A Comprehensive Guide to Pumping for Breastfeeding: When, How, and Why
Breastfeeding is a beautiful and natural way for a parent to nourish their baby, fostering a strong bond and providing vital nutrients. However, there are times when pumping breast milk becomes necessary and beneficial to a breastfeeding routine. In this article, we’ll explore when, how, and why you should consider pumping from the perspective of a lactation consultant.
When to Introduce Pumping
Ideally, parents and babies should establish breastfeeding without interventions during the first six weeks. This period allows supply and demand to find their natural balance, which is crucial for both short and long-term milk production. However, there are scenarios when early pumping is required:
1. Low Birth Weight/Preterm Baby: Babies with low birth weight or born prematurely may tire quickly and struggle to meet their caloric needs at the breast. If a parent experiences more than 10% weight loss in their newborn within 48 hours, supplementation with breast milk or formula may be necessary. Pumping can help reduce the need for formula and stimulate milk supply.
2. Sucking Issues: Some babies have small mouths or low birth weight, making it challenging to maintain strong suction throughout a feed.
3. Resting Sore Nipples: If latching and having the baby drinking directly from the breast is causing persistent and increasing trauma to the skin, sometimes bringing in 24-48 hours of pumping to give the nipples a rest can be helpful. It is key that any latching issues are addressed within this time to avoid further damage and to help get mum and baby back to direct breastfeeding as soon as possible.
4. Illness: Jaundice, while common, may require pumped breast milk to boost calorie intake if it reaches concerning levels. Babies with low blood sugar, particularly those born to parents with gestational diabetes or extreme birth weights, may also need pumping to stabilize their sugar levels.
5. Genuine Low Supply: Parents with a history of low supply or specific risk factors may need to introduce pumping to support their breastfeeding journey.
6. Triple Feeding: Some parents may need to include pumping in a triple feeding routine, which can be physically and emotionally demanding. Triple feeding consists of breastfeeding, topping up the baby with either pumped milk or formula (or both), and pumping after the baby has had their feed.
How to Pump
Pumping should typically start within 24 hours of birth. Hospitals often provide guidance on pump usage and flange sizing, though having your own hospital-grade breast pump is an option. Pumping should occur after a breastfeed or, for babies in the Special Care Nursery (SCN), just before a feed for the freshest milk. Pumping sessions should last no more than 30 minutes to allow time for breast refilling between 3-hour feeds, common in triple feeding plans.
Here are some essential pumping tips:
1. Between 6-8 pumps per day are recommended, depending on your baby’s unique needs and feeding plan.
2. Double pumping stimulates more oxytocin and yields higher milk production.
3. Ensure the flange fits comfortably around your nipple, without pulling in the areola.
4. Avoid excessive suction, which can cause pain and swelling.
5. Use the stimulate feature on the pump to encourage oxytocin flow and boost milk supply.
6. Switch to a maintenance cycle once milk flow is established or the breastfeeding patent is collecting 10 ml or more per pump session/ or day five postpartum (whichever comes first).
Pumping Tips for Oxytocin and Milk Supply
To enhance oxytocin production and milk supply, try these techniques:
1. Double pump to save time and stimulate more oxytocin.
2. Gently massage your breasts to stimulate oxytocin and encourage better milk flow.
3. Use a hands-free pumping bra for convenience.
4. Never use excessively strong suction.
5. Relax while pumping, and have a drink and a snack such as a nutritious lactation cookie.
6. Visualize your milk flowing, which can help stimulate oxytocin.
7. Listen to soothing audio, such as a podcast or guided meditation, to relax your mind.
Type of Pump
Make sure you are using a hospital-grade pump, and I recommend wearable models for their discreet flexibility. Many of my clients are very happy when they invest in an Embody double wearable electric pump by Youha. Use code JWPCARE for 10% off the entire YOUHA range.
Pumping Tips to Avoid Oversupply
Introducing pumping too early (within the first six weeks) when not medically necessary can lead to oversupply. This excess milk can cause problems like a forceful letdown or an increased risk of lumps, inflammation, and mastitis.
Avoid pumping more than about 60 millilitres from each breast in the early days. The recommended amount increases when your baby is over six months or if you’re pumping at work.
Pumping to Replace a Breastfeed
When considering pumping to replace a breastfeed, it’s essential to choose the right teat and bottle. Ensure that the bottle provides a seamless latch and consider paced bottle feeding, especially for younger babies. This method reduces digestive discomfort, overfeeding, and the risk of bottle preference.
Pumping can be a valuable tool in your breastfeeding journey, helping you overcome various challenges and ensuring your baby receives the nourishment they need. With the right timing, techniques, and equipment, pumping can complement your breastfeeding experience while maintaining a healthy supply. Always consult with a lactation consultant for personalized advice to ensure the best results for you and your baby.