Do You Have To Pump If You Plan To Breastfeed?

I’ll never forget those first few nights with my breast pump: 3 in the morning, tiny baby awake for what felt like 24 hours a day, recovering from a scheduled C-section at 37 weeks. My milk still hadn’t totally come in yet, and my kind-hearted pediatrician’s words were ringing in my ears, “You gotta pump.”

“How often do I have to pump?” I asked.

“Every 3 hours, all night, if you want to boost your supply,” she replied.

I think I cried. I cried a lot during those early weeks, so that’s not all that newsworthy. But the knowledge that I would have to wake up to pump even when my daughter was (finally) sleeping was somewhat shocking. You mean I will have to sleep even less than I already do? When I look back on those long first nights, I mostly remember sitting on the living room floor, slightly lost and more than a little overwhelmed, with a pump attached to me. Who could ever forget the sound of that thing?

The good news is a few weeks later, my supply finally came in, meaning I would no longer have to pump to boost production. However, there are several other reasons why new parents might want to — or have to — use a breast pump. Here are some of the most common scenarios where a pump might be your secret to breastfeeding success.

Reasons to pump breast milk

You’re going back to work.

For most new moms, the decision to pump is made more out of necessity than anything else. More than half of American women (55%) go back to work when their child is an infant, and most return within the first three months after giving birth, according to a study published in March 2020 in Safety and Health at Work.

“Almost everyone going back to work, if their goal is to continue to exclusively breastfeed and not to introduce formula or slowly wean, will probably need to stimulate their breasts once every three hours with a pump,” says Ayelet Kaznelson, an International Board Certified Lactation Consultant based in New York City who has worked with over 10,000 breastfeeding parents over the past 23 years. So, if you are going back to work and you would like to continue to breastfeed (especially if you’d like to exclusively breastfeed), you will almost definitely have to pump.

You plan to be away from your baby for more than three hours.

“Even if my clients are not going back to work, I ask them if they plan to give a bottle sometime within the first year of the baby’s life,” says Kaznelson.

If you plan on being away from your baby for longer than three hours at any point (e.g., if you want to go out for an appointment, a date night, or even just have some much-needed time for yourself) and you want to offer breast milk when you’re gone and have someone else feed it to your baby, Kaznelson recommends starting to pump when your baby is between 4 and 6 weeks old and introducing a bottle. In this scenario, you could even just do an occasional pump twice a week, once a day or every other day, depending on your individual needs and preference, she says.

You need to boost your supply

If a breastfeeding parent is dealing with low milk production (not making enough milk for their baby’s needs), pumping can help increase supply. “Standard protocol is to pump once every 3 hours — about eight times a day — for 15 to 20 minutes using a hospital-grade pump,” says Kaznelson. Hospital-grade breast pumps can usually be rented or even obtained for free with certain health insurance plans.

You want to maintain your supply

Pumping needs vary depending on your work schedule and breastfeeding goals, and whether you plan to supplement or combo-feed with formula. Some breastfeeding parents opt not to pump during the work day and instead breastfeed mornings, evenings, and weekends, supplementing with formula when needed, says Kaznelson. Some pump a little extra milk in the mornings or evenings after they feed and/or before bed. But the downside to skipping a pumping session when you’re away from your baby (or not pumping at all) is if you’re not stimulating your breasts every three hours, your milk production may start to go down, meaning you may not be able to breastfeed for as long as you planned.

“[Breastfeeding parents] need to understand what may happen,” Kaznelson explains. “They need to know there is a risk for breastfeeding to be negatively impacted if they don’t pump at all while away from their babies.”

You want to create a reserve or “freezer stash.”

Some breastfeeding parents pump while they are on maternity leave, creating a reserve that they can rely on when they go back to work. This way, if they don’t want to pump or can’t pump when returning to work, they may still be able to provide their baby with breast milk for a longer period of time. (While starting to pump at four to six weeks to build a reserve or a “freezer stash” can be beneficial, especially if you’re going back to work, there is no need to over-pump or pump for the sake of pumping, which can even lead to a painful oversupply.)

“I’ve had moms that were able to use this reserve and didn’t have to give formula at all or not for a while,” says Kaznelson. “Some will use formula during the day because production goes down if you’re not pumping.” Any amount of breast milk is beneficial to infants, even if they are not exclusively receiving breast milk, the Centers for Disease Control and Prevention (CDC) notes.

The benefits of delaying pumping

Think you have to start pumping as soon as your baby is born? On the contrary. In many cases, it’s more beneficial to get into a “groove with nursing” before beginning to pump, advises Leigh Anne O’Connor, a New York City-based international board-certified lactation consultant with more than two decades of experience working with breastfeeding families. “It’s good to get into a rhythm and build trust in the process,” she says.

However, waiting to pump is not always possible. There might be latching issues, or you might be pumping to boost your supply (especially if your baby’s weight gain or intake are concerns), or you might be separated from your baby in the neonatal intensive care unit (NICU). These situations might necessitate immediate pumping and possibly storing milk.

When to start pumping

When possible, Kaznelson also recommends waiting about four to six weeks to start pumping, but if you ever want your baby to take a bottle, don’t wait much longer than that.

“You want to have the bottle as part of your baby’s vocabulary,” she advises. “If you want your baby to be able to take a bottle and not refuse it, you want to start giving it somewhere between four and six weeks.”

Pumping is always a personal choice

If you choose not to pump or breastfeed at all, that’s OK, too. A fed baby is a happy baby, and whether you pump or don’t pump, exclusively breastfeed or supplement with formula, Kaznelson recommends taking it day by day, rather than worrying about making it to the recommended six months or longer.

“During the first few days and first few weeks, you are exhausted and overwhelmed, especially with your first child … you are figuring out what it means to be a parent and feeding a baby. Why don’t we not think about six months of exclusivity … why don’t we just take it one day at a time?”

Experts

Ayelet Kaznelson, IBCLC, a NYC-based lactation consultant

Leigh Anne O’Connor, IBCLC, a NYC-based lactation consultant