PUMPING SCHEDULES

Once you’ve sorted out which pump you’re going to use, and set yourself up, you now need to figure out when to pump and how long for.

 

The short answer

👍 A schedule can be good for making sure you pump enough to build or sustain your supply

😟 But a schedule can also stress you out

⏱️ Start with a ‘Base Schedule’ and adapt from there

👩🏾‍🔬 We can’t find published research on pumping schedules. Have you?

👩‍⚕️ Ask your lactation consultant or doctor for help

 

What is in this article?

We have built you some base schedules that you can adapt for all sorts of scenarios for pumping, including: 

  • Inducing labor
  • Initiating or establishing supply (newborn)
  • Maintaining supply (about 3 months +)
  • Starting your baby on solids (5-7 months)
  • Weaning
  • Re-lactating
  • Starting lactating when you haven’t been pregnant
  • Increasing supply or power pumping
  • Building a stash
  • Returning to work
  • Pumping and dumping

Firstly, what is a pump schedule?

A pump schedule is just a routine you follow for pumping.

It can be as simple as a set of times each day that fit into your life, including other children, work, and your sleep patterns (if you still have those!).

Why have a schedule?

Your body’s ability to create breastmilk is all about supply and demand.

You need to ‘remove’ milk from your breast to create more milk. You can remove milk by expressing with your hand or a pump, or by feeding your baby directly at the breast.

Schedules can be a simple way of making sure that you consistently remove milk, which will help you settle into a rhythm of producing milk.

Your schedule will need to change over time, depending on your baby’s age and your feeding goals. For example, if you find yourself pumping to initiate or build lactation (those first few days and weeks post birth), you will need to be pumping often and consistently to remove milk. If your baby is starting solids, you can space your pumps out a bit.

You can choose to follow a strict schedule if that helps you. You can also simply pump when you feel like it, or when your baby is hungry.

However you choose to schedule your pumping sessions, it can help to keep the following principles in mind:

  1. You need to ‘remove’ milk from your breast to create more milk. The more you pump, the more milk you will make and vice versa.
  2. Every breast and baby is different, but if you’re pumping for all your baby’s milk, and your baby isn’t having solids or other milk or supplements, then you’ll need to be pumping about 2-3 hours in total per day.
  3. There are two things you can vary in your schedule: the number of times you pump and the length of time you pump. For example, while you are establishing your supply with a newborn, you might pump 8-10 times a day for about 20 minutes. For an older baby, you might drop a few pump sessions to 6-8 times but pump for longer each time.
  4. If feeding isn’t going too well for you, seek advice from a lactation consultant, preferably one with pumping experience and insight. They should be able to approach your situation holistically, and help you create a schedule that fits into your life and needs. 

Why not have a schedule?

Here are some problems with pump schedules:

  1. Schedules can be unrealistic A 2 or 3-hour pump schedule (often required in the first few weeks to establish supply) can be tough to actually do. Many people find that the continuous pumping, feeding, settling, cleaning, and sleeping, especially without support, is too hard to sustain. 
  2. Schedules can stress you out Schedules can be rigid, and you can find yourself in a mental pump spiral (we made that term up) if you miss a pump, or don’t keep to time. Often if you’re on a schedule, you’re also logging the time, the volume for each breast, type of milk you fed the baby (expressed milk, supplement, milk directly from breast). For some people, this structure brings comfort, and it can be good to see numbers start to look the way you want. For others, this structure just introduces more stress, especially if you’re trending away from your goal.
  3. Babies don’t follow schedules Babies cluster-feed, have growth spurts and go through changes in their feeding patterns. This article from Emma Pickett IBCLC for UNICEF, talks you through all the reasons why schedules aren’t great to follow for breastfeeding a baby directly. It follows that pumping schedules may not be great to follow either.

If a schedule is not working for you, then you could simply pump when your baby gets hungry or when you’re feeding them. If you can stay one or two feeds ahead, you will have a bottle available of previously pumped milk to give them, and you can pump the next bottle while they’re feeding.

This method is much easier if you have help, so that someone else feeds your baby while you pump.

The Milkdrop Base schedules

Here are some schedules based on the number of times you are pumping per day. You can use these as a starting point for developing a schedule that works for you.

Choose the number of sessions you need to pump per day (speak with your lactation consultant if you’re unsure), and start your session whenever there is a red dot.

☝️ This is a base schedule that you can start with.

Remember to change it to suit you!

These base schedules are focused on:

  1. Getting you one straight stretch of sleep. If you’re not finding sleep an issue (🎉 yay you!), then you might want to make your sessions more regular, rather than spacing them apart at night.
  2. Clustering pump sessions in the morning, when many people find they have more milk available. If this isn’t you, then change them up to suit.
  3. Spacing out your sessions as evenly as possible.

