Pumping Guidelines

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There are many reasons women pump their breasts to provide milk for their babies. Some are separated from their hospitalized newborns and must pump to provide the many benefits of mothers' milk. Others must return to the workplace but want their babies to continue receiving breast milk. The majority pump to add some convenience to busy lives while still providing their babies 100% breast milk. Dads enjoy being more involved in the feeding process while giving their partners a little break. Whatever the reason, mothers have many questions about the pumping process.

The mothers in our breastfeeding support groups have shared many successful pumping styles. This supports recent research suggesting that almost all women can produce enough milk for their babies but no two seem to do it in exactly the same way.

Some women can store large quantities of milk in their breasts and feed their babies less often for shorter periods of time. These women can pump larger quantities of milk easily. Other women store less milk in their breasts, feed their babies more frequently, and have to pump more often to achieve a satisfactory supply of stored milk.

Things we know:
If it's important for you to have your baby take a bottle, start between 2 and 4 weeks of age. Starting too early can interfere with breastfeeding and a good milk supply, while starting too late may mean a baby will refuse the bottle altogether. Be sure to give the bottle at least three times a week to ensure the baby will continue to accept it. Giving a bottle once a day is usually fine.

• Most women are more successful with a good quality pump.
• Pumping both breasts at the same time raises the milk producing hormone Prolactin, and increases milk supply.
• Women produce different amounts of milk at different times of day.
• The highest milk volume is usually in the morning and the lowest is in the late afternoon or early evening. The lower supply allows a baby to suckle for long periods during his fussiest time of day and not receive excessive amounts of milk.
• It takes time to get used to pumping and to "let-down" to a pump. The let-down reflex is the hormonally triggered release of milk from the cells where it is made. You may get only a little milk the first few times you try. The amount you pump will increase with your continued effort and patience.
• Staring at the pump and anxiously awaiting each drop can slow milk flow. The old adage "a watched pot never boils" seems to hold true for pumping.
• The amount of milk you express with a pump does not necessarily equal what your baby drinks at each feeding. The breast responds better to a baby's mouth than to a pump.
• Pumping time varies from 5 minutes on one breast to 20 minutes on both.

Things to try:

• Pump both breasts simultaneously, approximately half an hour after the first morning nursing. If you want to increase the amount of milk you are storing daily, pump half an hour after several feedings each day.
• Pump one breast while nursing on the other. This takes a little practice to get positioning just right, but the baby can enhance your let-down reflex. Turn the pump on before you begin feeding. Try pumping into a milk-storage bag instead of a bottle. The bag is lighter weight, more flexible, and allows more room between your body and the baby.
• If your baby goes to sleep an hour or two before you do, try pumping right before you go to bed. Although not usually a high volume time, it gives you some bonus milk.
• If you are using a single pump, switch to the opposite breast each time the milk stops flowing. Switch back and forth several times.
• If pumping one breast at a time, massaging the breast with the opposite hand can increase flow.
• Try "third breast" pumping to increase overall output. Nurse on one side then switch to the second side. While nursing on the second side, pump the side already nursed (the third breast).
• Be consistent. Pumping several times one day and not at all the next could lead to problems with plugged ducts and milk supply. Pump around the same time every day. This is not a hard and fast rule but seems to help the body adjust to the need.
• If your baby feeds on only one breast at each feeding, pump the opposite breast one or two times a day. Choose the time of day when you feel the fullest.
• If you are a large producer, pump only the amount of milk you want and don't necessarily "empty" the breast.
• If you are trying to increase your overall production, pump 5-10 minutes past your last drops of milk. When flow stops, take a break of several minutes, and then pump again. A second let-down reflex is often triggered in this way.
• If you are an average producer, pump until flow stops or for as long as you have the time-up to 20 minutes.
• Try using the breast shield to apply pressure to different areas of the breast as you pump. This helps stimulate and drain different lobes of the breast.

It is a satisfying feeling to be able to provide breast milk for your baby even when you need to be away for a few hours. We hope these tips are helpful in providing you with strategies to make this a successful experience.

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