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. Exclusive pumping may be a temporary break for moms who are both directly breastfeeding and pumping at every feeding. The break may last anywhere from one feeding a day, to half of the feedings, to taking a break from direct breastfeeding for a full 24-hours to a full week or two.

One study stated that almost 6% of breastfeeding moms are exclusively pumping.

Why Choose Exclusive Pumping?

Initiating Breastfeeding With Exclusive Pumping: Some moms begin their breastfeeding journey having already chosen exclusive pumping and bottle-feeding. Their reasons vary. They may have had a challenging breastfeeding experience with a previous baby which led them to exclusive pumping, and they do not want to go through that struggle again. I have also seen moms start out the breastfeeding journey with the new baby heading down that difficult road again and quickly make the switch to exclusive pumping again. Some moms are very uncomfortable with the thought of direct breastfeeding but are aware that breastmilk is so very valuable to their baby, and choose exclusive pumping.

 

Photo credit: edenpictures via VisualHunt.com / CC BY

Temporary Exclusive Pumping: The reasons for take a break from direct breastfeeding can vary. The feeding routine may be taking a very long time, as can happen with triple feeding. If you’ve never heard the term “triple feeding,” this is when a mom is directly breastfeeding, pumping and bottle-feeding at every feeding. It is hard work and very time-consuming. Some moms just need a break from one aspect of triple feeding, and the only thing that can be skipped is direct breastfeeding. Babies must be fed, and if they are not getting enough from the breast, then they must be supplemented. The milk supply must be supported which requires pumping if the baby is not breastfeeding adequately or at all.

Other reasons for exclusive pumping might be a mom who has damaged nipples, and a break from breastfeeding is required to help them heal. I have also worked with moms whose baby had a severe tongue-tie, and her nipple trauma was not going to heal until the tongue-tie was released.

Of course, a mom with a premie 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 a similar number of times as a newborn would eat, which is going to be a minimum of eight times in a 24-hour period. When you first start pumping, before your milk comes in, you will want to pump for 15 minutes.

The Medela Symphony pump is what we use at our hospital, and they have the Plus setting, which is a random pattern that simulates how a newborn would suck before the milk comes in. It turns off automatically after 15 minutes. Medela states that using this pattern will stimulate a greater milk volume, according to a research study performed which looked at this. If you go home before your milk comes in, chances are a pump you rent will not have this feature and you will need to keep track of the length of the pumping session yourself. When your milk comes in, you should pump until your milk stops flowing.

Pumping discomfort

Pumping should not be uncomfortable and should not cause any trauma. A couple of 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
    • Incorrect flange size can decrease milk output
  • Lanolin often makes pumping more comfortable. Apply a small amount on the inside of the flange, where it bends.
  • If pumping is still causing discomfort, consult an LC.

 

Pumps

I recommend that if you are not directly breastfeeding at all or your baby is not effective at the breast, for any reason, you should use a hospital grade rental breast pump for the first 4-6 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.

I am asked frequently what the difference is between the hospital grade pumps and the personal pumps are. Personal pumps may have suction levels that are lower, and frequency of suction can be slower, compared to hospital/rental pumps. The pump companies say that their personal pumps are for the mother with the established 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.

Research, Research, Research!

A mom who chooses exclusive pumping wants an effective and comfortable pump. When choosing a personal pump, these are the types of research I recommend:

  • I recommend talking with a lactation consultant, who has no financial interests in which pump you choose, about 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, January 2018, breast pumps are covered for breastfeeding moms under the ACA.
    • There are about as many different ways that insurance companies handle this as there are insurance companies.
    • Some will include rentals; most will only provide a personal pump. I have rarely seen an insurance company do both.
    • Some insurance companies will only offer one particular pump; others will give you many choices.
    • Medicaid does not provide breast pumps. 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 breastpump. They 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. Breastpumps aside, WIC has excellent benefits, especially for breastfeeding moms, and if you think you might qualify or are even on the border, 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.

Accessory Equipment

Photo credit: Alice Chaos via Visualhunt.com / CC BY-NC-SA

There are other accessories that will make your exclusive pumping journey easier.

  • A hands-free pumping bra is probably a must
    • You can buy these at maternity/nursing boutique stores as well as large big box brick and mortar and online stores
    • You can also make them yourself with an inexpensive bra 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 because you can rotate the pump parts and don’t have to wash your pump parts after each pumping session; this will allow you to wash every other pumping session.

All or Nothing?

Some moms really want to provide all their baby’s food from the breast, but either have low supplies. Check out my post about low supplies:

https://breastfeedingconfidential.com/increase-milk-supply

Other moms just cannot manage to pump frequently enough. Any amount of breastmilk is going to be valuable to your baby. Go ahead and pump as many times as you can and supplement the rest with formula. Check out my post about formula:

https://breastfeedingconfidential.com/breastfeeding-formula-not-f-word

While 100% breastmilk is best, some is better than none. Getting breastmilk for less than a year is better than not at all.

Pump Schedule

Ideally, you will want to pump as frequently as your baby is eating. If you find that you are pumping more than your baby needs, keep track of the volume of milk that you pump. If your volumes pumped are relatively consistent, you can start dropping one pumping and continue to keep track of amounts of milk pumped to make sure that you are keeping up with your baby’s needs. Make sure, if possible, to have several days ahead of your baby’s needs stashed. A couple of weeks is even better! If the amount you pump starts to fall below your baby’s needs, you will still have your backup milk, and you can add one or more pumping sessions until you are back to what your baby needs. Many more moms get higher volumes in the morning. In this case, you will want to drop a pumping session that yields less milk.

How Long?

The American Academy of Pediatrics recommends breastfeeding through at least the first year. This would ideally be how long you pump breastmilk for your baby.

 

Try Again?

If you had planned to breastfeed directly, you could always try direct breastfeeding again when your baby is older. I have a good friend, who is a lactation consultant herself, and things didn’t go well. She had extreme nipple pain, saw an LC, who did not give her a manageable plan. She started pumping and bottle feeding after a week, and didn’t look back. For five weeks. When her baby was six weeks old, she went to a La Leche League meeting where they encouraged her to try direct breastfeeding again. When she went home, she latched her baby without pain. She continued to directly breastfeed for a full year. She went on to become a nurse and LC because of her experience.

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. 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.

Check out this website, for additional information on exclusive pumping.

https://exclusivepumping.com/

Did you choose exclusive pumping? Please share your reasons in the comments section! Let me know if you would like to share your story here on Breastfeeding Answers and Solutions.

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