Long-Term Pumping When Direct Breastfeeding Doesn't Work Out
Linda J. Smith, BSE, FACCE, IBCLC
Mother's milk is best for babies even when direct breastfeeding doesn't
work out. Perhaps the reason is persistent breast problems, perhaps the baby cannot suck
correctly and effectively, or perhaps there are other reasons that make direct
breastfeeding impossible or a barrier to the mother-baby relationship.
Human milk is the "Gold Standard" for babies, even when
provided by a bottle or special feeding device. Manufactured products based on cow's milk
or soybeans are not the same as human milk, no matter how carefully they are designed,
manufactured and prepared. Human milk provides substantial protection from illness, even
when all other health factors are equal. This is because:
Active white cells in the milk destroy many bacteria, viruses, and
Specific antibodies are manufactured by the mother to combat many
Fatty acids and other components help fight illness and minimize allergic
The species-specific nutrients maximize brain growth and mental
Many long-term and chronic illnesses are linked to artificial feeding,
including diabetes, multiple sclerosis, ulcerative colitis, and even some cancers.
Lactation is also good for the mother, whether she is directly
breastfeeding or using a pump. She still benefits from delayed fertility; reduced risk of
breast, ovarian and endometrial cancers; osteoporosis; less postpartum bleeding, and other
benefits of breastfeeding. The price of long-term feeding with human milk is the equipment for milk
collection and storage. The cost of equipment rent or purchase is less than the cost of
manufactured milks. For example, in Dayton Ohio, one months' supply of a typical
breastmilk substitute costs about same as a 5-month rental of a
high-quality electric breastpump or twice as much as a Nurture III hand-held electric
breastpump. The time spent collecting milk is shorter than the time needed to purchase and
prepare the substitute. Many mothers find that hand expressing is fast, effective, and
Changing feeding method or even the food given does not change the
baby's need for his mother's presence, nor his need to be held, cuddled, comforted, and
rocked. Feedings will take about the same amount of time regardless of the method used.
Babies need to eat frequently because they are growing so quickly. Feeding times should
always be a time for close, nurturing contact. Always, always respond to the baby's cues
for when and how much she needs to eat.
Here are TEN SPECIFIC TIPS:
- Buy or rent a good quality pump with vacuum pressure of 100-250
pounds and the ability to cycle at 40-60 times per minute. Also learn to hand-express.
Many inexpensive pumps are weak, uncomfortable, or ineffective. Expect to pay $100 or more
for a good electric unit.
- A woman's breasts will release over 75% of stored milk in the first two let-downs. Be prepared to pump for about 20 minutes per breast every
2-3 hours, with one 4-5 hour stretch once a day (often at night), just as the baby would
nurse. Do not allow milk to remain in the breast for more than 6 hours at any time,
because the retained milk will signal the cells to slow down production. Double pumping
cuts total time but does not speed up the rate of release of milk.
- Each woman is different. Some women's' breasts will "dump"
milk quickly, while other breasts release milk more slowly. Breast storage capacity
differs, too, and may be somewhat related to size. A small-breasted woman may need to pump
more often than a woman with more glandular tissue and more storage capacity. Most women
usually use only a small portion of their mammary tissue to make milk for one baby. Breast
surgery can affect milk supply.
- The milk-producing cells settle into a production rate that maintains
total volume about 25% over the baby's needs (or average amount removed) per day. To
increase total volume per day, add more pumping sessions so that the breasts are
"emptied" more often and more thoroughly. To decrease total volume, allow more
milk retention. It takes 1-4 days for the breasts to respond to different
- Maintain your supply about 15-20% above the baby's needs. This means
you will be able store (freeze) a little bit each day over what the baby takes. If the
baby takes all you are pumping and you need to use the stored milk, assume the baby is
experiencing a growth spurt. The baby would have nursed VERY FREQUENTLY for a few days to
boost supply, so mimic this pattern with your pumping regimen. Pump every 1 ½ to 2 hours
for a few days until supply increases.
- What you eat and drink has VERY LITTLE effect on milk volume
or composition. Additional fluids affect bladder function, not milk supply. A good diet
and sufficient fluids will help you feel better and stay healthy. While a few substances
can affect milk volume, the single most important factor in milk supply is regular
removal of milk.
- Hormonal contraceptives may cause a sudden and possibly permanent
drop in milk supply. Even progesterone-only products may affect some women. Be cautious of
using these drugs.
- Maintaining a milk supply usually becomes easier and more reliable
over time. Some mothers can extend the time between pumpings. Others find that their
breasts release milk faster over time and therefore can shorten the time of the pumping
- Long-term milk production may suppress fertility in the same way that
long-term breastfeeding does. Please read about the Lactation Amenorrhea Method of
- Maintaining a milk supply for a baby is a separate issue from how
the milk is fed to the baby and the mother-baby relationship. Pay as much or more
attention to the baby as the pump.
QUESTIONS? Please call a lactation consultant if you think your supply
is dropping. Or you want more help getting baby back to direct breastfeeding. Or if you
want to stop comfortably. Your lactation consultant is trained to handle all
breastfeeding-related problems without judging you on your decision. This is what we do
for a living.