HOW TO PUMP FOR A NEWBORN: PUMPING 101
If you’re an expecting or new mom, there’s a fair chance you’ve planned to get a breast pump from your insurance company without much thought on how you’d use it. That’s certainly what I did! I had heard different and vague things from experienced moms about needing to pump at work or making sure I could leave the baby with my husband, but other than that, I hadn’t given it much thought. I just knew I could get one for free, and therefore; I needed one.
In this post, I’ll attempt to cover as much as I can about newborn pumping, or at least the core topics you need to make an informed decision for you and your baby. I will cover the following:
1. How Milk Production Works
2. Should I Pump for my Newborn?
3. What Pump Should I Use?
4. When Should I Pump, How Often, and For How Long?
5. How To Create a Pumping Schedule
6. How Much Milk Will I Make? How Much Milk Does My Baby Need?
7. What If I’m Not Making Enough Milk for My Baby?
8. Cleaning Pump Parts for a Newborn
9. Safe Milk Storage
10. How Can I Make Pumping for My Newborn Easier?
Of course, you can also contact me with any questions if they’re not answered here.
So why would a breastfeeding mom want or need to pump and how do you know if it’s right for you?
There are several reasons why moms pump breast milk, including:
-low milk supply
-a baby who is unable to latch
-returning to work
-building a milk stash
Some moms pump in order to donate milk and some moms pump because, while they want to provide their baby with breast milk, they don’t want to nurse. When a mom chooses to feed expressed (pumped) breast milk without nursing directly from the breast, we call that exclusive pumping. It may mean that the baby is getting 100% breast milk, or it could include forms of supplementation like formula.
All of these reasons are legitimate and can help optimize your breastfeeding experience. For this blog, we’ll focus on why you may want to pump during the newborn period (typically categorized as 0-12 months of age for a full-term baby) and how to do it correctly and safely.
How Milk Production Works
When pumping, it’s important to understand how our bodies make milk. Milk production begins as a hormonal process. About half-way through pregnancy, the body starts to create colostrum, newborn milk. Colostrum is a very thick, very concentrated form of breast milk and we make it in small quantities. This is on purpose - newborn babies have very small stomachs. After delivery, progesterone (the pregnancy hormone) drops and prolactin levels (milk hormones) rise and trigger mature milk to come in. This process occurs whether we want to breastfeed or not and milk will come in approximately 3-5 days after delivery. As mature milk comes in, the process changes to supply and demand. More milk removal triggers more milk production. This is why milk will eventually dry up if a mom chooses not to breastfeed.
Throughout the first 12 weeks postpartum, our bodies respond very sensitively to the supply and demand process. When nursing, it is important to nurse frequently and on demand so that our bodies adjust to our baby’s needs. At around 12 weeks, our bodies regulate, meaning that our body understands how much milk baby needs, and at this point it becomes much harder to increase or decrease supply.
Should I Pump for My Newborn?
Now that you know the basics of milk production, we can get into the details of pumping. If you choose to nurse your baby and everything is going well (meaning that your baby is latching without nipple pain, gaining weight appropriately, and having enough wet and dirty diapers) my professional opinion is to wait 4-6 weeks to pump. The reasons why are directly related to how our bodies produce milk.
In those first few weeks, our bodies and our babies are communicating with each other. Our body is learning how to regulate supply and respond to our baby’s nutritional needs and we want to allow that to happen without interference. But there are some very good reasons why you may want to pump for a newborn. These may include:
-a baby who is in the NICU and cannot nurse
-mom is sick and cannot be with the baby
-baby has early trouble latching due to ties or other complications
-mom chooses to exclusively pump
What Pump Should I Use?
If you’ve decided that pumping for your newborn is for you, you want to make sure you have the right equipment - most importantly, your pump! When pumping in the hospital, request to use a hospital grade pump, as this will be most effective in establishing your milk supply. If you know ahead of time that you are planning to pump, ask for it in advance and take one item off your to-do list.
In addition to the hospital pump, I highly recommend hand expression, especially in the first few days while you are making colostrum. As I mentioned, colostrum is very thick and concentrated and your baby needs very small amounts to fill his marble-sized belly. You may only get a few drops, but don’t be discouraged! This is PERFECT! Because it’s so concentrated, many moms find it more effective to hand express colostrum into a spoon or syringe that can be directly fed to baby.
If you plan to continue pumping once at home, you will need your own pump. While some hospitals will allow moms to rent their hospital grade pumps, under the affordable care act, most expecting and new moms in the United States can get a pump that is completely covered by their insurance. There are many options that vary in effectiveness, portability, and ease of use and I won’t get into all of them here. I will say that the Spectra s1 and s2 are very popular and effective pumps that are often covered by insurance. While every mom’s body is different, this is the pump I recommend most often to new moms.