You can use them as a start, but adapt as you learn what works best for you.

You might be wondering…

How many sessions should I pump per day?

The number of times you pump will depend on your baby’s age, your reason for pumping, amount of support you have and your mental and physical health.

Typically, people tend to start with 8-10x sessions for a newborn, and reduce over time as your baby grows, starts solids, and eventually weans. You can add sessions if you’re trying to increase supply, and you can reduce sessions if you’re trying to reduce your supply.

For example, if you have a newborn and you have support, you might start at 10x sessions per day. Once your supply regulates, after several weeks or even months, you might drop another session or two. When you baby starts solids, you might reduce to 5x per day. If you return to work, you might reduce to 2-4x per day. And then when you wean, then you’re heading down past 1x to …eventually, 0x.

How long should I pump each session?

There doesn’t seem to be a referenced or consistent recommended length of time for a pump session.

Some people suggest 15 minutes, others suggest 30. Some recommend pumping in total 120 minutes a day, others up to 240 minutes. Some suggest you pump until your milk starts to slow or stop. Others suggest that you pump past that point to try to get a second letdown.

All this conflict can be, well, conflicting.

We suggest starting by choosing the total amount you think you can spend pumping in a day based on your support situation, and work backwards. If you’re pumping to initiate supply, and you have good support, then you might be able to sustain 180 minutes per day, and 10 sessions. This means each session should be just under 20 minutes.

Use that as a starting point, and then adjust your sessions based on how your breasts seem to be behaving. For example, if it only takes you 5 minutes to get your milk out, and nothing is happening for the next 15 minutes, then just stick with 5 minutes. If you find that you feel like you have more left in the morning after 20 minutes, then perhaps make the morning sessions longer. If you can’t get through the night without discomfort from full breasts, pump more at night. 

If you are dropping the number of sessions, you might consider increasing the length of each session so that you’re pumping the same amount in total each day.

Remember, your breasts may be different. They’re sisters, not twins. Plenty of people have one large breast, which produces most of the volume, and another which is a little more relaxed.

What if I’m nursing as well as pumping?

Many people mixed feed, meaning that they do a combination of nursing and pumping, and supplementing with formula too. You can use the schedules here in these situations, by simply replacing a pump session with a nursing or bottle-feeding session.

**warning: be aware that feeding a baby directly at the breast is different from pumping. Where a schedule might help you with pumping, it is not necessarily the best thing to be doing if your goal is to nurse at the breast more. This article from Emma Pickett IBCLC for UNICEF, talks you through all the reasons why schedules aren’t great to follow for breastfeeding a baby directly.

If you find yourself on the pump, but you’d prefer to be feeding at the breast, then try to find a lactation consultant who can help you.

Where can I find an evidence-based schedule?

As far as we can tell, there is no published research on pumping schedules.

There is research on pump settings, and even the effect on milk volumes from pumping both or one breast at once, and there is also research on how schedules affect feeding directly at the breast. However, most research that mentions pumping schedules is usually talking about the challenges that people have returning to work, and being able to schedule in regular feeds, rather than the effectiveness of schedules themselves.

🤷🏼‍♀️ Do you know of any research in this area, we’d love to hear from you!

So to answer your questions about when, how often, and how long to pump for, we have trawled the forums and websites, and compiled their advice and practical tips into one spot.

These schedules were developed after looking at various forum comments from people who have exclusively pumped for some time, personal experience, and recommendations from private-practice lactation consultants.

We are not lactation consultants or doctors here at Milkdrop. But we do help women with pumping comfortably, having experienced it ourselves. Please see your lactation consultant or doctor for advice for you and your situation.

Building your own schedule

Your body goes through enormous change to produce milk, especially immediately after birth as you initiate lactation and build your volume. As you settle into a feeding pattern, your baby will be the cause of the change, first by starting solids, then eventually when you wean.

In this section, we talk about how you might adjust your base schedule as you go through these changes.

Inducing labor

We’ve put this first, because it’s the earliest point that you might start pumping. It’s also a really common question asked in forums.

In short, nipple stimulation can cause the womb to contract, possibly due to increased oxytocin. However, a review of studies looking at this recommended that it not be used in high-risk pregnancies and that more research was required to assess its safety.

Because pumping to induce labor is something that you really need medical advice and possibly even supervision for, we haven’t included a schedule for it, but you can read more about the practise here.

Initiating or establishing supply (newborn)

You may find yourself on a pump in the first hours or days after birth. This might be by choice or might be because you’re having trouble feeding directly at the breast.

