Thinking About Adding Pumping to Your Breastfeeding Routine?

Here’s What to Consider First…

Written by Karen Miles, IBCLC
Clinically reviewed by Laura Serke, RD, CSPCC, LD, IBCLC

Let’s suppose you’re already exclusively nursing your baby at the breast for feedings. And for whatever reason, you are thinking about adding a little (or a lot of) pumping to your routine. Before using your health insurance benefit or hard-earned cash on the purchase of a pump and altering your schedule to include pumping sessions, ponder these important questions. Doing so may save you money, regret and frustration in the long-term!

Ask yourself:  Is your main reason for pumping…

1) …to have milk available to cover times when you are away from your baby?

When you are too far away to join the baby for direct breastfeeding, such as when at work, class, or an evening out with friends, a pump can be pivotal in alleviating your full breasts of some milk – while also keeping up your milk supply and having some milk ready for a future need.

If times away from the baby are extremely rare – a monthly coffee date with friends, for example – then you may be able to get away with a manual, single-flanged pump. But if it is daily or frequent, a double-electric pump that pumps both breasts at the same time and has plug-in-the-wall capability for stronger suction may be best.

2) ...to fulfill a medical need, at a lactation consultant or healthcare provider's prompting?

For example:

• After a Caesarean section, some mothers experience a slight delay in their milk coming to fuller volume (greater than the typical 3 to 5 day window for milk increase). If you find yourself in these shoes, a healthcare professional may encourage you to pump in addition to breastfeeding in order to tell your body to produce more milk. And you may want a dependable double-electric pump, or even a multi-user hospital-grade rental pump temporarily, because you could be relying on it around the clock for a handful of days until your milk volume spikes.
  
  
• If you have a premature or medically fragile baby, their suck may not be as strong and vigorous at the breast to encourage milk let-down so you may be advised to supplement with some pumped milk for a while. If you find a double-electric pump that is plugged into the wall doesn’t have the output you were hoping for, consider a multi-user hospital-grade rental pump instead as for some parents, it results in the greatest milk yield. 
  
  Hospital-grade pump rental programs can be found at many hospitals (call the lactation department to inquire), lactation consultant private practices, and through many durable medical equipment (DME) suppliers. Just be sure to purchase your own personal accessories kit to keep for use with the rental pump; many rental programs have these kits separately available for sale.
  
  
• If you have an upcoming planned surgery or are temporarily taking a medication that is not compatible with nursing, you may be asked by your healthcare provider to pump (and possibly dump) for a short spell to maintain your milk supply until a specified period of time has passed. Always ask if an alternative medication that is compatible with breastfeeding is available. Fortunately, most prescription medications are compatible. (If in doubt, contact the InfantRisk hotline to inquire: 1-806-352-2519.)
  
  

3) ...to relieve engorgement that is occurring well past early postpartum?

Beyond the first couple of weeks postpartum, pumping frequently after breastfeeding sessions in order to relieve engorgement could lead to unintended consequences: a huge (and sometimes painful) overproduction of milk, plugged ducts, and even mastitis.

Instead, meet with an IBCLC lactation consultant to see if you can pinpoint the cause of your oversupply that is contributing to the engorgement, and then reduce your milk output to make it more manageable. And if your freezer is already overflowing without room to spare for more, consider giving some milk to a human milk bank to help families who need it, or freeze-drying some of your milk to make it shelf-stable for your own baby’s use.

4) ... to resolve a painful breastfeeding latch, or another breastfeeding issue?

Exclusive pumping may appear at first glance to provide an easy workaround for breastfeeding challenges, but exclusive pumping is not without potential drawbacks. Instead, consider scheduling a meeting with a lactation support person (for complex issues, opt for an IBCLC), if you haven’t already, to explore all your options. Many health insurance plans cover lactation consultant visits. True, some parents succeed at maintaining a full milk supply with exclusive pumping. On the other hand, others find it more difficult to encourage milk let-down at the pump versus breastfeeding, grow tired of washing all those pump parts and collection bottles multiple times a day, have days where they wish they could throw their pump out the window, and may grieve the breastfeeding connection.

If you have made the decision to add pumping to your routine, you will next need to make a decision about what type of pump to invest in.

Ask yourself:  What do you want your pumping time to look like?

1) Is your desire to relax while pumping?

 Do you imagine yourself destressing, putting up your feet, and cranking up some relaxing music while pumping – either at home or in a private pumping room at work or school with an electrical outlet? You may be onto something! After all, a systemic review and meta-analysis shows that providing relaxation can increase milk quantity. For daily work or school pumping in a pumping room with an outlet, the powerful motor and suction found on most double-electric, plug-in-the-wall pumps meets many parents’ needs. Ideally, schedule pumping sessions for the same amount of times your baby would typically feed if you were together.

2) Or is multitasking while pumping your goal?

Do you dream of doing light chores around your house while pumping, or pumping discreetly while knocking out some tasks in the presence of friends or colleagues? Then you may want to consider adding a cordless wearable pump to your wish list. (A pump that you can secretly wear inside your bra.) Bear in mind though, under the U.S. Fair Labor Standards Act (FLSA), “Most nursing workers are entitled to reasonable break time and a private space to pump at work for up to one year after their child’s birth.”

For some but not all parents, a double-electric, plug-in-the-wall pump yields more milk than a cordless wearable pump. On the other hand, some parents find that the ability to multi-task with a wearable pump makes them more consistent with pumping. And that consistency may add up to a greater daily milk yield overall.

