In this post I am jumping directly into how to increase supply when pumping exclusively. This post is direct tips on how to increase supply. I will have another post on how to survive and succeed exclusively pumping while juggling a newborn and other crazy stuff that goes on in new parent’s life (Note how I mentioned parent instead of new mom – that is one of the key to success in exclusive pumping) and get support for pumping.
Now we know clearly that you are here while you are probably pumping or feeding baby and scrolling through your phone. To make this easy and simple for you, I am listing the high level points in the first section and elaborate on each point in second section. That way, if your baby cries in 5 mins, you would still have had time to go through the key points, think about these points while you take care of your baby… Once your baby is tucked away and napping peacefully, be sure to come back (quietly if I may add), and go through the detailed notes.
| Tip | Don't forget to read the detailed notes below. | |
|---|---|---|
| 1 | Get the right pump | Pump to Increase supply - If you are exclusively pumping from the get-go, it is recommended to get hospital grade pump. Pump once supply is up - If feasible continue with the hospital grade pump, however if that is not possible go for a regular pump. |
| 2 | Scheduling Pumps | Choose your pump time wisely by pumping at the right time and pumping at regular intervals and factoring in rest as well - check notes below for more details |
| 3 | Breast Massage / Compression | Massage before the pump and during the pump to get all the milk out. |
| 4 | Water & healthy snacks | Have a bottle next to you for every pump session and drink up Have a bunch of healthy snacks next to you as you get hungry while you pump |
| 5 | Reduce stress | Don't look at pump output, Listen to your fav music or video or read to distract yourself. |
| 6 | Parts maintenance and cleanup | Parts needs to be changed often Pump may require cleaning on regular basis This will make sure supply is not impacted. |
| 7 | Flange size | Get the right flange size to get better output and be comfortable. |
| 8 | Nipple care | Use proper nipple care like lanolin or coconut oil. Close up right after pump with warm cloth to reduce sensitivity. |
| 9 | Give yourself a break! | Try to get some good rest When it gets tough, get recharge and restart |
| 10 | Warm foods and Warm bath | Drink something warm (milk or soup) before pump Take a warm bath before pump Use heat therapy as suggested below (no direct heat please). |
| 11 | Nurse when possible | If possible nurse regularly as there is no good pump that matches babies suction. |
| 12 | Food choices | Oatmeal, galactogogues foods, garlic, carrot, oatmeal cookies. Note: It did not make much difference for me, but eating healthy foods does help a lot for a pumping/breasfeeding mom. |
| 13 | Visit an LC | Visit a LC in case of nipple issues, info on how to use pump, flange size etc. The sooner you visit the better. |
| 14 | Supplements | Check with your gynec or LC or both before taking supplements. Some supplements can interfere with milk production and hence do proper research. |
| 15 | DO NOT QUIT on bad day | DO NOT QUIT on a bad day. Take a break and recharge and turn the day around and then you can revisit quitting. |
Get the right pump
Pump to Increase supply
If you are exclusively pumping from the get-go or pumping to increase supply, it is recommended to get hospital grade pump. I used medela symphony for the first 3 months until my supply came up.
Once supply is up –
If feasible continue with the hospital grade pump, however if that is not possible go for a regular pump. After my supply was up I tested for a few days with medela PISA and my supply was the same. Hence I returned symphony and started using PISA.
Note:
- Check with your insurance to know if your pump is covered. Some insurances allow switching in between (e.g. renting pump for few days and then you can buy what you need). Most insurances cover only one pump.
- Research well on what is the best pump. I have read that different women react differently to different pumps. My pump was not extracting milk that well (I had to use breast compression to get all milk out with both symphony and PISA), but by that time, I got used to it and did not want to change and go through getting all the supplies and extra parts again.
- Ask for LCs in your hospital to show you (if you have time and do not know how to use it) how to use a pump. If things don’t seem to work with breastfeeding in hospital, do not hesitate to ask for support with pumping while you are in hospital. If you are already home, visit an LC if you are not sure how to use the pump.
