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.
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.
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.
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!
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.