Pumping 101: Why, When, and What You Actually Need

Since I started working as a midwife 22 years ago, pumping has evolved significantly and has become an important part of the breastfeeding journey.

There is no pressure on anyone here—it is simply a shift in perspective, along with better knowledge on how to support mothers with their milk supply and breastfeeding journey.

Let’s talk first about why we start pumping

Pumping can be a personal choice, but it can also be necessary to get a good start or to boost your supply.

• The most common reasons I see with the mothers I support are:

• Separation between mother and baby (e.g., baby in the NICU, mom has an appointment, etc.)

• Medical or feeding challenges (preterm baby, weak latch, jaundice, tongue tie, etc.)

• Supply needs: extra stimulation to produce enough breast milk

• Comfort (oversupply, clogged duct). I want to be really careful with this one: while you want relief, you don't want to overstimulate your breasts—we don't want your body believing you're nursing twins when you're not!

• Exclusively pumping: this may simply be the breastfeeding path that works best for you.

In all of these situations, having the right support is key.

I always remind mothers that expectations vary depending on when you begin pumping.

If you start pumping in the first 5 days, the goal is to establish a strong start. This often applies when mother and baby are separated for medical reasons, such as a NICU stay. It also helps if the baby is sleepy, having trouble latching, or losing too much weight, helping to safeguard mom's milk supply. Those first few days are vital for getting proper stimulation off to a good start.

If you start after day 6, the goal is usually to boost your supply. This typically happens when we notice baby isn't gaining enough weight or transferring milk effectively (often indicated by fewer wet or dirty diapers). We may introduce a "Triple Feeding" plan: nursing on the breast, pumping, and bottle feeding baby. If you follow this path, keep in mind it can be exhausting—make sure to prioritize your own rest, nourishment, and hydration.

I generally recommend holding off on building a freezer stash until around 3 to 4 weeks postpartum. The first couples of weeks are here to recover, to understand your body and understand your baby. Once you can read the hunger cues and the satisfaction cues, recognize the difference between a good latch and a bad latch, it is when you can start to work on building a stash but not on overstimulating your breast. If you begin pumping after 30 days, your focus will be on maintaining your supply. You can maintain it by pumping whenever your baby takes a bottle, which is especially helpful when returning to work or spending time away.

Moms frequently ask me when the best time to pump is. You will generally yield more milk in the morning, as prolactin levels naturally peak during the night (around 3:00 to 6:00 AM) and your body is rested.

I suggest working with an IBCLC to create a personalized routine that fits your schedule and aligns with when your body responds best.

What do I actually need to pump?

There are several types of breast pumps available:

• Milk collectors: These are usually passive collectors with no additional suction, designed to catch your let-down on the opposite breast while nursing. Note that some models do create continuous suction and should be used cautiously to avoid accidental oversupply or tissue inflammation from excessive pull.

• Manual hand pumps: Great for occasional sessions when you are out and about, or for relieving fullness quickly before feeding. Some mothers also find their body responds much better to a manual pump than an electric one.

• Electric breast pumps: There are many options to choose from. I like to walk through options with each mother based on her lifestyle and goals. In my 22+ years as a midwife, pump technology and features have advanced tremendously!

• Pump Type Comparison (This guide gives you a helpful comparison of what to expect from each type.)

When comparing specific pump models, consider your budget and what your health insurance covers. Here is a helpful chart I often share with mothers. It's a great resource for comparing features based on your personal criteria.

What matters most to me is your flange size, followed by finding the right pump settings.

Flange size makes a huge difference! Special thanks to Jeannette Mesite, whose research transformed how we view proper flange fitting. A proper fit should feel comfortable and pain-free, helping you find the right suction intensity, efficient tempo, and optimal milk output.

While you can measure on your own, I consistently see mothers achieve much better comfort and output after a hands-on fitting. Don't hesitate to ask your IBCLC for assistance!

Before closing, here are the CDC breast milk storage guidelines for quick reference. A simple rule to remember is 4-4-12: up to 4 hours on the counter, 4 days in the fridge, and up to 12 months in the freezer for freshly expressed milk.

You can download a printable chart to post on your counter or fridge here.

Common mistakes to avoid

• Pumping too early or too frequently without a medical or supply reason.

• Using the wrong flange size.

• Comparing your milk output to freezer stashes seen on social media.

• Judging your overall milk supply solely by pump volume.

Please remember: every breastfeeding journey is unique, and you don't have to navigate it alone. If you'd like ongoing guidance, check out my online course or book an in-person or virtual consultation with me!