Scheduling Pumps
Choose your pump time wisely by pumping at the right time and pumping often. It is recommended to pump as often as your baby eats. E.g. if your newborn eats every 2 hours, then it is recommended to pump every 2 hrs. If your 3month old eats every 3 hours, then it is recommended to pump every 3 hrs. I, however, learnt from an LC that while it is important to keep up with the schedule, it is equally important to be sane and well rested. Hence they suggested me to pump often during some critical hours and then take at least one longer rest during the day preferably the afternoon.
- Prolactin is high between 12.00 am and 4.00 am – Hence try to ensure few pumps between this time. Note you may or may not see good output in the initial days. I did not see any difference until my supply increased. However once my supply increased, this timeframe was the highest yielding pump. I put in one pump at 12.00 am and one at 3.00 am – 3.00 am pump was the hardest for me and hence my husband used to keep an alarm and wake me up.
- pump as often as you can during the day when you have less things going on. E.g. baby taking a long nap, someones is there to care for baby and feed baby – during these times pump often.
- Take one good rest – 3 to 4 hr rest – my LC suggested afternoon as the best time for this 12.00 pm to around 4.00 pm.
- How long to pump: Pump for 15 mins or until empty (note that milk technically never stops producing and hence you may still see drops coming out but with less frequency. If you are pressed for time, my LC suggested to still pump at least for few mins instead of skipping a pump.
- There may be some periods where your baby may cluster feed – like growth spurts, teething etc. During this period your baby may take more than usual amount. I ended up supplementing with formula until my supply could match my babies intake.
- Power pump – This is pump 20 mins, take 10 min break, pump another 10 mins and take 10 mins break, and finally pump 10 mins – total for an hour. This is said to mimic cluster feeding and hence helps increase the supply. If you really have a supply issue, try to add one power pump a day or one power pump a week.
- As your baby grows the quantity of milk consumption changes and you can reduce pump times accordingly, however do it gradually.
- There are some exclusive pumping schedule images online (google on image) that have information on how often to pump based on babies age. However that is for 1 year goal. If your goal is higher or lower, adjust the schedule accordingly. I used that as a rough guideline, however I had to adjust a lot based on demands of the day.
- Remember a short tip – Do not have long gaps when supply is still establishing. It is recommended not to exceed 5 hrs between two pumps.
My typical pump schedule during first 3-4 months (when supply is getting established)
- pump every 2 hrs in the morning until noon or 2 pm
- pump every 3 or 4 hrs in the evening hours.
- pump at least twice between 12.00 am and 5.00 am.
Breast Massage / Compression
Massage before the pump and during the pump to get all the milk out. Even though this is listed as third topic, I cannot stress how important this is.
- Massaging before pump helps to get letdown sooner.
- Massaging or compression during pumping is critical especially if your pump is not emptying you well. For example, both my pump did not empty me well and I had to message with every pump session. If my supply dropped it was mostly when I multitasked and forgot to massage.
- Use warm therapy (refer below) before pumping
Water & Healthy snack
- Have a bottle next to you for every pump and drink up. Initially this might sound like a hard thing to do, hence do not worry about it much. Just have water bottle next to you and you will eventually empty it with every pump.
- Dehydration could impact supply.
- Some LCs suggest not to drink too much water as well. However I just went with hydrating with every pump and drinking whenever I felt dehydrated.
- Avoid caffeine content drinks during pumping session and substitute with water. Research says that 1 cup of coffee per day is okay for breastfeeding moms and hence avoid going above that limit.
- Have healthy snacks next to you – pumping burns lot of calories and hence makes you hungry.
Reducing stress during pumping
Stress does not go well with producing breastmilk whether you are nursing or pumping. Remember, stress impacts oxytocin which is directly related to milk production. The more relaxed you are and your positive emotions increases oxytocin.
Here are few tips to avoid this.
- While it is tempting to do this, DO NOT WATCH your pump output while you pump. If you want, cover up with nursing cover to force yourself out of this habit.
- Watch a funny video or listen to pleasant music or read a good novel (remember to massage once a while) while pumping to get your mind out of pumping and output
- It may seem important to track your output to note your progress, but if your output is discouraging or upsetting you, stop tracking your output.
