To Pump or Not to Pump?
I get more questions about pumping than almost anything else. I have come to conclude that pumping has taken on a loaded role in our society. This can come with many presumptions and potential manipulations. Is there a time when pumping is helpful and necessary? Most definitely yes. Are there many situations where pumping can interfere and be detrimental to a breastfeeding mom and baby. Absolutely! Let’s tease it out.
In my opinion, pumping can serve a purpose if there is a need. Otherwise, removing milk from a breast is best done by the baby. What are clear reasons to pump? If a baby is separated from mom for any reason. Examples include but are not limited to: A baby being sent to the NICU, a baby or toddler needing hospitalization or surgery, a mom being out of town, a mom needing surgery, a mom leaving her baby for work or any other reason longer than three hours. The pump in these instances is crucial for not only giving breastmilk to your baby, but also for protecting your milk supply. If a baby will not latch for any reason (I had two out of four that had difficulty at first), then the most important thing to do is to protect your milk supply by pumping. This gives you and your baby the best chance of returning to breastfeeding. A breast that is making milk can (most of the time) make more milk. (There are instances such as breast surgeries that could interfere). If your baby will not latch for any reason or is not withdrawing milk from the breast effectively, it is crucial to work with an IBCLC (International Board Certified Lactation Consultant) to come up with a plan. This plan includes a pumping schedule to protect your supply, assessment of the underlying problem, and strategies for your baby returning to the breast. How a mom pumps during this time is important. Also, there are many ways of delivering breastmilk to your baby. Every dyad is unique, and we want to find the way that best fits with you and your baby.
In today’s culture, at many hospitals, every mom who has registered as a ‘breastfeeding’ will have a pump waiting in her room upon admission. As both an IBCLC and a Clinical Psychologist, I am not a proponent of this approach. In my opinion, it sends a message to moms that pumping is an essential part of breastfeeding, when in fact it is not. Many moms throughout history have successfully breastfed without ever having pumped. If breastfeeding is established and going well, outside of circumstances such as the ones mentioned above, there is no need to pump. In fact, colostrum, which is the first milk following delivery, has the consistency of thick maple syrup. Pumping this type of milk is tedious and often gets in the way of establishing breastfeeding. Colostrum sticks to the pump parts, is difficult to remove, and can leave a postpartum mom feeling anxious, defeated, and exhausted. This can sabotage breastfeeding from the start and lead to early introduction of formula. This is yet another reason why I do not support a pump being in every breastfeeding hospital room. A much better option for removal of colostrum is to hand express (there are great videos online. Please reach out to me). Hand expressing colostrum into a small cup, then feeding it to the baby using a non-needled sterile syringe, is an easy technique for the baby to get the expressed colostrum.
I have seen many ways in which pumping and our ‘pump culture’ have interfered with establishing effective and enjoyable breastfeeding. In many instances, new moms are being told that they must have a deep freezer filled with pumped milk ‘just in case’. This mentality can take on a life of its own and get in the way of not only breastfeeding, but also bonding with your baby, fully healing from birth, and transitioning to your new role as a mom. It can be a set up for taking the enjoyment out of this special time in your life.
In addition, pumping can interfere with your milk supply being dialed in to the needs of your specific baby (or babies). I recently worked with a new mom whose baby was suddenly extremely discontented. She could not figure out what changed. She was at a point of desperation, leading to the borderline of postpartum depression, due to the stress of a discontented baby who suddenly was not feeding or sleeping well. I asked several questions to gain a full picture and tease out what had changed. It turns out she began pumping the breast her baby was not nursing on in order to store milk. She didn’t need the excess milk as she was almost always with her baby. What had happened here is that she had driven her supply up well beyond what her three month old baby needed and he was not only having difficulty with the quantity of milk, but he began to get excess foremilk (the first milk released, which is less highly concentrated in fat and calories). This was leading to gas, bloating, and not being satiated. The cascade of events from merely pumping to store milk had a long reaching impact and could have led to a sabotage of breastfeeding all together. I gave her a plan for getting her milk supply back dialed in to her baby and making sure he was receiving the hindmilk during feeds. Within a couple of days, he was back to the contented, happy baby she remembered. Her mood had also lifted and she returned to enjoying motherhood. As you can see, throwing off what nature intended can have consequences that reach farther than we sometimes think. Also, this mom was a yogi. She would pump every time she left for yoga, even though she was only gone 90 minutes and most often her baby was not hungry during that time. Again, this is an instance where she did not need to pump. She could feed her baby right before leaving and again when she returned if he was showing cues. Our culture has us believing we need to have copious amounts of milk on hand at every given moment. When we only need to have what our babies require.
If you are going back to work or school, then this is a time when pumping is useful. I have a great course on how to pump to your benefit in this instance. Please take my online course and if you have any questions, I am here to help.
This article could be pages long about when to pump or not to pump. Overall, I hope you have gotten the sense that pumping is a tool we can use when and if we need to. However, the messages we are given are often misguided and backfire, leading to unneeded stress, worry, and a potential sabotage of breastfeeding. If you want or need to pump breastmilk, please contact an IBCLC to make a sound plan that works with you, not against you, to meet your breastfeeding goals.
By Danielle Sharon, Psy.D., IBCLC