Exclusive Pumping

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When a baby isn’t breastfeeding, effective milk removal from the breasts becomes critical in order to build or maintain a milk supply.   Exclusive pumping can be necessary in a variety of settings: when a baby is born prematurely or cannot breastfeed due to illness; when a baby refuses to latch at the breast; in cases of adoptive breastfeeding, induced lactation, and relactation, or when mom needs to be away for a period of time.  Some moms begin pumping and, though the reason they initially began to express is resolved, find that their baby prefers receiving expressed breast milk. If you are in a situation of exclusively pumping, here are 5 tips for your situation.

  1. Establish your milk supply.
    The most important thing you need to do when exclusively pumping is establish a full milk supply. Your body needs to get the message to make enough milk for your baby. Perhaps your baby was born prematurely and isn’t taking much milk in a 24 hour period. This will change in a few weeks and your body needs to make sure it has the supply ready for your baby. In the beginning, a mother should pump a minimum of eight times in a 24 hour period for at least 20 minutes on each breast.  It will help to record what time you pump and how much milk you get. A double electric pump is the most efficient way to do this.  Though hand expression, single pumps, and manual pumps are all other options, a double electric pump of good quality has been found to stimulate greater milk production. 1
  2. An empty breast makes more milk.
    It’s the law of supply and demand. Therefore the more completely the breast is drained and the more frequently this occurs, the more milk a mother’s body will make. 2 It is completely possible for you to make enough milk to exclusively nurse twins or even triplets!
  3. Shorten pumping duration AFTER supply is established.
    After a full supply is established (25-35 ounces per baby every 24 hours) 3 then you can shorten the duration of pumping at each session to the amount of time necessary to gather the required milk. Many times this is as short as 5 minutes!  In general, once a strong milk supply is established, one nighttime pumping session can be dropped but it is important to ensure you are still pumping at least once during the night and never going more than 4-6 hours between pumping during the longest interval between sessions. Every mother is different and every breast has a different storage capacity. While a few mothers may be able to go 10-12 hours between their longest stretch, other mothers can only go 3-4 hours. Full breasts make milk more slowly so the longer a mother waits between pumping sessions, the slower the milk production becomes. Every mother will have to work out what her “magic number” is for how many times to pump and how long in order to maintain supply.
  4. If you begin to notice a drop in supply, increase pumping sessions and/or duration.
    A general guide, once milk supply is established, is to pump 6-7 times in a 24 hour period, at least once during the night, and only for the time it takes to get the required amount of milk. Should you notice your milk supply beginning to decrease from the shortened pumping duration and/or number of sessions you should return to pumping more often and for a longer duration.
  5. Your “magic number” will be different than another person’s.
    Don’t worry if you have to pump more often than another mother to get enough milk. Don’t worry if you don’t have to pump nearly as often. Every mother is different. Not only is every mother’s breast storage capacity different, but each breast on the same mother can vary! It only matters what your magic number is. Therefore, once you have worked out how frequently you need to pump and it works for you, don’t worry if someone else does it differently.

Expressing breast milk is hard and can be very emotional. You may need to grieve not being able to nurse your baby at the breast. While expressing milk can help you connect with your baby, it also is a symbol of the disconnection. 4 Realizing that grieving is not only important but normal is critical to dealing with one’s feelings and healing. Also realize that no matter how long a mother has been exclusively pumping, transitioning back to breastfeeding is an option.

When the time comes to wean from expressing there are ways to do this both safely and comfortably.

Show 4 footnotes

  1. Slusher, T. et al. (2007). Electric breast pump use increased maternal milk volume in African nurseries. Journal of Tropical Pediatrics, 53(2), 125-130.
  2. Morton, J., et al. (2009). Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. Journal of Perinatology, 29(11), 757-764.
  3. Hurst, N.M. & Meier, P.P. (2010). Breastfeeding the Preterm Infant. In J. Riordan (Ed.), Breastfeeding and Human Lactation (4th ed., pp. 425-470). Boston, MA: Jones and Bartlett.
  4. Sweet, L. (2008). Expressed breast milk as ‘conection’ and its influence on the construction of ‘motherhood’ for mothers of preterm infants: a qualitative study. International Breastfeeding Journal, 3, 30.
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