- Do not compare your output with another mom’s output. It does not matter, this is not a race. Remember, every women is different.
- In the end, all that matters is that your baby is well cared and well fed. In 10-20 years, your baby will not worry if they were fed breastmilk or formula milk. Have that high level perspective in mind, in case supply is short of demand and you end up supplementing with formula.
- Take it ONE DAY AT A TIME. On somedays, goals do not matter, just get through the next pump or the next day. Once you are in comfortable position, increase your goal to 1 week or 1 month or 3 months or 1 year etc.
- If you just had a rough time (like an argument, or something that upset you), take time to relax before you start the pump (comedy shows, funny videos etc.)
- If there are people in your life who do not support your pumping journey, try to avoid being impacted by their thoughts. Remember it is your baby, your life, your choice. Don’t get trapped by mom guilt. You can try to educate them, but avoid wasting your energy if that does not work. You have more important things in your life – your baby!!
Parts maintenance and cleanup
Depending on your pump, your pump and parts may need cleanup and replacement. For example, for PISA:
- Membranes needs to be changed every few months – otherwise they impact supply
- Pump may need to be cleaned – refer to the manual for frequency and steps.
- Tubing may have milk deposits and may need to be cleaned
- Know/learn the knitty-gritties of how to put the pump together, how to clean and sanitize etc.
- After replacing parts and cleaning your pump, if the pump is still not working or if suction is not good, contact the customer support.
Refer your manual for instructions on how to maintain your pump and parts.
Flange size
It is very important to choose the right flange size for your nipple (if your pump requires a flange). Correct flange size will reduce nipple trauma and increase milk output -> comfort and output. Remember the following points:
- Your left and right breast may have different sized nipple, and hence may need a different flange size
- The nipple size changes throughout breastfeeding journey and hence you may need to size up or down as days/months go by.
- The nipple size may be different with every pregnancy.
- When in doubt visit an LC or support groups for help with sizing.
Nipple Care
- Gradually increase the speed of the pump to identify what is the comfortable speed for you. If you are already having nipple pain, start with low settings and gradually increase during a pump or over several pumps. Do not pump at high speed right when you start. This could cause nipple trauma and in turn impact the supply.
- After pumping use the left over breastmilk drops on your nipple and apply that breastmilk all over the nipple – The breastmilk is supposed to be best healer as per what my nurses told me.
- Apply nipple cream (my LC suggested lanolin cream) after pumping
- Use warm therapy (refer below) for nipple sensitivity and cover your nipples right after pumping – as the cold air could increase the sensitivity.
- I read this in some babycenter article that was very helpful during my pregnancy to avoid extreme dryness. This can be started during pregnancy itself. Avoid applying soap in nipple and areola area as it can cause dryness of the area. If you have severe dryness or sensitivity, avoid soap, and just let warm water run over it.
- If you have nipple trauma or blisters or bleb or whiteness in your nipple after pumping (vasospasm), please visit your LC or gynecologist to figure out the cause for this and get treated right away. Some LCs suggest APNO cream, however my gynecologist did not approve/recommend this for me. Check with your doctor for this.
Give yourself a break, Recharge and Restart.
This goes hand in hand with reducing stress.
There were several days where it was disheartening to see drops dry up on the bottle and the output of an entire day is just parts and bottles to wash up and no milk to show for the hours you put in pumping. Somedays it was so painful to even attach the pump. I had once or twice took an entire night off and slept through the night (4 or 6 hr). The pain was so intolerable, I got very weak that I could barely move my limbs, let alone hold my baby, that I had to sleep to gain my energy back.
If it gets really tough, give yourself a break. Take a 4 hr nap – with the baby or ask someone else to care for the baby and take a long hard nap to clear your head, recharge your body and soul.
Skipping pumps is very risky during the milk establishing phase and can affect the supply, but I did not see value in pumping when I was so sick. My LC did agree with this and that is when she suggested that 3 to 4hr break in the afternoons instead of night.