These first few days are critical for setting up your supply. You will need to be pumping often and consistently to remove milk from your breasts.

You will likely need to be pumping 8 to 10 times per day, for at least 15 minutes per pump, totalling 2 to 3 hours. Some clinicians advocate for even longer time on the pump for this period, to establish supply, or even build over-supply if you want to.

Although there doesn't seem to be research comparing outcomes for the number of pumping sessions, there is some research on comparing outcomes from the number of nursing sessions. One study compared two groups of mothers who nursed for the same amount of total time each day (137-138 minutes). They found that the group who nursed more often (10x per day) but for shorter lengths (about 14 minutes average), had babies with more weight gain at Day 15, than the group who nursed fewer sessions (7x per day) but for longer durations (about 20 minutes average). By day 30 though, there was no significant difference.

Given this is such a critical period, it is worth seeking advice from a lactation consultant to develop a schedule that works for you.

If your goal is to feed directly at the breast, rather than to exclusively pump, then this is particularly important. Some research suggests that very early use of breast pumps may affect breastfeeding rates at 6 months.

Maintaining supply (about 3 months +)

Once your body is creating the level of milk you’re happy with, and your supply has regulated, you can start to drop pumping sessions.

Remember, that as you reduce frequency of pumping or nursing, your prolactin levels will decrease, and you may see a change in the volumes that you express - every body and every breast is different! Take a little extra notice of your volumes when you drop a session, and adjust accordingly.

Things you can change up:

  • Your session time. You may need to lengthen each pumping session. For example, at 3 months, you might drop down to 7x sessions per day. If you add a few minutes extra to each session, even though there are fewer sessions, you’d still be pumping for the same time each day.
  • The particular pump session that you drop. You may find that dropping the early morning pump reduces your overall volume too much, but dropping an afternoon session pump doesn’t.

When you drop a session, you want to try to avoid any issues that you can get from not effectively removing milk from your breast. You may have heard of blocked ducts, lumps, milk stasis (stagnant milk in your ducts), inflammation or infection. Some people say they’ve had issues with these from dropping sessions abruptly. And one study from 2016 mentioned that that dropping pumping sessions (their study participant didn’t pump over a weekend), may have caused milk stasis due to irregular breast emptying.

In the schedule above, you can see that the session times change each time you drop a pump. If you like your current pumping session times, and just want to drop one session entirely without changing your whole schedule, you could just gradually reduce the time or volume that you pump over a week or two.

All of this comes with a big caveat: milk volumes are highly variable and dependent on many factors. Try to focus on whether your baby seems satisfied and is hydrated with the volumes you’re giving them after the change.

Starting your baby on solids (5-7 months)

Once your baby starts solids, around 5-7 months (depending on where you get your advice), you might start to drop more sessions. You might find that 4x sessions per day works best for you, but that each session is quite long.

You will know your body well by this point, and you probably will have developed tricks for really getting the most out of each session.

In the best case scenario, you can stay with this level of pumping as long as you choose to feed breastmilk to your baby.

Weaning

The last big change to your schedule is when you start to wean.

To do this, slowly work your way down the number of sessions per day.

Why slowly? To try to avoid any issues associated with not removing milk from your breast effectively, such as milk statis, blocked ducts, inflammation or infection.

You may wean after your baby has fully transitioned to solids. If it happens before that, then you will need to supplement your reduced breast milk with donated milk or formula.

Re-lactating

It is possible to re-start breast pumping even if you have weaned.

Sometimes you may stop feeding due to sickness, or you felt you or your baby was ready. Sometimes you have second thoughts about weaning.

To re-establish lactation, you may need some medication, and you will likely need to start back on a high number of pumping sessions per day.

Seek advice from your doctor and lactation consultant. There are doctors out there who are also IBCLC certified, who would offer excellent support for this.

Starting lactating when you haven’t been pregnant

Rather wonderfully, it isn’t necessary to be the gestational mother to your baby to breastfeed.

There are some incredible case studies of people who have successfully induced lactation. In 1999, a woman and her doctor developed a protocol for establishing milk supply in preparation for her son who was born via surrogacy. Their protocol involves taking medication from six months before the baby arrives and starting to pump six weeks before the baby arrives. The pump schedule is three-hourly for 5 to 7 minutes per side, and continues after the baby arrives. They do have an accelerated protocol.

Since it involves a few types of medication, seek advice and support from your doctor and lactation consultant. There are doctors out there who are also IBCLC certified, who would offer excellent support for this.

Increasing supply or power pumping

You may be turning to your pump to try to increase your supply.