If you find a wearable pump doesn’t yield quite the amount you’d hoped, one possible solution may be using a wearable pump for some times of the day and a double-electric plug-in-the-wall pump at other times – to have the best of both worlds, so to speak. Perhaps your health insurance can cover one, and you (or a generous family member) can purchase the other.

Another possibility if you find the wearable pump does not yield adequate milk output for you? Adjust your life to solely using the plug-in-the-wall, double electric pump – coupled with a hands-free hack such as a pumping bra. (Or, if a pumping bra is too costly, a sports bra with holes strategically cut in it to allow the flanges through may work, too!) That setup would allow you to do tasks such as typing, reading and paying bills in one spot while pumping.

3) Do you picture yourself using a pump only in a rare emergency?

For example, your car breaks down and you are not with your baby. Or, an unexpected weather event warning to “stay in place” leads to you being cooped up at a friend’s house for several hours, without your baby. In such cases, a single-flanged, manual (handheld) pump may adequately fulfill your needs, and at a much nicer price tag than a double-electric pump. (Single-flanged manual pumps typically cost under $50. Mid-range double-electric pumps, on the other hand, cost in the triple digits.)

And even if you already own a double-electric or wearable pump, a single-flanged, manual pump – coupled with some collection bottles for it – is a nice extra pump to have in your desk drawer or car trunk in case you ever forget your main pump and/or one of its many tiny pump parts. It requires no batteries or power, so can even be used when the power is out!

And to be prepared for times when you don’t have access to a breast pump at all, learn the “handy” skill of hand expression which involves expressing milk using only your hands. In some parts of the world, hand expression is a popular way to collect human milk, and some may even prefer it to using a breast pump! Clear, step-by-step instructions for hand expression can be found here on the CDC’s website. 

Also, in order to always be ready for the unexpected, keep some extra plastic breast milk collection bags in your purse or backpack. Expressed breast milk can be kept at room temperature for a limited time until you have access to a working fridge, freezer, or cooler bag. (For specific breast milk storage guidelines, see the CDC’s webpage here.)

Ask yourself: Do you want to maintain at least some breastfeeding along with pumping?

Keep in mind, regardless of which pump (or pumps) you choose, maintaining at least some direct breastfeeding, even if just once or twice a day or when feasible, may be beneficial for many reasons.

For instance:

1. Pumping exclusively does not have the benefit of something amazing, called either “retrograde milk flow” or “intramammary communication,” where the baby’s saliva enters the mother’s nipple and goes into the milk ducts to positively impact the milk’s microbiota (beneficial microbial) composition during breastfeeding. Another theory is that this retrograde milk flow during breastfeeding acts as immune signaling, communicating what is needed in the milk to combat whatever the baby has been exposed to in their environment. Even if you cannot directly breastfeed, non-nutritive suckling at the breast, some theorize, may boast a similar effect.
   
   
2. If your baby is able to effectively feed at the breast, the skin-to-skin contact and surge of milk-making hormones can aid bonding and support milk production. However, if you are unable to breastfeed directly for a short or extended duration due to surgery or another medical issue affecting you or your baby, there are still meaningful ways to maintain closeness with your little one. For example, providing oral care with drops of breast milk applied to your baby’s mouth (when approved by your healthcare team) or spending some time skin-to-skin with your baby can help support that connection. A breast pump can help establish or maintain your milk supply during any windows of time when direct breastfeeding is not possible.
   
   
3. Direct breastfeeding promotes parent-child bonding. (Although being interactive and attentive toward a baby during bottle feedings also aids bonding, of course!)
   
   
4. As my Milkify colleague, dietitian and lactation consultant Laura Serke, likes to point out, “Breastfeeding uses unique tongue and jaw mechanics that support strong muscle formation that are later used in chewing, rhythmic pressure that expands the dental arch and palate, and supports an open airway and nasal breathing.”
   
   A few other possible dental health perks? Research shows direct breastfeeding may lower the odds of dental issues such as cavities, the development of an open bite (where the lower and upper anterior teeth don’t meet when the mouth is closed), and the development of a posterior crossbite (where the bottom back teeth aren’t in line with the top back teeth).
   
   If your baby is unable to breastfeed directly, there may still be some ways to promote their healthy oral-motor development. Consider consulting an infant feeding specialist (a speech language pathologist or occupational therapist) for an oral function evaluation. And check in with a pediatric dentist if you have any questions about your baby’s palate, dental arch, or bite. Together, they can help you develop a game plan specific to your baby’s oral-motor needs.  
   
   

And of course, remember that breast milk in any form is valuable – no matter whether it is provided by direct breastfeeding, or pumped and delivered to your baby through an alternate feeding device. All breast milk is power-packed with macronutrients, micronutrients, bioactive and immune components.

So whether you need to pump a little or a lot, know that you are providing a truly wonderful gift of love and nutrition for your baby in each and every drop.

Karen Miles is an International Board Certified Lactation Consultant (IBCLC) and Lactation Content Specialist with Milkify.

Laura Serke is a Registered Dietitian and an International Board Certified Lactation Consultant (IBCLC) with Milkify.

This blog is for informational purposes only and is not intended to diagnose, treat, or be a substitute for medical advice. Please consult with your healthcare provider for any questions you may have related to your own health, or your baby’s health.

Image Credit #1: fotoduets / stock.adobe.com
Image Credit #2: GOBINDO / stock.adobe.com