When can I start pumping my breast milk?

As an International Board-Certified Lactation Consultant (IBCLC), I field a ton of questions about pumping. Some parents want to know if they can pump right away. Some parents don't intend to pump and want to know if it is okay to hold off on pumping. Others desire to gradually add in pumping and combination feed their baby with breast and bottle. And of course, many, many parents will return to work sometime in the first year. Some of these parents plan to pump while away from their baby to continue providing breast milk. These are just some of the myriad reasons that pumping can be part of your lactation journey.

There are also reasons why it may be prescribed to pump by an IBCLC. This pumping is recommended to manage challenges with breastfeeding, such as ineffective milk removal from the breast for various reasons. Some common concerns are prematurity, poor weight gain, medical issues, tongue tie, and very high palate, to name a few. This type of pumping should be managed in cooperation with an IBCLC. I won’t be discussing this here. (Please see my blog on Triple Feeding). Triple Feeding: Let's break this down!

In today's blog, I’m going to be addressing managing milk supply, how the milk is made, and how pumping can affect your journey. 

Manual Breast Pump

Your baby is the driver of your milk supply!

If your breastfeeding journey is off to a good start, your baby is likely much better at removing milk from your breast than even the best double electric pump. If nursing is going well your baby should nurse 8-12 times every 24 hours, weight gain should be healthy, your baby should have lots of pees and poops (8 pees and 3-4 or more poos every 24 hr) and you should have no pain. After the first several weeks, feedings at the breast should get more efficient and are likely 10-25 minutes in length. The more milk that is removed efficiently in the first 6 weeks post-delivery, the more milk you will make for your baby and your lactation journey. 

Pumps are less efficient!

It is harder to build a supply just from a pump (but not impossible, and many parents do!), as they aren't removing quite as much from your breasts as an efficient baby. This is why it is recommended to primarily directly breastfeed (direct breastfeeding = feeding at the breast) in the first 4-6 weeks after birth. 

If your baby removes more milk from the breast than your breast pump, your breast will make more milk when you nurse. The milk supply follows supply and demand. Let's say your baby removes 2 oz most of the time. Your body will make 2 oz the next day, and so on. Let’s say, for example, that your pump only removes 1 oz, so using it often can make building a supply more challenging. 

So let’s say you occasionally pump instead of nurse in the first 3-6 weeks. This won't negatively impact your supply. But let's say you pump 2 times every 24 hours instead of a nurse in the first month, you may have less milk. Each person will vary a bit. 

Once your milk supply is more firmly established, there is more flexibility with this, and you can introduce pumping carefully with less impact on supply. 

Scenario One

Let's say your goal is to directly breastfeed after birth. Aim to nurse and hold off on pumping for 4-6 weeks after birth.

Scenario Two

Some parents will know that they plan to incorporate a bottle once a day as soon as they go home from the hospital. This is another choice. If the goal is still to build a full milk supply, you can do this with this in mind: Pump in place of that missed at-breast feeding. You can do this in two different ways. 

1. First approach: If possible, pump at the time that your baby is getting that bottle. Early on, your breasts will likely get full, congested, and uncomfortable if you don't drain them every 4 hr. 

2. The second approach is to sleep or rest while your partner or helper is giving that bottle. Aim to still pump to match that missed at-breast session, but you can do it at another time in the same 24 hours. 

Most parents cannot comfortably go more than 4-5 hours without draining the breast. Try not to go more than 5.5 hours in a row once in 24 hours in the early weeks to avoid lowering milk supply.  (You can do more bottles and more pumping if desired, with the understanding that building a supply is harder this way. Example: 2 bottles =2 pump sessions, 4 bottles=4 pump sessions)

When the heck do I pump?

Babies nurse 8-12 X every 24 hours. So there is little time to pump, especially in the first 2 weeks when each feeding takes longer. That is the other big reason I don't recommend pumping early unless that is part of the goal and then we tailor our approach. So, when should you do those pumps I mentioned?

Let's say your partner or helper gives a bottle at 9 pm, and you sleep from 7 pm to 11:30 pm. Aim to nurse when you awaken and pump about 30-60 minutes after one of the morning nursing sessions. Prolactin (the milk-making hormone) is highest between 2 am and 7 am, so there is still usually more milk at that time and for a few hours afterward. You might pump after the 7 am or 9 am feeding. Waiting a bit after nursing will yield more milk, and you can store that milk for the next day's bottle. Be aware that pumping in between when you are nursing full time will usually yield about 1-2 oz per session. (after day 14 after birth). (Pumping instead of nursing will yield 3-4oz). With this knowledge, we know that you may need to pump twice to get a full feeding for your baby, depending on their age and appetite. 

How much can I pump if I am also nursing full-time?

It is not recommended to pump more than 1-2 times every 24 hours in addition to breastfeeding 8-12 times. Pumping more will likely lead to an oversupply, which is a bad thing. Trust me.  For some parents, pumping even 2 times is enough to create an oversupply. My clients who suffer from oversupply have bothersome symptoms, and their babies are also unhappy at the breast and are so uncomfortable with gastrointestinal symptoms. This is not a goal to strive for. Ignore the pictures on Instagram, etc, of freezers full of milk. This is pathological.  If you have concerns about your milk supply, please book a consultation with me, and we can assess and evaluate everything together and create a plan.

I hope this blog answered some of your questions regarding pumping. For some, a consultation with an IBCLC can really clarify the best approach for them in their particular situation. We can assess the factors impacting your supply and the feedings and provide a tailored plan. Reach out to learn more. 

Please also see my blog on Flange fitting! Why is breast pump flange fitting so important?

~Cathy Walker, MA, RN, IBCLC

Registered Nurse and Lactation Consultant