Should i pump after nursing: Combining Breastfeeding and Pumping: Reason, Tips, and More

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Combining Breastfeeding and Pumping: Reason, Tips, and More

Medically reviewed by Mia Armstrong, MD — By Catherine Crider on August 24, 2021

Peanut butter and jelly. Movies and popcorn. Shoes and socks. Some of the best things in life come in combos. But what about breastfeeding and pumping?

If your milk supply is low or you just need some extra expressed milk for bottles, you may be wondering how to combine breastfeeding and pumping, if it will increase your supply, or if there are any downsides to it.

Have no fear: We’ve got answers! Plus we have some tips if you do decide to try breastfeeding and pumping.

There are many reasons you might choose to do a combination of breastfeeding and pumping. A few common ones include:

Increasing your milk supply. Breast milk production generally works on supply and demand. The more milk is drawn out, the more milk your breasts may potentially make. If you are trying to increase your milk supply, this can be a good first step to try.
Helping with discomfort. This involves clearing milk out of your breasts to help with clogged ducts and mastitis (inflammation of breast tissue).
For bottles. You may want to have some breast milk for bottle feeding if you need to be away from your baby for any length of time.
Breastfeeding difficulties. If your baby has challenges latching or drinking a sufficient amount from your breast alone, it can be helpful to have some extra milk on hand to follow up breastfeeding with a bottle.

If you’re considering combined breastfeeding and pumping, here are a few suggestions to help you get started:

Breastfeed first. It’s generally best to pump after breastfeeding. That way your little one can have their fill first, you’ll be able to empty your breasts fully after, and your breasts will have maximum time to refill before the next feed!
Use your hands. Hands-on pumping and hand expression can help to increase the amount of milk you get out of your breasts. Doing these things can also help increase the amount of milk your breasts produce in the future.
Get storage. You may wish to use a Haakaa silicone breast pump or other milk storage container to collect the milk leaking from the breast your baby is not currently using, so this milk isn’t lost before you pump.
Find the best fit. Before pumping, make sure to double-check the flanges to make sure that they fit properly. This can help prevent damage to your nipples and discomfort while you pump.
Keep accessories handy. You may want to place a few baskets around your house near your favorite breastfeeding locations that hold a water bottle, easy-to-eat adult snacks, nipple cream, burp clothes, wipes, and diapers, so you don’t have to get up to look for these items once you start feeding and pumping.
Learn bottle feeding techniques. Use the paced bottle feeding method to help ensure that your baby is more likely to want to continue breastfeeding. (As an added bonus, a 2018 study showed that this may just help to prevent respiratory and ear issues!)
Warm up. If you’re having trouble getting your body to let down with the pump, consider placing something warm on your chest first and looking at videos of your little one while you pump.

What is power pumping?

If your goal is to increase your supply, you may want to consider a technique known as power pumping. Power pumping mimics the more frequent feeding style of an infant who is cluster feeding.

Exact power pumping schedules can vary. Generally, you’ll want to try pumping for 1 to 2 hours per day for 1 or 2 weeks to increase your milk supply.

A sample power pumping routine might look like this:

20 minutes pumping
10 minutes rest
10 minutes pumping
10 minutes rest
10 minutes pumping
10 minutes rest

Potential benefits

increasing the amount of milk your breasts produce
extra expressed breast milk for periods of separation or if you become ill
relieving engorgement pressure and helping prevent clogged ducts
encouraging your baby to accept bottle feeding so they don’t rely solely on breastfeeding

Potential downsides

Oversupply issues, such as clogged ducts, engorgement, and mastitis, may occur if the additional pumping increases your supply too much.
Milk can spoil if it’s not properly handled and stored.
More pumping will mean more things to keep sanitized to prevent the spread of germs.
Pumping supplies add additional costs.
Your breasts/nipples may be more tender due to the longer amounts of suction.

You should speak with your doctor or your child’s pediatrician for guidance if you have any specific health concerns or if problems develop when you combine breastfeeding and pumping.

Making decisions around formula, breast milk, and pumping can feel overwhelming. Being informed can help you feel more confident in whatever choice you make.

