Exclusive pumping is when someone provides breast milk through pumping only, and never directly feeds the baby from the breast. The breast milk that is collected using a pump can then be fed to the baby in a number of different ways, but usually from a bottle. This is becoming a more common practice.

There are a lot of different reasons why someone would choose to do this, but it’s not usually an easy path. Sometimes exclusive pumping is a temporary solution. If you were hoping to breastfeed your baby, know that sometimes you can re-establish feeding at the breast. Depending on the reasons you are exclusively pumping, the problems might resolve enough to make breastfeeding possible.

Reasons for Exclusive Pumping

Exclusive pumping can be really hard, so it’s important to consider this when you’re making a decision, and then do everything you can to prepare for success. Most of the time, people choose to exclusively pump because they are not able to breastfeed directly, AND they strongly value breast milk and want to make sure their baby can get it. Before you decide to pump exclusively, the first thing to do is visit with a lactation consultant (IBCLC). They can help you figure out if there is anything else you can do to preserve or go back to direct breastfeeding, if you would like to. They can help you figure out a pumping routine that works for you and your milk supply, and also how to use a pump so you get the most milk for your time and effort.

Reasons people might choose to exclusively express or pump milk include:

• Baby does not have the ability to latch on to a breast correctly because of a physical restriction. This might be due to a deformity in the mouth or a lack of strength. For example, a baby with a cleft lip or palate may not be able to latch on to a breast. A baby who is born prematurely might be too small and weak to hold on to a breast and suckle.
• A problem with the breast or nipple which makes it difficult or impossible for the baby to latch on. This might include nipples that retract (go inside) when grabbed. 
• Continued pain with breastfeeding. 
• A preference for pumping because of emotional or personal reasons. 

How to Get Started

If you make the decision not to breastfeed directly at or before birth, it’s important to start expressing your milk right away. In the first few days, you only have a very small amount of milk called colostrum. The best way to get colostrum for your baby is to hand express. A pump doesn’t work as well in the first couple of days because you produce  such a small amount of milk. Much of the milk gets lost in the pump parts! You can watch this video to see how hand expression is done.

Pumping might also be important for stimulating milk production during the early days. You may need to do both hand expression and pumping. A lactation consultant can help you figure out the best method for you. Milk is made because there is a demand for it. When a baby is suckling or when a pump is pumping at the breast, your body gets the message that milk is needed and it gets made and delivered. If there is no one asking for milk, the production slows down and eventually shuts down. The key to being able to make enough milk for your baby when you’re choosing to pump exclusively is to pump and/or hand express often and consistently. You are basically trying to mimic what a breastfeeding baby would do.

So, in those first few days while you are still producing just small amounts of colostrum, you can hand express some milk for your baby when they need a feed, and you might also pump to provide some extra stimulation of the breast as the baby would if they were breastfeeding. You should do this as often as your baby is asking to be fed. For most newborns, this is approximately every 2-3 hours or 8-12 times a day.

Once your milk supply increases and you no longer need to do hand expression to collect colostrum, you might switch to just using the pump in a more consistent way.

How to Deliver the Milk

If you are in the early days and your baby is just getting small amounts of colostrum, some people prefer to give it to the baby from a spoon, a small cup, or from a syringe. It’s easier to give your baby every drop using these methods than trying to use a bottle. After about 3-5 days, as long as you keep up with a good pumping/hand expression schedule, you should be able to notice that you have more milk. At that point, you’ll probably be able to switch to using a bottle for the feedings.

How Much Should You Feed Your Baby?

In the first day or two, your baby might literally be getting just a teaspoon of milk at each feeding. This is normal when you are producing colostrum, and their bellies are so tiny that is all they need. The amount your baby needs will increase a little each day for the first month or so.

• By three days, a lot of babies are wanting almost an ounce of milk at each feeding.
• At one week, they’ll likely be ready for 1.5-2oz.
• By one month of age, most babies are taking in about 25 oz per day. If your baby is eating every three hours (or 8 times per day), this averages out to about three ounces per feeding.
• After that, babies will usually need 25-30 oz of milk daily through the rest of the first year! The breast milk adjusts and increases the nutritional content of the milk so your baby can have about the same amount of liquid, but there are more calories and macronutrients as the baby grows.

This is NOT an exact science! Some babies will need a little more or less than the average. Babies will also be more hungry and eat more at some feedings and less at others. When you are pumping to feed your baby from a bottle, it’s important to watch your baby closely. When your baby loses interest and wants to let go of the bottle or turns away, they are probably satisfied and you can stop feeding.