As you know, your body should create more milk when you remove more milk.

To remove more milk you need to either:

  • increase the number of sessions you pump
  • increase the time you pump each session
  • make your sessions more effective at removing milk

There are studies that show that more frequent nursing (10x per day) resulted in more weight gain for babies at Day 15, than less frequent nursing (7x per day), even though the total time nursing was the same (137-138 minutes). So it may be that you choose to increase the number of sessions if you can, rather than just increase the time you pump. Again, we don't know if this translates to pumping, as opposed to nursing, so we are stuck with trial and error!

Power pumping

Some people feel that they can stimulate more milk by ‘Power Pumping’.

The idea is that you mimic a baby’s “cluster-feeding”, by pumping frequently over a short period of time. Again, we haven’t been able to find research supporting the effectiveness of this or any guidance on the timings, but there are plenty of comments swearing by this on the forums.

To do this, choose a 1.5 hours a day, perhaps over a week, where you can follow this routine, or something similar:

  • 20 minute pump
  • 20 minute rest
  • 10 minute pump
  • 10 minute rest
  • 20 minute pump

If you’re trying to increase your supply, and you’re mixed feeding, some people suggest pumping after you have nursed.

Building a stash

You may like to ‘build a stash’ of milk that you can keep in your fridge or freezer.

It might give you comfort to know that there will be milk available if you get sick or need to go away. Or you might want to build in preparation for going to work or travel.

In theory, it’s simple to build a stash. You add in one or two extra pumps on top of your current schedule and watch your freezer bags grow.

In practice, it can be tricky to do it well without getting yourself into a quagmire.

How? If you build up a stash too large, you will need to use it (if you don’t want to throw it out). Every time your baby is fed thawed milk, you will either need to replace it with a pump session or expect your supply to reduce. If you are pumping to replace that thawed milk feed, then your fresh milk will need to be refrigerated or frozen. The extra thawing, cleaning, organising, and fast diminishing freezer space can take time, expense and mental load.

If you don’t pump to replace that feed (this is especially common when you return to work because you get held up), then your supply will decrease. This is fine if you wanted it to, but don’t get caught out if you don’t!

To avoid this, aim for having as few extra (1 - 2) feeds as possible stored at a time. If you’re away from your baby for work or other reasons, aim to have only as much as they’ll need until they see you next.

There is also the option to donate your milk to a local milk bank. There are usually strict requirements for this, so it's best to check ahead of time.

Returning to work

Heading back to work is possibly the biggest disrupter to your feeding journey.

It really is a huge topic, worthy of its own book (or two), but here are the highlights of pump schedules for work:

  • If you want to keep your supply the same, you will need to keep removing about the same milk from your breasts. To do this you might shift around some sessions to cluster outside your work hours. You could also increase your duration for those sessions.
  • If you are ok with reducing your supply, then you can gradually reduce the number of pump sessions that you’d need at work. If you still wanted to provide your baby breast milk, you could draw on a previous stash while you let your supply fall.

As for schedules, a good method we have seen is to pump the next workday’s feed today. So on Monday you pump for Tuesday, on Tuesday you pump for Wednesday. This way, to prepare for returning to work, all you need is one workday’s worth of milk, plus an extra just in case. Then each day your baby’s carer simply takes yesterday’s milk, which you replace when you get home or send with them to daycare.

Some other notes on pumping schedules at work:

  • Setting and sticking to a schedule while at work is hard. You get busy, your workplace, job itself or workmates may not be that supportive, your pump setup and cleaning session may take longer than you think because it all has to be portable, or you may simply find it hard to get milk flowing when your baby isn’t there.
  • Consider your pump type. One interesting recent study, surveyed over 500 doctors who pumped when they returned to work. They found that using wearable pumps (as opposed to traditional pumps) was correlated with having shorter lactation breaks (presumably because they were pumping while working), and also with being able to provide their baby with milk for as long as they had planned to. This doesn’t necessarily mean that a wearable pump is the way to go for you, but it could be worth considering.

Pumping when you return to work is such a huge topic that we’ve just kept it brief here and have given it its very own chapter, which you can skip to here

Pumping and dumping

Pump and Dump is a popular concept out there. Probably because it rhymes.

The idea is that you can ‘pump’ your breast milk and then ‘dump’ it out. Some people do this if they have an alcoholic drink or take certain medication.

The contentious part about pump and dump is that it is not always necessary, and sometimes pumping and dumping can affect your breastfeeding journey. For example, if you have trouble with supply.

We will expand this section with a review and links to the literature.

For now, contact your lactation consultant or doctor, or InfantRisk with questions.