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Exclusive Pumping

Some mothers exclusively pump and bottle-feed expressed breastmilk. Some mothers pump exclusively from birth by choice, while others reluctantly resort to pumping full or part-time due to problems with breastfeeding that have not been solved. Some reasons that mothers may resort to exclusive pumping might be:

  • Premature or ill baby
  • Anatomic problems in baby
  • Baby who will not latch on to the breast.
  • Severe engorgement, pain, mastitis, inverted or flat nipples
  • Painful breastfeeding
  • Poor or no help with early breastfeeding causing mom to stop breastfeeding
  • Unnecessary advice recommending weaning
  • Temporary medical crisis involving medications
  • Mother who has psychological issue around breastfeeding, i.e. sexual abuse victims
  • Desire to pump exclusively without medical or other indication
  • Perceived low supply


For mothers who are pumping but who wish to breastfeed directly, we recommend personal consultation for breastfeeding problems with an IBCLC. There are other excellent support services such as physicians, La Leche League, and the Nursing Mothers’ Council. Go to Medela’s Ask the LC pages for on-line support. Problems such as low milk supply, or low weight gain in the infant can often be easily fixed with help and support.

If a mother cannot or does not wish to breastfeed directly, exclusive pumping, begun soon after birth, can provide baby with breastmilk, which is highly superior to artificial baby formula. Use a hospital grade pump with a double kit, such as the Lactina Select, or the Symphony. Milk production depends on frequent and effective milk removal from the breasts. Pump at least 8 times in 24 hours, or a minimum of 100 minutes per day. Many exclusively pumping mothers find it helps their milk supply if their baby is allowed to spend time skin-to-skin at the breast, even if the baby only nuzzles the nipple.

Several short pumping sessions are preferable and more effective than longer less frequent sessions. Some herbs and medications can be used to improve supply in mothers who find supply to be an issue. Avoid medications that may cause a decrease in supply, such as birth control medications and over-the-counter oral cold medicines.

Make sure that the breastpump flange fits well, and that the nipple moves freely within the flange. If a larger breastshield flange is needed, Medela makes PersonalFit™ kits with wider flanges, large ( 27 mm diameter) and extra large (30 mm diameter). If a mother wishes to exclusively pump, the correct equipment, comfortably fitted and used properly and frequently will make her experience more successful.


Sometimes, mothers who exclusively pump worry that they won’t have enough milk to meet the needs of the older, heavier, 3-6 month old infant. It is normal for milk production to be fairly constant over time. Interestingly, while the volume of milk produced doesn’t change much, the energy requirements of babies actually decrease as they grow towards the 6- month mark. This is because the rate of growth of babies is very rapid at first, but slows down later, providing protection against obesity.

For information on ways to remedy low supply, see FAQ Low supply or ask our LC.


Editors:

Barbara Wilson-Clay BSEd, IBCLC
Mary V. Bibb BA, IBCLC
Catherine Watson Genna, BS, IBCLC

References:

Cunningham AS, Jelliffe DB, Jelliffe EFP. Breastfeeding and health in the 1980's: a global epidemiologic review. J Pediatr 1991;118:659-66

De Carvalho M, Anderson DM, Giangreco A et al: Frequency of milk expression and milk production by mothers of non-nursing premature neonates, Am J Dis Child 139:483, 1985.

Hale, Thomas PhD. Medications in Mothers’ Milk. 9th edition. 2000.

Hill PD, Brown LP, Harker TL: Initiation and frequency of breast expression in breastfeeding mothers of LBW and VLBW infants. Nurs Res 44:352- 5, 1995.

Hill PD, Aldag JC, Chatterton RT: The effect of sequential and simultaneous breast pumping on milk volume and prolactin levels: A pilot study. J Hum Lact 12:193-9, 1996.

Hopkinson J, Schanler R, Garza C: Milk production by mothers of premature infants. Pediatrics 81:315-20, 1988.

P Hill, J Aldag, R Chatterton, Effects of Pumping Style on Milk Production in Mothers of Non-Nursing Preterm Infants, JHL 1999, 15(3):209-216

P Hill, J Aldag, R Chatterton, Initiation and Frequency of Pumping and Milk Production in Mothers of Non-Nursing Preterm Infants, JHL 2001, 17(1):9-13

Walker M. A fresh look at the risks of artificial feeding. J Hum Lact 1993;9:97-107 2. Cunningham AS, Jelliffe DB, Jelliffe EFP. Breastfeeding and health in the 1980's: a global epidemiologic review. J Pediatr 1991;118:659-66

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