Question: Hi. I’ve read most of your blogs on breastfeeding and first, thank you so much. We’ve had a rough start and my baby was in the NICU for a few weeks so I had to pump. But when she came home, I stopped pumping because I had read somewhere that you said pumping does not increase your supply. However, the nurses in the hospital said I need to keep pumping to keep up my supply because the baby won’t suck effectively. What’s your advice?
First of all, you’re welcome and I’m glad you’re breastfeeding your baby.
You’re right. I frequently advise mothers not to pump until their supply is well established. One of the key factors in increasing supply is the effective removal of breastmilk. A pump does not do as good of a job as a baby and so consequently, mothers who go on a pumping spree right after delivery to build that sacred stash, often find their supply dwindling and can’t figure out why. It takes time for your body and your baby to adjust to making milk, and so as a general rule of thumb, when all other factors are equal, it is better to wait until your supply is well established and is meeting the needs of your baby on demand before you start pumping. When you do start pumping to build the stash, you should choose one or two times during the day rather than after every session.
However, I already know that your case is not the typical case because your baby was in the NICU. I also cannot answer your question entirely because the reason that the baby was in the NICU is pretty critical. Here are a few general guidelines:
1) The way to tell whether or not baby is getting enough is that he/she should have about 8 or more wet diapers per day. Chances are good that you instinctively know whether or not your baby is hungry–so follow his cues and your instincts.
2) Preemies, frequently lack the ability to suck well. All my rules about no pacifiers, bottles, etc. go out the window when you’re dealing with a preemie. In fact, pacifiers can be really helpful in teaching preemies to suck and are a necessary step in the breastfeeding relationship.
3) Do not rely on a pump to build your supply IF your baby is able to suck. Instead, you can take a galactagogue, and nurse the baby on demand–not letting more than 2-3 hours pass without a feeding–around the clock for a few days. You can also use an SNS so the baby doesn’t have to take any more bottles if supplements are still necessary.
4) If you need to pump, use a hospital grade electric pump. Also, most women are most successful pumping, first thing in the morning.
Also remember, everyone is different. I highly recommend that if you are determined to breastfeed and are struggling that you go see an IBCLC who will be better able to assess your situation in person.
Have you seen the Breastfeeding Index from 2007? It lists all of my articles on breastfeeding. Also, you can ask questions in this thread in the forums.