When Should I Start Pumping?

This is probably the most common question I’m asked when consulting with new moms in the hospital. Almost every new mom is concerned about baby being able to take a bottle. Sometimes, it’s so “dad can help,” but more often because mom will be returning to work outside the home. Here is the information I share - I hope it helps your patients too.

When Should I Start Pumping?

There are multiple reasons for pumping breast milk, and so there are different answers to this question, depending on the situation.   Here is a general guideline for when to begin breast pumping.

If your baby is unable to breastfeed due to prematurity or illness.

When baby is born, ideally breastfeeding would begin as soon as an hour after birth.  If you have experienced complications with birth and your baby is not able to breastfeed, it’s best for you to begin pumping as soon as you are able, and to continue pumping about every 3 hours until your baby is able to breastfeed.

If your healthy, full-term baby is not breastfeeding well by 24 hours.

Most babies have an alert period following birth and breastfeed well.   After this first good feeding, babies can get quite sleepy.   Hand expression and feeding colostrum every few hours can bridge the baby over until baby is breastfeeding effectively.  But if your baby is not effectively feeding after the first 24 hours, it’s a good idea to start pumping about every 3 hours until baby is breastfeeding well. 

If you have risk factors for a low milk supply.

There are a few things that are considered risk factors for a low milk supply.   Some examples are:

·      Breast reduction

·      Previous history of a low milk supply

·      Certain medical conditions

Your nurse and/or lactation consultant will discuss pumping with you if you have any risk factors, and may encourage you to begin pumping a few times per day in addition to breastfeeding, to help stimulate your supply. 

If there are medical indications that your baby may need a supplement in addition to breastfeeding.

While most babies breastfeed well in the first few days of life, some babies may require additional feedings due to medical conditions.   Your care team will discuss these issues with you if they arise.   If supplementing breastfeeding is advised, you should begin pumping for two reasons:

·      To stimulate your supply

·      To provide your milk for baby

If none of these apply to you, but you’d like to begin pumping in the future for your baby to be able to take a bottle of your milk.

If your baby is breastfeeding well, it is recommended that you exclusively breastfeed until your milk supply is established and your baby is “expert,” at breastfeeding, or for about 3 weeks, before introducing pumping and bottle feeding.  There’s no perfect time to start, but 3 weeks seems to work well for most babies.  Pumping/bottle feeding earlier can lead to baby preferring bottles.  Waiting much longer that 3 weeks, can lead to baby struggling with bottle feeding.

Beginning pumping.

At about 3 weeks, if you choose to begin pumping, start by pumping about an hour after a morning feeding  (your milk supply tends to be higher in the morning). Whatever amount of milk you collect, you can begin by offering just a small amount to your baby in a bottle (approx. ½ oz), and you can freeze the remainder of the milk for a future feeding.   You can repeat again daily until your baby is taking a bottle comfortably.   Offering this “snack,” amount of milk each day is an easy way to introduce the bottle while also saving some milk for later use.  As things progress with with breastfeeding, joining a new mothers support group such as Baby Café (www.babycafeusa.org) is a great way to connect with other moms for ideas on how to manage these new phases of your journey.