There is no doubt that breastmilk is nature’s perfect nourishment for your little bundle of joy. Breastmilk follows the laws of supply and demand, the more you express, the more your body produces. How much milk you make and how long it takes to mostly empty your breast can vary from person to person. Once you’ve established your milk supply, the key to maintain it is to mostly empty your breasts (I say mostly empty breasts because you never truly empty your breasts), each time you express. Doing this cues your body to make more, whether you are nursing, pumping and bottle-feeding.
Whether you choose to breastfeed exclusively, pump and bottle feed exclusively, or explore a combination of nursing, pumping and bottle-feeding, consider this your cheat sheet to make your pumping and breastfeeding journey much easier.
Benefits of Breastmilk
Let’s talk about breastmilk, nature’s finest – if you can figure it out.
- Breastmilk helps protect against infection and illness.
- Breastmilk contains omega-3 fatty acids like DHA that may help your baby’s brain and eyes develop.
- Breastmilk is usually always readily available.
- Breastmilk changes as your baby grows. So, baby gets exactly what is needed at every stage of development.
Reasons for Pumping and Bottle-feeding
- You simply do not want to breastfeed.
- Your baby is premature and is in the NICU.
- You have multiples (twins, triplets, etc.).
- Baby has difficulty latching.
- You’re returning to work or school.
- You prefer to see how much milk baby is actually getting.
- Breastfeeding is painful because your baby thinks your nipples are chew toys.
- Your partner wants to get in on the feeding action.
- You want to maintain milk supply even when away from baby.
Your Breast Pump Shopping Guide
If you choose to pump, there are different types of breast pumps available. The best pump for you depends on your situation and how frequently you plan to pump. You may want to wait until after baby is born to buy a pump, as you will have a better understanding of your needs. Let’s break it down into simple terms:
Multi-user or Hospital grade pump
Hospital grade pumps are great for daily use. They are very helpful in increasing, establishing, and maintaining milk supply in a way that a home pump may not be adequate for. Hospital grade pumps are highly durable and can be used daily and frequently over many years.
Perfect for moms of preemies or multiples, if there is a separation between mama and baby (like a NICU stay), or moms with milk supply concerns. Rent a hospital grade pump either from a hospital or a medical supply company, as they can be quite expensive.
Examples: Medela Symphony, Ameda Platinum, Spectra S3.
Double electric pump
Double electric pumps the closest you can get to hospital grade pump. They are also great for daily use. Double electric pumps are also very helpful in increasing or establishing milk supply. They are perfect for moms nursing multiples or mamas who plan to exclusively pump, these pumps will be the most efficient in the long term and will be able to keep up with the daily demand.
Examples: Spectra S1 or Spectra S2, Medela Sonata, Medela pump in style double electric breast pump, Medela swing marks double electric breast pump.
Portable breast pumps
Portable breast pumps are great for traveling, pumping at work, or wearing while you multitask, like while doing the laundry. They are great for occasional use. Some pumps may require you to hold the pump or flanges in place while others are hands free. With a well-fitted nursing and pumping bra, all pumps can be hands-free. Portable breast pumps do not reach the same suction levels as double electric personal use pumps or hospital grade pumps, so while they are not recommended for increasing or establishing milk supply, they are very helpful for maintaining milk supply.
Examples: Spectra S9, Medela Freestyle, Medela Swing Max, BabyBuddha portable breast pump.
Wearable breast pumps
Wearable breast pumps are electric breast pumps that fit inside your bra. They are great for occasional to frequent use. Wearable breast pumps are great for discreetly pumping during meetings or pumping in public.
Examples: Elvie, Willow.
Manual pump (Hand-operated pump)
Manual breast pumps are great for if you want to pump once a day, are travelling or only need to express occasionally. They can also assist with emptying breasts at the end of a nursing session. Manual breast pumps are great for increasing milk supply, stimulating let down and more.
Examples: Medela harmony, Lansinoh manual breast pump, Ameda manual hand pump, Haakaa silicone breast pump, Spectra cara cups.
How Long Should a Pumping Session Last?
At each pumping session, you should pump for at least 15 minutes on either side. Try to empty both breasts at each pumping session. Emptying the breasts is an important part of stimulating the production of more breast milk. After emptying breasts, continue pumping for one to 5 minutes longer.
Pumping for 15 to 20 minutes more frequently throughout the day will generally produce more breast milk than pumping less often for more extended periods of time. While lengthening the time between pumping sessions would help increase milk supply in the short term over time your milk supply will decrease due to decreased demand.
How much should you be pumping?
Pump as much as you can at each pumping session. Then put breast milk in bottles or storage containers in the amount your baby will take at each feeding based on your baby’s age. Here is how much baby may need.
First week
The first stage of breast milk called colostrum is concentrated and very nutritious, so baby needs only a small amount. On the first day, so little may be expressed, so it is more beneficial to hand press a few spoonfuls worth. Then pump for a short while to stimulate milk supply until milk fully comes in. Also know that it is okay for your breast milk to take a few days to come in. Just consistently stimulating your breasts manually or with a breast pump will help establish milk supply.