There are many individuals and organizations that can offer you advice and resources. A few places you can reach out are:

La Leche League International
a local breastfeeding support group
a private lactation consultant (IBCLC)
your child’s pediatrician
Women, Infants, and Children (WIC) program
Nursing Mother’s Counsel

If you find that your breast milk supply is lower than you (or your baby) would like it, a combination of breastfeeding and pumping might help. Pumping after breastfeeding sessions can also offer a way to collect breast milk for bottles when you need some extra sleep or have to be away from your baby for an extended period of time.

Schedules for breastfeeding and pumping can vary depending on many factors, so you may want to discuss your situation with a lactation consultant.

If you experience breast discomfort or find that your milk supply is at an uncomfortable level, you’ll want to talk with your doctor or a lactation professional. Their support can help to make your experience breastfeeding and pumping a more comfortable one. It’s important to remember that everyone’s experiences are different!

You may find that you love doing a combination of breastfeeding and pumping, or you might discover just like peanut butter and jelly, it’s overrated to you. It’s OK to feel however you feel. There’s no one right answer when it comes to feeding a baby!

Last medically reviewed on August 24, 2021

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How we reviewed this article:

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Avital A, et al. (2018). Feeding young infants with their head in upright position reduces respiratory and ear morbidity.
ncbi.nlm.nih.gov/pmc/articles/PMC5920104/
Hemmelmayr A. (2016). Power pumping — super stimulation for milk production.
cdn.website-editor.net/fbecae35f0d04078b90baf90c3032ed5/files/uploaded/EN%20Power-Pumping.pdf
Increasing supply. (2018).
breastfeeding.asn.au/bf-info/common-concerns–mum/supply

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Aug 24, 2021

Catherine Crider

Edited By

Afton DeLucca

Medically Reviewed By

Mia Armstrong, MD

Copy Edited By

Sofia Santamarina

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Medically reviewed by Mia Armstrong, MD — By Catherine Crider on August 24, 2021

Breastfeeding FAQs: Supply and Demand (for Parents)

Breastfeeding is a natural thing to do, but it still comes with its fair share of questions. Here’s what you need to know about your milk supply.

How Do I Know if I’m Making Enough Milk for My Baby?

Your baby’s diapers can help you tell if your little one is getting enough to eat. The more your baby nurses, the more dirty diapers you’ll see.

Pee

Because colostrum is concentrated, your baby may have only one or two wet diapers in the first 24 hours of life. After 3–4 days, look for:

6 or more wet diapers per day, with clear or very pale pee. Fewer wet diapers or darker pee may mean your baby’s not getting enough to drink. If you see orange crystals in a wet diaper, call your baby’s doctor. They’re common in healthy, well-fed babies and usually not a cause for concern. But sometimes they’re a sign that a baby isn’t getting enough fluids.

Poop

A newborn’s poop is thick and tarry at first, then more greenish-yellow as mom’s milk comes in. After 3–4 days, look for:

4 or more yellow, seedy poops per day, usually one after each feeding. After about a month, babies poop less often, and many may go a few days without pooping.

Your baby probably is getting enough milk if your little one:

feeds 8–12 times a day
seems satisfied and content after eating
sleeps well
is alert when awake
is gaining weight

If you’re worried that you baby isn’t getting enough to eat, call your doctor.

How Can I Increase My Milk Supply?

Your milk supply depends on how often you nurse or pump your breasts. The more you breastfeed or pump, the more milk your body makes. So, if you seem to be producing less milk than usual, nurse your baby more often. You also can pump after nursing to help stimulate more milk production.

Some things, like stress, illness, and some medicines, can temporarily lower your supply. But drinking plenty of water and eating nutritious foods can help. Also try to take some time for yourself each day, even if it’s only for 15–30 minutes.

If your baby is younger than 6 months old and you’re away from each other for long stretches during the day, pump or hand express every 3 hours to maintain your supply.

If your milk supply still seems low and you’re concerned, talk to your doctor or a lactation consultant.

If I Wait to Nurse, Will My Milk Supply Increase?

