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Sometimes when breastfeeding gets really hard a mom will ask, “Can I just pump and bottle feed?” This is know as exclusive pumping, or EP.
And it’s a huge commitment. It takes time, energy and dedication.
Studies have shown that about 6% of moms are exclusively pumping.
Why Choose Exclusive Pumping?
Moms often choose exclusive pumping because they have experienced challenges with breastfeeding that they feel they cannot resolve. Other moms choose exclusive pumping because it has become too emotionally taxing to continue to work on those problems.
Some moms are both breastfeeding and pumping at each feeding and just need a break. They may choose to exclusively pump temporarily. The break may last anywhere from taking a complete break from direct breastfeeding for a full 24-hours to a full week or two. Or, they may take a break from one feeding a day, to half of the feedings.
Exclusive Pumping Right From the Start
Some moms begin their breastfeeding journey having already chosen exclusive pumping and bottle-feeding. Their reasons vary.
They may have had a challenging experience breastfeeding a previous baby which led them to exclusive pumping. They decide that they do not want to go through that struggle again.
I have seen moms who start out the breastfeeding journey with the new baby start to head down that difficult road again. She quickly makes the switch to exclusive pumping again.
Some moms are very uncomfortable with the thought of direct breastfeeding. But they are aware that breastmilk is so very valuable to their baby and choose exclusive pumping. This allows them to provide their baby with their breast milk without having to directly breastfeed.
Temporary Exclusive Pumping
Some moms exclusively pump for a short period of time The reasons for taking a break from direct breastfeeding can vary.
The feeding routine may be taking a very long time. This can happen when a mom is triple feeding.
Triple feeding is when a mom is breastfeeding, pumping and bottle-feeding at every feeding. It is hard work and very time-consuming.
Some moms need a break from one aspect of triple feeding, and the only thing that can be skipped is direct breastfeeding.
- Babies must be fed. If they are not getting enough from the breast, then they must be supplemented.
- The milk supply must be supported. Pumping is necessary if the baby is not breastfeeding adequately or at all
Exclusively pumping gives a mom a chance to get more rest. She does not feel so overwhelmed. She may resume triple feeding after a break. She may wait to resume breastfeeding when her baby is able to get a full feeding from the breast and no longer needs to be supplemented.
Severe Nipple Damage
A break from breastfeeding may be required when nipple damage is severe. When the nipples heal breastfeeding can resume.
A break from breastfeeding may be indicated when nipple trauma is caused by a severe tongue tie. In this situation, the nipples will usually not heal until the tongue-tie is released.
A mom with a premie who is not breastfeeding yet will be exclusively pumping until her baby is able to breastfeed.
How to Get Exclusive Pumping Established
In the early days, it is important to pump the same number of times as a newborn would eat. This is going to be a minimum of eight times in a 24-hour period.
Before your milk comes in, pump for 15 minutes.
Once your milk has come in you will pump until your milk stops flowing.
For the first 6-8 weeks pump eight times in a 24-hour period. At 6-8 weeks your milk supply will be established.
If you produce a lot of milk you may be able to pump less frequently. Only try pumping less frequently after 6-8 weeks.
You will want to pump as much as your baby needs plus some extra.
Talk to a lactation consultant if you want to pump less than eight times every 24-hours. She can help you decide if this is a good choice for you.
If you are not directly breastfeeding at all, or if your baby is not effective at the breast, for any reason, you should use a hospital grade rental breast pump for the first 6-8 weeks. Your milk supply should be established by that time.
If you have a milk supply that is within normal limits, you can usually switch to a good electric personal pump. If you struggle to produce enough you should stick with a rental pump.
The Spectra is a very good pump. It gets rave reviews from moms.
I am frequently asked what is the difference is between the hospital grade pumps and personal pumps. Personal pumps may have suction levels that are lower, and the frequency of suction can be slower, compared to hospital/rental pumps.
The pump companies say that their personal pumps are intended for the mother with the established milk supply. They recommend that a mom use a rental pump to establish her milk supply.
I want to be clear that when I talk about hospital/rental grade pumps, I am referring to the types of pumps that they use in hospitals and are available to rent. Some personal pumps claim to be hospital grade, but as far as I know, there is no research to back this up, and I am not sure what exactly they are basing those claims on.
Related Post: Everything You Need to Know About Pumping Breast Milk.
Nipple Pain From Pumping
Pumping should not be uncomfortable and should not cause any trauma.