[Related Post: Delayed Milk Supply: Why New Mamas Shouldn’t Worry]
First month
After the first week, baby needs about 2 to 3 ounces of milk every 2 to 3 hours, or about 24 ounces in a 24-hour period whether you’re nursing or pumping and bottle-feeding.
Two to Six months and beyond
After the first month, baby needs approximately 3 to 4 oz every 3 to 4 hours or about 24 to 32 ounces each day until solids are introduced. As they increase their solid food intake, their milk intake would gradually decrease to about 20 oz a day.
A simple formula to calculate how much breast milk baby needs is.
(babies weight in oz / 6) / number of feedings
So, if baby weighs 12 pounds (192 oz) and feeds 7 times a day.
192 / 6 = 32 / 7 = 4.57oz per feeding
Breastmilk Storage Guidelines
After each pumping you can
- Keep at room temperature for up to 4 hours.
- Refrigerate breast milk for up to 4 days.
- Place milk in the freezer, if you are not going to use milk within 4 days of pumping. Freeze it right after pumping. Store for 6 to 12 months. Within 6 months as best.
- Put breast milk in an insulated cooler packed with frozen ice packs for up to 24 hours. After 24 hours in a cooler, the breast milk should be refrigerated or frozen.
When freezing breastmilk
- Clearly label milk containers with date the milk was expressed.
- Store in small amounts (2 to 4 ounces) for later feedings.
- Leave an inch from the milk to the top of the container, as it expands when frozen. Store in the back of the freezer, not the shelf of the freezer door.
When thawing and warming up milk
- Thaw oldest breastmilk first.
- Thaw milk by putting breastmilk storage bottle or bag in the refrigerator overnight.
- Thawed breast milk can be served cold or at room temperature, it doesn’t need to be warmed.
- If you decide to warm the breast milk, keep the container sealed while warming. Hold it under warm running water or set in a container with warm water. Never microwave breast milk. Test temperature of milk before feeding baby.
- Use breast milk within 24 hours of storing in the refrigerator i.e., from when it had defrosted not when it was taken out of the freezer.
- If breast milk is warmed or thawed to room temperature, use within 2 hours.
- Do not refreeze breast milk after it has been thawed.
Your Breastmilk Production Playbook
- If you can, start breastfeeding or pumping within 6 hours of giving birth.
- As soon as possible, pump or breastfeed 8 to 10 times a day.
- Breastfeed or pump for at least 15 to 20 minutes per session until your milk comes in. Hand express any remaining milk afterwards, to better drain your breast.
- Pump at least twice between 1:00 and 6:00 AM. In early morning hours, milk making hormones increase and taking advantage of this will increase your milk production.
- Focus on total number of pumping each day (8 to 10 times per 24 hours) rather than the time between pumping (every two to three hours).
- Don’t allow more than a 5-hour period to pass without pumping in the first two weeks after giving birth.
When you reach 25 to 35 ounces of breastmilk per baby per 24 hours you’ve achieved full breastmilk production. Maintain a schedule that continues producing approximately 25 to 35 ounces of breastmilk per baby in 24 hours, whether it is exclusive breastfeeding, exclusively pumping or a combination of nursing, pumping and bottle-feeding.
How to Increase Breastmilk Production
- Massage breasts before and during pumping or breastfeeding.
- Hand express after breastfeeding or pumping.
- Pump or breastfeed more, about 10 to 12 times per 24 hours.
- Breastfeed or pump until your breasts are softened and no longer feel full.
- Ask a lactation consultant or your healthcare provider for additional information on increasing milk supply.
Bottle-feeding Like a Boss
Babies can be picky, it is sometimes difficult to combine nursing, pumping and bottle-feeding, but don’t lose hope. Here is how to bottle-feed like a boss.
- Offer baby freshly expressed breast milk in a bottle.
- Try different caregivers. Baby might get confused initially if mom is offering a bottle and not the breasts.
- Try bottle feeding while holding baby skin to skin.
- Try different times of the day and at different levels of hunger.
- Test out different bottles, different teat shapes and different flow rates.
- Experiment with different positions: sideline, sitting up, standing up, etc.
- Introduce bottle when baby is calm e.g., just waking up or about to fall asleep.
- Let baby suck for 30 to 60 seconds before tipping the milk into the teat.
- Try leaving a clothing item of yours near the person giving the bottle, so it smells like “mama”.
The Takeaway, You’ve Got This Mama!
This is a lot of info to take in especially while trying to care for yourself in this postpartum period. Feeding your baby is a wild ride with plenty of spit-up, milk stains and panicked moments. The good news? Whether you are navigating breastfeeding, mastering the art of pumping, or embracing the convenience of bottle-feeding, you don’t need to know everything at the get go. Nursing, pumping and bottle-feeding is a mix of instinctual and learned behaviour. You’re learning, they’re learning, and you are not alone. You will have some challenging days. So, take a breath, laugh at the ridiculousness of it all and know that it gets easier over time.