When Should I Pump, How Often, and For How Long?
You’ll remember from our section on milk production that once the baby is delivered, our body starts producing milk based on a supply and demand system. So you want to tell you body to start making milk ASAP and begin expressing (either with hand expression or a pump) shortly after delivery. The ideal time frame is within the first 2 hours, but any time within the first 6 hours will optimize milk production later on. The most important thing to remember is that you have to remove milk to make it, so you’ll want to express frequently in those early newborn days. A newborn baby will typically eat between 8-12 times in a 24-hour period. If you’re pumping, you want to try to mimic that. Pumping 12 times a day is incredibly hard, so give yourself patience and do the best you can. Anything in that 8-12 range is great! And you can even look at your pumping time as a form of self care. Read a book, watch tv, or listen to a podcast while you’re pumping. I watched the entire series of Sex and The City while I was pumping! And it can be a mix of pumping and hand expression.
How to Create a Pumping Schedule
You may be wondering if there’s a ‘best’ way to get in your 8-12 pumps per day (ppd) and while there isn’t a best way, there are 2 techniques that you can use - you can pump on the baby’s schedule or pump on our own schedule. This is a personal choice and you don’t have to stick to one if it doesn’t work for you. Breast fed babies feed on demand (even bottle-fed babies!), and if you pump on the baby’s schedule, you’ll pump after each feeding. If you pump on a schedule, set a pump alarm for every 2-3 hours. Remember that if you go the schedule route, you may need additional help if your baby is hungry when you need to pump. It can be hard to feed a baby while pumping.
When exclusively pumping, collective wisdom suggests that your goal should be 2 hours or 120 minutes a day of total pumping, divided by however many pumps you do. This is a useful guideline and helps ensure you are pumping enough, but try to remember that your body is not a machine. For example, let’s say you’re pumping 10 times a day making your goal 12 minutes per pump. Once your mature milk comes in, you’ll be able to see it drip into your bottle. If one day, you hit your 12 minutes and the milk is still flowing, there’s no need to stop! But if you notice the milk stops flowing at 10 minutes, keep that pump going for an extra minute or two. It will send the message to make more milk next time.
How Much Milk Will I Make? How Much Milk Does My Baby Need?
The amount of milk you produce will fluctuate throughout the day and over time as your baby ages. The amount your baby drinks will quickly increase between 0-4 weeks (or your baby’s first month) and then begin to level out. A breast fed baby’s milk intake does not change dramatically between 1-6 months of age.
Over a typical 24-hour period, moms see the most milk volume in the early morning hours (between around 1pm-6am) and a decrease throughout the day. This is quite normal and nothing to be alarmed by.
Every baby has different needs, so there is a wide range of ‘normal’. A typical newborn will eat between 25-30 oz a day by around 7-10 days after birth (it’s important to remember that if you had a c-section, your transition to mature milk be delayed by a few days. Don’t worry, you'll catch up).
What If I’m Not Making Enough Milk for My Baby?
This is one of the biggest fears I hear from new moms—and understandably so. The idea of not being able to provide for our babies is scary. There are some biological and anatomical issues that can cause low milk supply and so if you’re having trouble, definitely speak to a lactation professional to rule those types of issues out. But regardless of the reason, the most important thing to remember if you’re not making enough milk is that you are still a wonderful mom. Your worth as a mother is NOT measured in ounces and you are not doing anything wrong. Pumps are not perfect and there are two important points to remember.
1. Even though the technology of pumps has improved greatly over the years, a pump will still never be as effective at removing milk as a well-latched baby.
2. Every woman’s body responds differently to pumps. Some women are able to have huge success while pumping and make way more milk than their baby needs. And some moms don’t respond well to them at all. I once knew a mother who nursed her baby for 6 months without any issues, but when she returned to work, she wasn’t able to pump. This had nothing to do with her supply or her ability to make milk, her body just didn’t respond to a pump the way that it did to the baby.
This means that there are factors beyond our control when it comes to supply and pumping.
Remember that every ounce of breast milk that your baby gets IS important and is beneficial. Whether it’s 12 bottles a day or 1 bottle a day, you are providing something beautiful for your baby.
So I’m going to say this again because it’s just that important - your worth as a mother is not measured in ounces. Repeat this as often as you need to. Write it down. Say it in the mirror. If you are not able to make enough milk, for ANY reason, you are still a great mom. You are still doing everything right. We are so lucky to live in a time and place where formula is safe, nutritious, and readily available. If you need to use it, USE IT. Talk to your pediatrician about specific types and what amount is best for your baby.