Things that can affect the comfort of pumping are:
- Correct flange size: Both too small and too large can cause discomfort
- Too small can cause laceration on the areola or breast
- Too large pulls too much of the breast into the flange
- Incorrect flange size can decrease milk output
Lanolin applied to the inside of the flange usually makes pumping more comfortable. Apply a small amount on the inside of the flange, where it bends.
If pumping is still causing discomfort, consult a lactation consultant.
Choosing a Breast Pump
A mom who is exclusively pumping wants an effective and comfortable pump. You will want to do your research.
When choosing a personal pump, these are the things you will want to research.
- Talk with a lactation consultant. Ask her what pumps are good choices.
- If you live in the US and have insurance, you probably will get a pump from your insurance.
- At the time I am posting this article, April 2019, breast pumps are covered for breastfeeding moms under the Affordable Care Act.
- There are about as many different ways that insurance companies handle breast pumps as there are insurance companies.
- Some will cover the cost of a rentals.
- Most insurance companies will only provide a personal pump.
- I have rarely seen an insurance company cover the cost of both.
- Some insurance companies will only offer one particular pump; others will give you a selection to choose from.
Medicaid does not always provide breast pumps. It depends on the state.
We will skip the irony of the government exempting the insurance they provide from complying with their own insurance regulations. The reason they give is that if you have Medicaid, then you are almost certainly on WIC and WIC will provide you with a breast pump.
WIC may or may not provide you with an electric pump. They should definitely provide you with a manual pump. But, let’s get real. It is the rare mom who will be able to keep up with exclusive pumping with a manual pump.
Breast pumps aside, WIC has excellent benefits, especially for breastfeeding moms. If you think you might qualify you should definitely look into it.
The big online sites (think the big A) have breast pump reviews. This is a great place to find out what other moms think of pumps.
Other pumping moms are a great resource for pump feedback. They don’t need to be exclusively pumping.
The Spectra is a winner. For the exclusively pumping mom, the model with the battery pack is a good choice.
There are accessories that will make your exclusive pumping journey easier.
- A hands-free pumping bra is probably the most popular breastfeeding accessory for exclusively pumping moms.
- Some moms may prefer a hands-free pumping tank.
- You can buy these at maternity/nursing boutique stores as well as large big-box brick and mortar and online stores
- You can make a hands-free pumping bra or tank yourself with an inexpensive bra or tank that you have cut small holes in to hold the flanges in place
- Many moms find that having two pump kits make exclusive pumping more manageable. You can rotate the pump parts and don’t have to wash your pump parts immediately after each pumping session. This will allow you to wash every other pumping session.
- Another must-have is a pumping bag.
In the beginning, you need to pump as often as your baby is eating. It doesn’t need to be at the same time. It does need to be the same number of times.
You need to pump during the night. Our prolactin levels are highest during the night. You need to take advantage of this. Pumping during the night is important, even if you produce tons of milk.
It is always a good idea to have some extra in the freezer. A couple of days is a minimum. A couple of weeks is ideal.
If you are meeting your baby’s needs and not making any extra you will add 1-2 pumping sessions per day. This will gradually increase how much you make so you can get some extra milk stored in the freezer.
If you find that you are consistently pumping more than your baby needs then you can drop 1-2 pumpings. Make sure you have a good freezer stash first.
Continue to track the amount of milk pumped to make sure that you are keeping up with your baby’s needs.
If the amount you pump starts to fall below your baby’s needs and you are using your backup milk then add one or more pumping sessions until you are back to what your baby needs.
Many more moms get higher volumes in the morning.
If you drop any pumping sessions you should drop a session that yields less milk.
Exclusive Pumping When You Have Low Milk Supply
Most moms want to provide all their baby’s food from the breast, but either have a low supply or cannot manage to pump frequently enough.
Any amount of breastmilk is valuable to your baby.
Go ahead and pump as many times as you can and supplement the rest with donor milk or formula.
While 100% breastmilk is best, some is better than none.
How Long Should You Exclusively Pump
The American Academy of Pediatrics recommends breastfeeding through at least the first year. The ideal would be to exclusively pump for that long.
Any amount of breast milk is valuable. But getting breastmilk for less than a year is better than not at all. At the end of the day, every mom should do the best she can.
One Last Thought
A breastfeeding mom who has chosen exclusive pumping has chosen a path on her journey that is often a lot of work. It has amazing benefits for her baby. She is an amazing mom.
There are great resources out there to help you with your journey. Your baby is so lucky to have you for a mom.
Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.