A good strategy would be to start with a smaller amount of milk in the bottle and then add more if your baby finishes it and is still hungry. You should not try to save a bottle that has already been used, so it’s better to offer too little over too much so you don’t waste any pumped milk. Watch your baby for satiety cues. These are the signs your baby is showing you to signal that they are satisfied.

These are things you might see when your baby has had enough to eat and feels satisfied. It’s great to let your baby get to this point and then stop. Don’t try to force your baby to eat more. Remember, it’s not an exact science. They’ll probably eat more later that day or the next.

• Closing the mouth
• Stops sucking
• Pulling off and turning away from the breast or bottle
• Relaxed hands and body
• Falls asleep
• Is easily distracted by other things

Overeating can be a problem when you’re bottle feeding. So it’s important to watch for those signs that your baby is satisfied and stop. It’s also good to let the baby eat slowly. You might even work on making it take as long as breastfeeding would take. That’s often 20-30 minutes. One way to help your baby eat slowly and more like a breastfeeding session is to use the paced bottle feeding method. You can see a video about paced bottle feeding here. You can also make sure that the bottle nipples you are using have a smaller opening for the milk so that it doesn’t come out too fast.

How to Determine an Exclusive Pumping Schedule

It’s most important to feed your baby when they are hungry! Especially when they’re newborns, babies will need to eat often. Their bellies are very small and can’t hold much, so they get hungry again quickly. This is a normal part of their growth and development. Gradually, they will eat more at each feeding and need to eat less often.

These are things you might notice in a hungry baby. They go in order of first signs to late hunger cues. If you miss the early or more subtle cues and your baby is now crying, you might need to calm your baby first. A crying or fussy baby might not be able to eat, so it’s best to catch those earlier warning signs!

• Licking lips or making smacking and sucking sounds
• Putting things in the mouth
• Rooting (turning head and opening mouth as if toward a nipple)
• Restlessness – lots of fidgeting and squirming
• Putting their body in the position for nursing
• Fussing
• Seeming frantic
• Crying

Babies also go through short phases where they seem to be more hungry than usual. This is also part of their normal growth and development. It’s called cluster feeding. They are growing and just need some extra feedings for a little while. This might not be as much of an issue when you are exclusively pumping. But know that you might need to pump more during these times so your body gets the signal that your baby’s needs are increasing and can increase the milk supply. This happens typically when your baby is around 2-3 weeks, 6 weeks, 3 months, and 6 months old but there is some variability here. If your baby does seem extra hungry during these times, you might introduce a power pumping session into your routine for a couple of days. That can stimulate your body to increase the milk supply.

Emotionally, there is a huge range of experiences. It can be hard to come to the realization that you can’t breastfeed directly. You might feel disappointed. You might feel like your body has failed or that you are not a good enough parent. You might also feel relieved and happy that there is still a way to give your breast milk to your baby without breastfeeding. You might be very conflicted feeling a combination of all these things.

Know that you ARE a great parent. Exclusive pumping is a labor of love. It’s not easy, and it takes a lot of serious commitment and dedication. Pumping can work, but it also requires more effort and time from you than direct breastfeeding or formula feeding. You will likely spend a similar amount of time on the pump as you would breastfeeding your baby, but you also have to deal with the pump set up and break down. You will need to wash and sanitize pump parts and bottles. You will store the breast milk that you collect. You will fill and warm bottles.

Sometimes, pumping is not quite enough. It can be difficult to make enough milk by pumping alone. Babies are usually much better at getting milk out of a breast than a pump is, and your body tends to respond better to a baby. If you don’t get enough milk by pumping, you might need to add formula bottles into the feeding rotation, but know that the breast milk that you are giving to your baby is still VERY beneficial! It doesn’t have to be all or nothing.

You also have the ability to make feeding time quality time for you and your baby, no matter what. You can focus on having some skin-to-skin connection. You can watch your baby drink the milk, give kisses and snuggles, make eye contact and smile. Talk to your baby, or sing. However you feed your baby, it can be a special time to connect and bond as long as you stay present and drink it in. It’s also fascinating to know that the closeness, and those kisses and snuggles are actually how your body recognizes that your baby is there and growing so that your milk can adjust to your baby’s needs even when you’re not directly breastfeeding!

If you’d like to learn more about pumping, we offer a pumping class! Whether you’re considering the idea of exclusive pumping or you just know you’ll need to start pumping when you go back to work, this class can prepare you.