when you have to choose between getting as much sleep as you’d like and maintaining your milk supply. The good news is that most moms won’t need to do this.


One last thought

Pumping can be easy to figure for most moms, but if it’s complicated for you, talk to a lactation consultant. She will help you figure out what your needs are, and what is appropriate for you. If breastfeeding is going well, give yourself at least the first 2-3 weeks to just work out a rhythm with your baby.

Next Time

Everything else you wanted to know about pumping!

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