Actually, no — it’s the opposite. Waiting too long to nurse or pump can slowly reduce your milk supply. The more you delay nursing or pumping, the less milk your body will make. That’s because overfilled (engorged) breasts send a signal to your brain that you need to make less milk.

I’m Producing Too Much Milk. What Can I Do?

Some women may feel like they don’t have enough milk, while others may feel like they make too much. Some mothers’ bodies just make more milk than their babies need. Others overstimulate their breasts by pumping or expressing milk between feedings.

If you feel like you have too much milk, here are some ideas:

Alternate the breast that you start each feeding with. Let your baby stay at the first breast until either the breast is very soft or your baby is full. If your baby is not satisfied with the first breast, offer the second breast.
Try nursing on only one breast at each feeding, if possible. Over time, you may notice your milk supply and “let-down reflex” (the milk ejection reflex) get easier to handle.
If expressing or pumping to relieve discomfort, remove just enough to feel comfortable but don’t empty the breast completely.

If you’ve tried these things and you still have problems with too much milk, talk to your doctor or lactation consultant.

My Baby Nurses on Just One Breast. Will This Hurt My Supply?

Some babies will be satisfied after nursing from only one breast. Others might prefer one breast over the other. If your baby has only fed from one breast and you are comfortable at the end of a feeding, you don’t need to pump. But if either breast is still full and uncomfortable, pump or hand express to comfort.

To keep up your milk supply in both breasts (and to prevent painful engorgement), it’s best to alternate breasts, whether in the same feeding session or between different sessions. Remember to keep your baby on the first breast until it’s soft, and then move your baby to the second breast. This ensures that your little one gets the hindmilk, which is creamier and has more calories than the foremilk, which comes at the beginning of a feeding.

My Baby Is Sleeping Longer At Night. Will This Hurt My Supply?

When babies reach their birth weight and can sleep for longer stretches at night, the time between nighttime feedings gradually lengthens.

Letting your baby sleep for longer periods during the night won’t hurt your breastfeeding efforts. Your growing baby can take in more milk during the day — and that, in turn, means longer stretches of sleep at night. Your milk supply will adjust to the new routine.

If you wake during the night with full breasts and a sleeping baby, consider expressing or pumping for comfort to help your body adjust to the new schedule.

If you follow your baby’s cues and spread out the feedings, your milk supply should keep up with your baby’s needs.

Reviewed by: Jamila H. Richardson, BSN, RN, IBCLC

Date reviewed: January 2021

Article “Pumping – when and how?”

There are times in the life of mother and baby when breastfeeding is either impossible or difficult for some reason. For example, a child has to be left without a mother for several hours – which means that a supply of milk is needed for him. Or in the case when the baby sucks badly at the breast, but eats well from the bottle, and pumping is the only way to feed him.

This can happen if the baby is born prematurely, and the very process of sucking the mother’s breast turns out to be hard physical work for him – such an infant can also be offered expressed milk.

The same applies to the situation when the baby is ill and feeling unwell prevents him from fully sucking, as he is too weak to make the efforts necessary to “extract” breast milk. In this case, it should be expressed for 2 reasons: firstly, to provide the child with complete and optimal nutrition for him, and secondly, to maintain lactation.

Situations are different, so it is important to understand why pumping is necessary, how to do it correctly and what are the conditions for storing breast milk.

When and why to express?

Pumping is the process by which a nursing mother manually or with the help of a breast pump extracts milk from her breast.

This is not a mandatory procedure for everyone, and it does not need to be carried out after each feeding, since the milk in the female breast is formed exactly as much as is needed to saturate the baby at a certain age. Those. how much milk the baby ate in one feeding – so much will appear in the breast by the next.

But if, after applying, you also express the rest of the milk, then by the upcoming feeding it will be produced more than the child can eat – and this often leads to stagnation of milk (lactostasis).