Cleaning Pump Parts for a Newborn
Cleaning your pump parts properly can be a bit of a pain, but it’s incredibly important. Babies have developing immune systems so we want to ensure that anything touching their food is as clean as possible. This is especially important for a newborn.
When cleaning pump parts, you’ll want to refer to the gold standard of cleaning - the CDC (Center for Disease Control) guidelines. These guidelines were created to keep your baby as safe and healthy as possible when pumping breast milk. You can see the full instructions by clicking here, but I’ll give a short summary:
1. Take apart your breast pump and rinse all parts that come in contact with milk
2. Clean each part by hand using hot soapy water and a clean brush that is used only for infant feeding items
3. Rinse each part well
4. Allow to air-dry thoroughly
5. Sanitize at least once daily especially if your baby is under 3 months, born prematurely or has a weakened immune system. Sanitizing can be done by boiling or a microwave or plug-in steam system according to the manufacturer's directions
The CDC does allow for cleaning in the dishwasher, provided it’s recommended by the pump manufacturer. Use the hottest water setting and a heated drying cycle (or sanitizing setting).
How NOT to Clean Your Breast Pump
You may have heard moms talk about different short-cuts for cleaning pump parts, including cleaning wipes or the refrigerator method (where pump parts are stored in the refrigerator in between pumps and not cleaned each time). These methods may be appropriate for some older babies, depending on the situation. While they may be tempting, for the health and safety of newborns, these methods are NOT recommended for babies under 3 months of age and They are NEVER recommended for babies who are sick or have a weakened immune system.
Safe Milk Storage
Storing your milk safely is another important logistical piece that you’ll need to consider when pumping. Breast milk can be safely stored at room temperature, the refrigerator, and the freezer for different amounts of time. Again, for a newborn, it’s important to refer to the CDC guidelines:
Freshly pumped milk -
-Up to four hours at room temperature (this means that for a newborn, you can pump the milk and leave it out until the next feeding. No need to reheat!)
-Up to four days in the refrigerator
-Within 6 months in the freezer
Thawed, previously frozen milk -
-1-2 hours at room temperature
-Up to 24 hours in the refrigerator
-It is NEVER safe to refreeze breast milk
Leftover from a feeding (baby did not finish the bottle)
-Use within 2 hours after baby is finished feeding
There is a lack of research and data on the storage of breast milk, which means you’ll see may a wide variety of information about this online. When we’re talking about a newborn baby, it’s always safest to go with the most conservative estimates and follow the CDC.
How Can I Make Pumping for My Newborn Easier?
Pumping for a newborn is hard work. You’re just getting used to being a mom and everything that goes with it and now you have to fit pumping into your schedule, too! But there are ways to make it easier.
1. Get a hands free bra, it will be a lifesaver. Not only will it free your hands up to do other things while you’re pumping, but you’ll actually get more milk when you pump both breasts together.
2. Check out Pumpin’ Pals. They’re an alternative to a typical flange made of either soft silicon or soft plastic. Pumpin’ Pals are curved downwards to allow for a more relaxed posture while pumping and are lined with soft ridging for added comfort. They can be used with almost any pump and many moms report a much more comfortable experience and greater output.
3. Opt for a battery operated pump for wall-free pumping. While many of them are not covered by insurance, the Spectra s1, Baby Buddha, Medela Freestyle, and Spectra 9+ are all great options for portable pumping. If you’re using a hospital grade pump, these battery options won’t be as strong, so you may not want to use them all the time. But they’re a great option for pumping out of the house.
4. Set up multiple pumping stations around your house with everything you need. Whether that’s a snack, a bottle of water, a book, or a phone charger—having your stuff set up where you need it will make the entire process seem a lot easier.
5. Buy multiple of sets of pump parts. The cleaning process can be arduous and it’s important not to cut corners when pumping for a newborn. One way to make it easier is to have 2 or 3 sets of pump parts ready. That way, you can pump a few times and then do a big cleaning just a few times a day.
6. Ask for help! This is a BIG one!! Whether that’s a parent, a sibling, your partner or paid help like a postpartum doula, having someone around can make a huge difference. Ask them to clean your pump parts or bottles. Have them old your baby when you’re pumping. Ask them to make you a sandwich so you can eat while you pump, Even if it’s just for a few hours a few times a week, having the support of people around you can make a huge difference on your pumping experience and your mental health in general.
7. Sign up for a free 15-minute virtual consult to see if Taking Care of Mama can help you take the guess work out of pumping - making it easier and more effective.
If you’ve got questions about pumping for a newborn, leave a comment below or shoot me an email. You can also check out my Pumping 101 one-on-one coaching that moms can take prenatally or any time after the baby arrives. It’s a great way to set you up for pumping success, no matter what your goals are.