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Physical Methods | Medicinal Methods (Galactagogues)

Latching | Breast Compression | Breastfeed Frequently | Milk Ejection Stimulation | Pumping | Skin-to-Skin

Using a Breast Pump

The main objective of pumping is to remove more milk so more milk is made according to the demand and supply principle of lactation.  In addition, to suction to remove the milk, nipple stimulation causes the release of prolactin, the milk-making hormone, and oxytocin, the hormone responsible for milk delivery.

There are advantages, as well as disadvantages, to pumping, and many ways to approach it.  Experiment to develop the methods that work best for you and your baby.

Why (and Why Not) to Pump

It is often helpful to remove more milk than baby takes by pumping with a breast pump. Babies rarely drain the breast completely, leaving an average of 25 percent of the available milk in the breast when they are finished.(1) Since the emptier the breast, the faster milk is made, removing milk left in the breast after baby feeds means your breast will work even harder to make more milk.  Pumping is also especially helpful when your baby is not nursing often or well.

Although pumping can potentially increase your milk production, it is not the best way to increase the milk production in all situations.   If your baby is nursing often and removing milk effectively and also likes to comfort nurse between feedings, his sucking may be stimulating your lactation system very well and extra pumping may not be worth the effort.  In this case, supplementation given before feeding at the breast is an effective alternative for increasing milk production without the need for pumping.

One way to know whether or not baby is nursing effectively is if he thoroughly drains at least one breast during most feedings. Although you will almost always be able to express milk because it is always being made, a thoroughly drained breast is noticeably lighter and softer than at the beginning of the feeding.

The way to keep production as high as possible is to follow up any feedings that aren’t thorough enough with a pumping session (five to fifteen minutes, depending on how well baby breastfed) to augment the stimulation your breasts receive and give your body the message that more milk is needed.

Even if your breasts were thoroughly drained, it can still be helpful to pump for a short time after the feeding to tell your breasts to make more milk. The dilemma, if you have a very young baby, is that pumping in the short amount of time you have between feedings can be exhausting and sometimes not even possible.  Mothers with more than one child often feel especially overwhelmed by the amount of time that frequent nursing and pumping between feedings can consume.  It is natural to feel frustrated by trying to do it all, which can make it very tempting to simply give up. 

When you are both breastfeeding and pumping to stimulate milk production, it may be necessary to limit baby’s feeding time to active suckling for short while. Many mothers want to give their baby every chance to get those last few drops and stimulate their production naturally, but if a baby spends only three or five minutes in active suckling and then nibbles off and on the next 20 or 30 minutes, those last 20 or 30 minutes of “comfort nursing” provide neither adequate food for your baby nor production-building stimulation for you.  It’s true that “comfort nursing” is wonderful for helping baby to feel comforted and secure–a very important part of bonding–and the snuggly time can be very nurturing for you, too, but when you are trying to balance the extra time necessary to increase your milk production with all the other things that need to be done to take care of your new baby, any older children, your house, and even yourself, there simply may not be time to do it all.  While it not usually helpful to limit feedings to any certain amount of time, some mothers find that balancing active suckling time and pumping to last no longer than 45 minutes total helps to maintain good feelings toward both baby and the pump, and also helps them fit in enough feedings each day. An alternative solution for many mothers who feel overwhelmed by the demands of pumping and breastfeeding is Power Pumping.

If your baby is not nursing effectively at all, especially if he sucks well only when milk is flowing strongly, pumping becomes the primary way that your milk production is maintained, so you need to make sure you are doing it often enough, ideally eight to ten times a day. Many mothers fit in the eight to ten pumpings during their waking time so they can have a longer stretch of sleep at night. One sneaky and fun idea recommended by lactation consultants Barbara Wilson-Clay and Kay Hoover to remember how many times you’ve pumped or need to pump is to place a Hershey’s Kiss™ or other treat on or near the pump for each time you need to pump in a day. Eat one each session; the rest help you to remember to come back again.(2)

When and How Long to Pump

The most common approach to pumping is to nurse your baby first for as long as he will actively suck and then pump, so that your baby receives the majority of the available milk at your breast. Another variation is to delay pumping until halfway between feedings to avoid any conflict between the need to feed baby his supplement after breastfeeding and the need to pump. Either way, it is best to pump only after your baby is settled and not in need of your attention; his needs come first. You can always pump when he is settled or sleeping.

When pumping for additional stimulation to increase your milk production, it is recommended that each breast be pumped for at least ten to fifteen minutes, even if there is no milk flowing during some of this time. The amount of milk you pump does not matter at this point; your goal is to stimulate your breasts and tell your body to make more milk than it is making right now.

Another question is whether or not to pump during nighttime feedings.  Linda Pohl, IBCLC, defines nighttime feedings as "anytime a mother can sleep after the feeding, not the position of the sun in the sky."(3)  Pumping around the clock is certainly good if you can do it, especially since prolactin levels rise naturally at night and nighttime sessions result in higher prolactin surges. However, getting adequate sleep is also important to your overall health and well-being, and can impact your milk production.  The trick is to be flexible in balancing the two. Sleep at every opportunity in the daytime, and if it is time to pump but you have a chance to take a nap and really need it, choose the nap instead of pumping. If at all possible, try to plan for at least one pumping session in the middle of the night.  If you don’t plan a nighttime session but you do happen to awaken in the middle of the night, use that opportunity. If nothing else, the sedating effects of oxytocin being released while pumping will probably help you get back to sleep when you are done.

Veteran “pumpers” who have particularly good dexterity have also found that pumping one breast while the baby nurses from the other can be an effective means of increasing the number and strength of milk ejections, providing excellent stimulation.  It is most important, though, that the baby be given the first priority at the breast since his ability to remove milk usually will be more effective than that of a pump.

Click here for information on the best kind of pump to use to make more milk

(1) Daly, S., Owens, R., Hartmann, P. The short-term synthesis and infant-regulated removal of milk in lactating women. Exp Physiol 1993 Mar; 78(2):209-20.

(2) Hoover, K. and Wilson-Clay, B. Pumping for your premature baby (handout, 2004).

(3) Pohl, L. Personal communication to Lisa Marasco, 2/22/03.
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