Milk should be expressed when:

Having to bottle feed or supplement a baby for one reason or another. If at the same time the pediatrician did not forbid the baby to eat breast milk, then the mother needs to feed the baby expressed.
The baby is left without a mother for a long time. There are times when a woman needs to go away, and she cannot take the child with her. In this case, you can leave a supply of milk for several hours, after decanting it.
Mom is sick. It happens that during lactation a woman becomes seriously ill and is forced to take medications that penetrate into breast milk, which is strictly forbidden to give to a child. Medicines contained in milk, once in the child’s body, can have an adverse effect on it. To prevent this from happening, the pediatrician will help you choose the milk formula that you need to feed the baby during the mother’s illness. Pumping in such a situation will help a woman maintain lactation until recovery.
Mom goes to work. A mother’s return to work before the end of lactation can put her before a choice: transfer the baby to formula milk or feed it with expressed milk. Recently, more and more parents are choosing the latter option, since breast milk is much healthier than artificial nutrition.
Injured nipples. With improper care and attachment of the child to the breast, cracks may appear on the nipples. Feeding in this condition of the nipples becomes very painful for the mother, and then the baby should be briefly transferred to expressed milk from a bottle. This is useful because the nipples are less likely to get irritated when they are expressed than when they are sucked by an infant. In a few days, the nipples will heal, and it will be possible to resume feeding the crumbs directly from the breast.
There is a risk of lactostasis. A child, especially in the first days after birth, is not always able to suck out all the milk. To avoid lactostasis, mom needs to express excess milk. If this is not done in a timely manner, stagnation of milk can lead to inflammation of the mammary gland – mastitis. However, you must follow all the rules of pumping and do not resort to it after each feeding: this will only increase the flow of milk.
Not enough milk is produced. Pumping will help normalize lactation, as it leads to an increase in the production of milk in the breast, which can be useful during a lactation crisis.

5 pumping inhibitions

In order not to harm herself and not leave the baby without breast milk, the mother must know and be sure to follow the basic rules of pumping:

Do not express more than 3 times a day if pumping is combined with breastfeeding because this will lead to excess milk production. If the mother is sick and the baby is not applied to the breast, it is necessary to express with a frequency approximately equal to the number of feedings (on average, once every 3 hours – 8 times a day).
Do not express immediately after feeding, as this may lead to hyperlactation, ie. increased milk production.
Do not express “to the last drop”. The main indicator by the end of pumping should be a feeling of relief in the chest. The female body regards the emptying of the breast without a trace as an increased need for milk by the child – and begins to produce more milk, which the baby cannot eat, therefore, there will be a threat of milk stagnation.
Do not express during the night, as this may also lead to the formation of excess milk. The main hormone responsible for milk production – prolactin – has a daily rhythm of formation, most of all it is produced at night, in response to the baby sucking or pumping.
Do not express on the first day after the arrival of milk. Usually, when lactation begins, more milk is produced than the newborn needs, and it is necessary to get rid of its excess. Therefore, just at the time of the arrival of milk, you can not express everything without a trace. If the breast is very dense, then it is recommended to express only a small amount of milk so that it becomes softer and the baby can fully capture and eat it.

Substances that signal that milk is being produced in excess appear in the filled breast after about 1 day. If you express all the milk accumulated in the chest earlier than in a day, then it will be produced in the same amount.

Hand Expression Technique

There are two ways to express – manually and with a breast pump. Usually, each mother chooses the most convenient option for her. It is better to do it manually at home, when a woman has enough time, since the whole process will take some time. Breast pumps will help a working mother, which greatly facilitate the pumping process.

Rules for hand pumping

It is best to express milk 10-15 minutes after the end of feeding the baby. Wash your hands thoroughly beforehand. If you use any breast cream, wipe the skin and nipples with a cotton swab or pad soaked in breast milk. Prepare a wide-mouth milk container by first washing it under running water and then sterilizing it (by boiling, in a steam sterilizer or in a dishwasher).

Sit comfortably, keeping your back straight, because pumping can take some time, and an uncomfortable position can cause back pain.

Gently grasp the chest: the little finger is under the chest at the ribs, the remaining fingers are positioned so as to support the chest from below. The thumb lies on top, about 3-4 cm from the nipple. In this case, the thumb and forefinger are located opposite each other, forming the letter “C”.

