Breastfeeding versus pumping for breastmilk

American Academy of Pediatrics recommends that babies consume only breast milk for about the first 6 months. Choosing breastfeeding versus pumping to supply breastmilk can depend on many factors. A mom may choose to breastfeed, exclusive pump, or pump and nurse, to feed their baby.

Deb Schumacher, lactation consultant with Marshfield Clinic Health System, recommends that moms wait about three-to-four weeks to start pumping until breastfeeding is well established.

“If you are planning on exclusive pumping, it is best started within the first couple hours after birth,” she said. “The hormone receptor sites in your breasts need early and frequent stimulation for optimal milk supply.”

Additionally, Schumacher said to try breastfeeding in the first few days because babies are better at establishing milk supply than pumps. Lactation consultants can help new moms if struggling with breastfeeding.

Exclusive pumping

In the beginning, a newborn’s normal frequency of feeding is eight-to-12 times in 24 hours. Schumacher recommends optimal pumping frequency is every two hours during the day and whenever mom is awake at night.

“It is recommended to wait no longer than four to five hours between pumping sessions,” she said. “Once milk supply is well established, many moms are able to pump less often, every three to four hours.”

Similar to the amount of time nursing at the breast, a pumping session should be 15 to 20 minutes. Another rule-of-thumb is to pump until two minutes after milk-flow has stopped.

Each woman is different when it comes to the amount of milk produced during a pumping session. Schumacher said in the first couple of days, it isn’t unusual to collect only drops of milk. By day three, a few milliliters per session with a daily total of 1-2.5 ounces is expected.

“These amounts will slowly increase,” she said. “By two weeks, the target goal is 750 milliliters or 25 ounces per day so about 3-4 ounces per session.”

Pumping before you return to work

Parents don’t always have to choose breastfeeding versus pumping. You may decide that you want to do a combination between breastfeeding and pumping for your child. Many mothers before returning to work will try to create a breastmilk stash for child care, and for others to help feed the baby.

As Schumacher mentioned you want to wait about a month for breastfeeding to be well established. If your maternity leave is longer, consider pumping about a month before your return to work.

Start gradually by pumping once a day in addition to feeding your baby on demand.

“Moms find morning times easier to pump since supply is a little higher and babies are more settled,” Schumacher said. “You may find it easier to feed on one side then pump the other, or pumping an hour after feeding.

From there, you can store breast milk in small amounts, like 2-4 ounces, to minimize waste.

How to help maintain milk supply

If you start to feel like your supply is dropping more than normal. Schumacher recommends checking your pump first to make sure it is still working well.

“Connections or membranes may have loosened or torn,” she said.

Flange sizes also could be a concern. The flange that fits closest to the actual nipple size usually works best.

To check your appropriate size, measure your nipple width in millimeters. Then, use the flange corresponding to your measurement, turn pump on low and pump for a couple minutes. No areola should be in the flange tunnel. The sides of the nipple should touch the sides of the tunnel, but the nipple should glide gently and comfortably back and forth.

If you’ve been ill, dieting or changed pumping routine, your supply may decrease. Adding extra pumping sessions will help increase supply.

One of the routines that can change your pumping schedule is when your infant sleeps through the night. It is recommended to not go longer than six hours during the night. However, every mom is different. If your supply has decreased, adding an extra pumping session during the day may help.

What to eat to build milk supply

When it comes to nutrition, your diet can hinder or benefit your breastmilk supply.

Foods generally thought to increase milk supply include: apricots, asparagus, green beans, carrots, sweet potatoes, peas, pecans, and all leafy greens, especially beet greens, parsley, watercress, and dandelion greens.

A daily bowl of oatmeal is traditionally used to increase milk supply.

Schumacher recommends a well-balanced diet with 2,000-2,500 calories, and drinking half your weight in ounces of water, are good goals.

When to supplement formula

Your child’s doctor will notify you during a well-child visit if your baby has poor weight gain or other medical issues. This may require supplementing formula with your breast milk. Talk to your child’s provider on what recommendations are best for your family.

Schumacher encourages all moms to talk to a provider or lactation consultant to help increase pumping productivity before using formula.

“We want to be there to support moms through their breastfeeding journey,” she said.