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, or is the preferred choice. 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.

2. Sucking Issues: Some babies have small mouths or low birth weight, making it challenging to maintain strong suction throughout a feed.

3. Weight challenges: 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.

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.

7. Resting sore nipples;

for parents experiencing latching challenges and nipple pain, sometimes the skin needs a break of >24 hours to heal. Pumping to stimulate and maintain supply is essential during a breastfeeding “break”.

How to Pump

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 reaches 10 or more millilitres per minute.

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 make sure to hydrate - the Franjos Kitchen Hydration Powder is great for this. And have a nutritious snack like the Franjos Kitchen lactation cookies. 

6. Visualise your milk flowing, which can help stimulate oxytocin.

7. Listen to soothing audio, such as a podcast or guided meditation, to relax your mind.

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 milliliters 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 personalised advice to ensure the best results for you and your baby.

Joelleen Winduss Paye is a Holistic Lactation Consultant, Midwife, Naturopath & Educator based in Melbourne, Australia. She is the founder of JWP, a holistic breastfeeding service that is both in-person and online. Joelleen can be found at www.jwp.care and also at @jwp.care where she shares holistic and supportive content for breastfeeding parents. 

Image: Lauren Trani