Use your thumb and forefinger to gently press down on your chest and hold this position for a few seconds. In no case do not bring your fingers together, they should remain in the same position, the letter “C”.

Repeat pressing, moving the palm in a circle – this way you will use all the ducts of the mammary gland.

Be patient, milk may not come out immediately, but only after a while. If you are pumping for the first time, check with your doctor or lactation consultant beforehand to show you how to proceed.

Manual pumping errors

Do not squeeze the nipple: this way you will only hurt yourself and injure the breast, and you will not express milk fully.

Do not press the palm too tightly against the skin, moving the hand across the chest so that there is no irritation and microtrauma.

Do not give up at the first unsuccessful attempts, be patient.

Breast pumps

Breast pumps make pumping much easier, as they are designed to fit all the anatomical features of the female breast.

Which one to choose? Breast pumps are divided into mechanical and electrical. In the first case, the pumping process is carried out manually: by squeezing the “pear”, the woman starts the suction mechanism. Electric models are good because they work independently: from the mains or from batteries (batteries, accumulators) and do not require additional effort on the part of the woman.

Mom usually chooses a breast pump model according to her taste and financial capabilities. It should be borne in mind that devices powered by batteries lose power faster than devices powered by the mains.

Many women are confused by the fact that electric breast pumps are loud enough. To date, there are a large number of silent devices, which is recommended to pay attention to when buying. The most effective are electric breast pumps that express both breasts at the same time and have the option of adjusting the thrust force and suction speed.

When choosing a breast pump, pay attention to the presence of the “boil and sterilize” marking. There must be the possibility of such heat treatment of parts of the apparatus. If the model cannot be boiled and sterilized, it is better to refuse to purchase it and look for another one.

Rules for expressing with a breast pump

Before pumping for the first time, carefully read the instructions for the device. Check that it is properly assembled.

Sterilize the funnel and sump (boil or use a sterilizer).

Position the funnel so that the nipple is in the center of the funnel.

The draw should be the lowest, especially at first, until the breast is accustomed to expressing with a breast pump. Each breast must be pumped until a feeling of relief, add 2 minutes to this time. On average, the process will take about 15 minutes.

Pumping, like manual pumping, should be carried out some time after feeding.

Basic mistakes when expressing with a breast pump

Incorrect position of the funnel of the breast pump can cause pain to the woman. Remember: the nipple should be located strictly in the center of the funnel of the device.

Very long pumping. Do not exceed the time required to collect milk, this can lead to hyperlactation (production of excess milk).

Very strong traction. If your breast pump has a selectable thrust function, you should use the smallest one so as not to hurt your breasts.

Care of the breast pump. A breast pump, like any machine, needs proper care. It must not be clogged so as not to contaminate the milk.

Each model has a care instruction that you should definitely read before using the device.

When washing, always disassemble the pump completely, removing even the smallest parts. This will prevent stagnation of milk residues in them.

Before each use, sterilize all parts of the machine that come into contact with milk. This can be done with a sterilizer.

Milk defrosting

Never thaw or heat breast milk in a microwave oven. When heated in the microwave, the milk warms up unevenly, while feeding the baby can burn. Also, due to the rapid heating of frozen milk when using a microwave, most of the useful properties of this invaluable product are lost.

To defrost breast milk, place it on the refrigerator shelf, and when it becomes liquid, heat it up. To do this, lower the milk bottle into hot water or put it under hot water. Also, special heaters can be used to warm milk.

If you have questions or don’t know how to express, it’s worth talking to a specialist. The doctor will not only tell, but also show how to do it correctly, give recommendations on the pumping schedule and advise which method is better to choose.

Remember that milk is undoubtedly a valuable food for the baby, but feeding with expressed milk should be used in exceptional cases.

At the School of Moms, our doctors talk in detail not only about how and when to express milk correctly, but also about how to properly attach a baby to the breast, how to avoid common problems with breastfeeding, such as lactostasis, as well as the rules for self-examination mammary glands.

