Breastfeeding in the Early Days: To Pump or Not to Pump?

This topic is something that I’ve wanted to touch on for quite a while now! I’m really excited to dig in and talk a lot more about when to pump (or to not pump) in those early hospital days. Because I work in the hospital currently, I feel like I encounter a lot of parents asking me about their breast pump or about pumping in general. Because I was a mother before I became a lactation consultant, I’m in a lot of Mom Facebook groups that also discuss pumping. The mothers in those either have very positive things or very negative things to say regarding pumping. In this post, I’m going to really do my best to educate y’all on this somewhat controversial topic. Enjoy!

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In my breastfeeding experience with my first baby, I began pumping very early on. I started pumping on postpartum day 1. I never discussed this decision with my lactation consultant or postpartum nurse, I just packed my breast pump in my hospital bag and began pumping one afternoon because “why not?”. If you read my post, you’ll know that I was engorged and had an oversupply and that caused an overactive letdown. My baby was gaining weight appropriately but had really weird poops. She showed signs of fussiness after my letdown. Breastfeeding was a little bit stressful. When my lactation consultant found out that I began pumping so early, she was puzzled. She questioned my decision to start pumping. When I told her that I just did it on a whim, she told me to stop ASAP. With her education, tips, and tricks, my supply stabilized to an appropriate amount for my baby. This made breastfeeding way easier and way more enjoyable.

Pumping in the early days of breastfeeding isn’t necessary for everybody

BUT it might be necessary for some people. As I creep on several Facebook breastfeeding groups, I see so many experienced mothers telling new mothers they don’t need to pump. Even though their lactation consultant or healthcare professional told them that they should. Now, I can’t defend every lactation consultant because I know that some definitely aren’t as good as others. I will just say that if someone gives you advice or education, you must do your research on that topic for yourself. As helpful as Facebook mom groups are, they can also be unintentionally misleading. The people that are helping you online don’t also have your complete medical history. Every duo is different. What works for one breastfeeding parent may not biologically work for another.

So, the real question that I really need to get to is:

When is a good time to start pumping in the hospital?

Here are the occasions when pumping in the early days makes sense:

• Your baby is going to be away from you
  (ex: in the NICU, staying in the nursery overnight, gone for a procedure). Anytime your baby is not there to stimulate your breasts to make milk, you need to create that stimulation with the breast pump.
• Your baby isn’t feeding well at the breast.
  This includes infants that aren’t transferring milk well due to oral anatomy restrictions, infants that are extremely lethargic past the 24 hour mark, infants that are in pain or have experienced painful stimuli after birth or procedure, or infants that are pre-term or late preterm.
• You’re using a nipple shield.
  Okay hear me out on this one because whew, I’ve mentally gone back and forth on this topic. Long story short, after reading several articles of literature and discussing this with very seasoned LCs, it makes sense. In the beginning days, while your supply is being based on your demand, pumping while using a nipple shield can be essential for establishing a sufficient milk supply. Every situation is different though, obviously.
• If you’re supplementing with formula
  I’ve seen it called the Formula “Booby Trap”. It is basically when you’re breastfeeding and “topping off” the feedings with formula. This creates a never ending loop of the baby getting her needs from both breast and the bottle. Because you aren’t stimulating and baby is still feeding, you aren’t telling your body to make milk to meet baby’s demands.
• You are at risk for low milk supply.
  This includes a maternal history of low milk supply and/or issues such as insufficient glandular tissue or a family history of low milk supply.
• You have had breast reduction surgery or any breast surgery affecting the areola.
   Early pumping can increase stimulation and potentially enhance your supply in the long run. Please refer to the Breastfeeding After Reduction website for more information.
• You plan to exclusively pump long term.
  I plan to discuss exclusive pumping more in depth later. If you plan to exclusively pump, which a lot of women do, then starting in the hospital is extremely beneficial.

Things to remember if you do decide to pump in the early days:

• If you are pumping for stimulation, remember that it is just for stimulation.
• The first couple of times that you pump, you may not see a lot of colostrum collected. THAT’S OKAY! Please don’t let it discourage you from pumping.
• I can’t say this for everyone but a majority of the women pumping will not fill the bottle with colostrum. I personally believe that the size of the bottle can also be very discouraging, giving unrealistic expectations of what we ShOuLd be making.
• If you’re pumping to relieve the pain of engorgement, pump for relief only. Don’t completely empty the breast at this time. Pump a little, then let the infant empty the breast.

I hope this post offered a little clarity on when to pump while in the hospital!

Did you pump while in the hospital or no? Comment below if you had a pumping experience during your initial postpartum days!