However, after that break, restarted with renewed energy and continued with strict schedule. Remember, you need to be healthy to have a good output.
Pumping may hopefully not impact everyone this way, so please do not take this to heart – 5 out of 5 people I had met in person did not have this issue. However I am adding this here since it could happen and you can get through it with proper strategy. (Again, if you are one of the person who have this issue, I would highly recommend visit an LC or gynecologist to figure out why you are hurting and get treated accordingly).
Warm Therapy:
- Consume warm foods before pumping – warm oatmeal, warm soup or milk.
- Warm bath before pumping helps in faster letdown.
- Heat therapy – put warm washcloth or pads (make sure to test it to ensure it is not hot) on your breast before pumping or during pumping. This helps in increasing pump output.
- take care not to put anything hot directly on nipple
Nurse when possible
This is a sensitive topic in exclusive pumping world and you can get kicked out for even mentioning this 🙂
However if your goal is to eventually nurse and if you can handle nursing once a while, I highly recommend nursing as often as possible. It can be once a day or once in 3 days or 3 times a day, it does not matter. There is no pump that can do what a baby does. Also it can help make transitioning baby back to breast easier. Keep offering the breast to baby as long as you can handle it and baby can handle it.
However, if both of you are screaming/crying constantly while latching or nursing, then it can have detrimental effects – impact oxytocin for you and cause negative association for the baby about the breast.
If nursing does not work, do not worry about it.
Have skin to skin as much as possible, spend as much time as possible with your baby to increase your oxytocin levels – that can in turn produce good output. Your happiness and health and your babies happiness and health is more important.
Food Choices:
I have read many articles that mention that certain foods that help with milk supply – Oatmeal, galactogogues foods like garlic, carrot that you can add to your food. Moringa leaves and moringa pods are another food that helps with milk supply
There are some good oatmeal recipes that you can make at home and have as a healthy snack with you while you pump.
Note:
- These foods did not make much difference for me in terms of milk output. However eating healthy foods does help a lot for a pumping/breasfeeding mom and it helped with the energy part for sure. You need energy for pumping and handling your life.
- Test the impact on any new food item that you are trying. e.g. monitor the pump output when you start consuming certain foods and if it seems to impact supply stop consuming that food.
Visit an LC/Doctor
As mentioned under different sections above, visit a LC or doctor for:
- Help with using a pump
- Help with treatment for nipple/ pumping issues
- Support with pumping.
- Evaluate your prolactin levels.
- Sometimes you may need several visits.
- Sometimes an LC may not work for you or your goals and you may need to find another one.
It would be really helpful to visit in the first or second week as you can learn sooner on how to do things the right way.
Supplements
Supplements did not make any difference to me, however I have added this, since I have read that it helped some moms. I do not have much information to add here, but wanted to call out few things:
- Check with your LC or doctor (gynecologist or primary doctor) before you take supplements. Note that some supplements can have detrimental effects on supply.
- E.g. fenugreek can interfere with supply for women who have thyroid issues.
- When possible, I used the actual food instead of supplements – e.g. cooked moringa pods or leaves instead of moringa supplements. These are very delicious and hence it was easier to consume as foods instead of supplements.
- Test the impact on any new supplement that you are trying. e.g. monitor the pump output when you start consuming certain supplements and if it seems to impact supply stop consuming that.
DO NOT QUIT on bad day
This point actually belongs to another post on how to survive pumping, however I am adding this here since this is important enough to be mentioned several times.
DO NOT QUIT on a bad day. Take a break and recharge (refer points above to reduce stress and take a break) and turn the day around and then you can revisit quitting and resetting your goals when things are going good.
Disclaimer:
I am not an LC or nurse or doctor. I am just a mom who went through this first hand and did a lot of research while trying to increase my supply. I wanted to share my experience and research that I learnt and still learning. I would highly recommend to meet with your nearest LC (there may be some LCs or La Leche League members who can come to your house). There are also online support groups you can join to garner more support and get real-time information for your questions.
This post is purely based on my experience, hence it may not cover all the pumping situations. If you have gone through something that is not listed above please comment below.