Questions for the pediatrician – articles from the specialists of the clinic “Mother and Child”

If after each feeding the breast is additionally pumped, then the body of a nursing woman receives incorrect information about how much milk needs to be produced, and produces more and more of it. As a result, pumping “leftovers” can turn into a continuous process

Doctors recommend feeding the newborn on demand, in this mode, he eats the amount of milk he needs. By the next feeding, the required amount comes again, and no pumping is necessary

A breast pump can be an indispensable tool in some situations. For example, the child categorically refuses to breastfeed, the mother needs to be away for a long time, the baby is not yet able to breastfeed (premature)

WHAT HAPPENED BEFORE

Previously, a nursing mother was advised to express her breast after each feeding, otherwise there will be excess milk, lactostasis and mastitis, and besides, it was believed that pumping contributes to the production of milk and the baby certainly will not remain hungry. Yes, pumping increased the amount of milk, but this did not take into account the fact that the mother’s breast adapts to the needs of the baby – and produces milk exactly as much as the baby sucks. It is now known that if after each feeding the breast is additionally expressed, then the body of a nursing woman receives incorrect information about how much milk needs to be produced, and produces more and more of it. As a result, pumping “leftovers” can turn into a continuous process: with each pumping, milk comes in, the baby cannot completely suck it out, the mother has to express the leftovers, and by the next feeding the milk again comes in excess. What’s wrong here? Excess milk is a direct road to its stagnation (lactostasis), and a woman is forced to constantly express her breasts. It turns out a kind of vicious circle.

WHAT THEY ARE SAYING NOW

Today, doctors recommend feeding a newborn on demand, in this mode, he eats the amount of milk he needs. By the next feeding, the required amount comes again, and no pumping is necessary. Yes, there will be periods of growth of the child when he needs more milk than before, but the baby will regulate this process on his own. At some point, the baby will begin to suck harder and ask for the breast more often than before. At first, it will seem to the mother that there is not enough milk, but in a couple of days everything will stabilize, the milk will begin to come in the right (larger) amount and no pumping, let alone supplementary feeding, will be required.

WHEN TO PUSH

So pumping is not necessary at all? Most often yes, but still there are some situations when you simply cannot do without it. When pumping is needed:

1. If the baby is premature or weak, he cannot breastfeed on his own yet and must be bottle fed.

2. If the mother has a very strong flow of milk, incipient mastitis or the first signs of lactostasis. In general, with a strong rush of milk and lactostasis, it is recommended to apply the baby to the breast more often, but if this does not help, then the breast will have to be expressed.

3. If there is not enough milk, but only if it really is, and not “I think so” or “my mother-in-law said that I have little milk and I need to pump”.

4. If it is necessary to part with the baby for a while, but at the same time you want to keep lactation.

5. If a breastfeeding mother falls ill and is prescribed medications that are incompatible with breastfeeding.

HOW IT WORKS

If you still need to express your breasts, you can do it by hand or with a breast pump. The advantage of manual pumping is that there are no material costs, but, perhaps, this is all its advantages. There are many more disadvantages: not all mothers know how to express their breasts correctly (even after looking at the instructions). And most importantly, manual pumping is not as effective as mechanical pumping, and in general is often unpleasant and even painful. But expressing breasts with a breast pump is much more convenient: it quickly helps to express a significant amount of milk, saves time and effort and does not cause pain. And there is only one minus – it costs money.

HOW TO CHOOSE A BREAST PUMP

· Do not rely on the opinions of friends and reviews on the Internet: like someone else’s breasts, it is impossible to try on someone else’s pumping experience.

· Examine the breast pump model carefully. For a device already purchased or donated, the size of the funnel, the intensity of pumping, the shape of the handle, the number of parts, the noise level may not be suitable.

· The more often you plan to pump, the more advanced and versatile you need.

· Strictly follow the instructions supplied with the appliance. Remember to sterilize your breast pump before each use and keep it clean.

· Don’t get carried away: if you use it too intensively, there is a risk of hyperlactation – more and more milk will be produced, and as a result, pumping will be endless.

WHY THE PROBLEMS HAPPEN

0221 to for more effect. There may be several explanations for this.