Many mothers pump breast milk for their babies at some point during their breastfeeding journey. There are a variety of reasons for pumping milk, including helping with the establishment of the milk supply when there are challenges in the beginning, increasing the milk supply, having milk to leave for your baby while away, or working, exclusively pumping your milk to provide for your baby or to build a small “just in case” stash. Pumping looks different for everyone depending on the reason for pumping and their baby’s needs.
During pregnancy, the breasts undergo changes to produce and store milk for the newborn baby. Colostrum begins to be produced as early as 12-16 weeks during pregnancy and may begin to leak in the 3rd trimester. (1) As estrogen increases, milk ducts are developed, and the secretion of prolactin is signaled. Higher progesterone levels are responsible for milk-making cells to form and grow.
Veining in the breast is more visible due to increased blood flow
Ache in the armpit area - breast tissue extends into this area and is called Tail Of Spence
After your baby is born, the placenta is delivered causing progesterone and estrogen to drop. This drop signals Prolactin, the hormone responsible for making milk, to increase and for milk production to increase. Over the next 2-3 days, your milk will transition from colostrum to mature milk. Colostrum is very concentrated compared to mature milk, which is abundant in volume.
Keep your baby skin-to-skin, beginning within the first hour after birth, and offer the breast often. Hormones drive this stage of lactation. Milk will be made even if milk is not being removed. How often your baby nurses and how much milk is removed each feeding is essential during this stage. When milk is removed, prolactin signals more milk to be made. If the breast remains full of milk, it signals to slow down milk production. Feeding your newborn often means more times milk is removed and more refilling of milk occurs. If your baby goes to the breast frequently but is not removing sufficient milk, production is also affected. Without effective and frequent milk removal, some of the cells that hold milk will begin to shut down. (2) Around 10 days postpartum, milk supply begins to be driven by demand.
When to start pumping breastmilk
Not all parents need to pump. You don't need to include pumping if you will be with your baby for every feeding.
If possible, wait to begin pumping until 4-6 weeks postpartum when your milk supply is well established, and you are making the amount of milk needed for your baby to grow and thrive.
You’ll want to begin pumping 2-3 weeks before returning to work. Suppose you need to begin pumping early for a return to work. In that case, scheduling a returning-to-work consult with your IBCLC (International Board Certified Lactation Consultant) may be beneficial to help navigate pumping.
Beginning to pump too soon can signal higher milk production and lead to an oversupply. You are meant to produce the amount of milk needed for your baby. Having too much milk can make you and your baby uncomfortable.
Choking and gagging during the letdown
Gulping during feeding
Resisting the breast/chest
Too much or too little weight gain
When to start pumping breastmilk
How often you will be away from your baby will determine your pumping and milk-storing needs.
You can use a silicone pump after your baby has nursed from both breasts. Your baby will nurse from breast #1, and then as they are nursing breast #2, you can have the silicone breast pump on Side #1 to collect milk to store. You can combine fresh milk with refrigerated milk following proper storage guidelines. (3) Only collect as much as you need to store for your baby to avoid creating an oversupply.
Add one regular pumping session daily. Pump ½-1 hour after your baby nurses with an electric breast pump for a small milk stash. Choose one time of day, typically the morning, when milk production is higher, and pump each day around the same time to store 2-4 ounces daily. Alternate which breast you pump each day. This method will gradually increase the milk supply to accommodate the one pumping session per day without causing an oversupply.
Hand expression is another effective option to remove milk. Some lactating folks get more milk from hand expression than from a pump. Benefits include no extra tools needed and always available.
Returning to work
Milk production remains fairly constant from about 6 weeks until the introduction of solid foods. Your baby eats about 24- 30 oz per 24 hours, taking 2 - 4 oz per feeding. (4) Most parents like to store enough milk for 2 days away from the baby to have a little cushion of extra milk.
Using a double electric pump is often the most effective way to collect milk if you need to pump for returning to work. Many options are available, including hands-free collection cups to make pumping more convenient when your hands need to be free or taking a break at work is challenging.
The Legendairy Milk Duette is a dual electric breast pump with a variety of individual speeds and suction levels for each breast to customize your pumping experience.
To determine how much milk you need to pump and leave for your baby while you are away from them, estimate how many times your baby nurses in 24 hours and divide that by the average amount of milk they drink in a day which varies between 24 - 30 ounces. You can use 25 ounces as an average. This will give you the amount per bottle. Plan on one bottle every 2-3 hours while away.
Example: 25 ounces divided by 10 feeds per 24 hours = 2.5 ounces
Example: 30 ounces divided by 10 feeds per 24 hours = 3 ounces
The amount of milk you are able to pump is dependent on how old your baby is, what time of day you pump, when you last nursed or pumped, and your breast storage capacity.
Most people make more milk in the morning, making it an excellent time to pump
Wait 30 - 60 minutes since the last milk removal
The average amount to expect from pumping during a regular pumping session is 3- 4 ounces. (6) If you are pumping between feeds, the amount may be closer to 1.5 - 2 ounces.
Ensure all your pump parts are working properly. Some parts will need to be replaced more frequently than others. How often you replace them depends on how often you are pumping. The guidelines below are based on pumping 3 or more times a day and less than 3 times per day. The more often you pump, the sooner the parts will wear out.
Pumping should be comfortable and never hurt. If a flange is too big or small, it can be uncomfortable and cause damage to the nipple and areola. If the shield/flange is the wrong size, it will not be as effective at removing milk and can affect your milk supply over time. If you’re taking the time to pump, you want to get the most milk possible.
Flange/shield size can change over the course of nursing. A nipple ruler can be a helpful tool for finding your correct flange size. Many IBCLCs (International Board Certified Lactation Consultants) offer Flange Fitting Consults.
Add heat - use a warm heat pack to encourage milk flow
Breast compressions (5)
Relax! Stress inhibits milk flow
Storing Your Milk
Always wash your hands and storage containers before pumping and storing your milk
Label the storage container with the date (and child’s name if needed)
Store 2 - 4 ounces per container. Smaller amounts are better so milk is not wasted
Freshly pumped milk can stay at room temperature for 4 hours (up to 6 - 8 hours)
In the back of the refrigerator for 4 days (up to 8 days)
In the freezer section of a refrigerator for 9 months
In a deep freezer for 12 months
Using Your Stored Milk
Milk quality does degrade the longer it is in the freezer, so it is best only to store what you will need for your baby for a couple of days in most circumstances. (7) Store newly pumped milk in the back of older pumped milk so you grab the older pumped milk to give your baby first.
Thaw milk from the freezer in the fridge overnight
Never microwave or heat milk on the stove
Warm defrosted milk in a sealed container in a bowl of warm water
Always check milk temperature before feeding your baby
Shake or stir the milk to avoid hot spots
Use thawed milk within 24 hours and room temperature milk within 2 hours
Never refreeze thawed milk
If milk is leftover after you feed it to your baby, it should be used within 2 hours
Learning about pumping can seem overwhelming at first. Having some basic tips and facts about what to expect can help make it easier. Experimenting is part of the process of finding what works best for you and your baby. Using flanges that fit you best, replacing pump parts as needed, and using hands-on techniques while pumping help you get more milk out at your pump sessions. Remember, your IBCLC is always available if you need a little extra guidance or a plan for making pumping work for you.