There are multiple circumstances in which a mother decides to choose exclusive pumping instead of breastfeeding directly; this means expressing her milk either manually or mechanically and offering it to the baby in a bottle or other container.

It can make it easier for you to know more about it and some situations that can occur when you consider this option.

Is breastfeeding directly the same thing as giving expressed milk with a bottle?

We could say that offering expressed breast milk is similar to breastfeeding, but it is not exactly the same because breastfeeding is more than offering breastmilk to the baby. The breast as a method also brings advantages such as milk being immediately available, temperature, body heat, baby’s control of hunger, and control of when it is full, among others.

That’s why, when we offer expressed milk to our baby, we can do things to try to make it look even more like direct breastfeeding.

To do this, we’ll look at the following:

• Choose a softer teat: there are no bottle teats that are similar to the breast, so look for the softest one possible to avoid the impact of the teat on the oral structures of the baby.
• Respect when the baby shows signs of being full: by using the paced bottle feeding method you can guarantee that the baby will get milk on-demand in the quantity she wants. This is very important in order to avoid overfeeding the baby.
• Offer the bottle close to our body: the breast is given in close proximity, from body to body, and this is something to “imitate” when giving a bottle. The closer the baby is to your body, the better.
• Swapping sides: just as we offer one breast side per feeding, give a bottle alternating right/left arm to guarantee the same development of both of the baby’s sides of the brain.
• Offer fresh breast milk whenever possible: breast milk is a live liquid, and some of those cells are affected by freezing and thawing. Therefore, if you can offer some fresh milk, you make sure the baby will receive the maximum of these nutrients.

How long can I maintain exclusive pumping?

It is not easy to determine how long you will be able to maintain exclusive pumping. There are two major issues:

• Maintenance of milk production: the mammary gland receives stimulation from the breast pump quite differently from the direct breastfeeding of the baby and maintaining milk production for many months becomes really hard. The first difficulties appear with the growth spurt (breastfeeding crisis or high-frequency days) at three months of the baby’s age, where milk production is usually adjusted a lot and it is likely that you begin to have difficulties expressing your milk easily.
• Fatigue and tiredness: without any doubt, the exhaustion in this process is an extra difficulty, since on top of the attention and care for the baby you need to add extra time to express, store and handle the milk. It is likely that at some point in the process of exclusive pumping, you will feel it is time to stop.

What do I need?

There are different things you may need when considering exclusive pumping:

• Support: You certainly need a lot of support and understanding from everyone around you. Often mothers receive unfortunate comments about not needing to express their milk. Having an environment that embraces and understands this desire is important in maintaining indirect breastfeeding.
• Information: The conservation and handling of breast milk is another learning process in this type of lactation.
• Double electric breast pump: Whenever an electric breast pump is available, it will be more positive both in terms of saving pumping time and in terms of maintaining milk production.
• Pumping top: having a bra that allows you to place both breast pump funnels at the same time and have your hands free is a real game-changer. You can buy one or customize your own, whichever you prefer.

My baby eats more than I can get!

It can happen that the amount of milk you get when expressing is not enough to maintain exclusive breastfeeding.

This is because the stimulation of the breast pump is less effective than the sucking motions of your baby and this can lead to a certain moment where the production of milk decreases significantly and then it is necessary to consider what to do.

Some ideas if you want to continue trying to breastfeed exclusively are:

• Improve your breast pump: having a dual electric breast pump usually makes it easier to get more milk in less time.
• Create routines: Short, frequent pumping sessions throughout the day and night (imitating a baby’s feeding cycle) make it easier to increase and maintain production.
• Using a different pumping technique: increasing the number of times a day you pump or using a different pumping technique can help you increase your milk production. We recommend you to review information in our App LactApp on hands on-pumping.

I have been recommended to use prescription medication to increase milk production, what should I do?

Medication to increase milk production (galactagogues) has become very popular in recent years, and they are readily recommended to mothers who are exclusively pumping, as for them it can be a lot more complicated to maintain milk production.

If you want to take any of these products, we recommend you talk to your doctor to assess whether there is no risk to you and to get a prescription for the medication in the most appropriate way.

On the other hand, there are herbal supplements and remedies which are culturally very widespread and normalized during breastfeeding time. But there is little evidence of their effectiveness, yet, understandably, many mothers want to try. We always recommend you check ingredient by ingredient on the www.e-lactancia.org website, as some may be dangerous for your baby and should be avoided during breastfeeding.

To find out more about exclusive pumping and breastmilk handling and storage or if you have any other questions about breastfeeding, download our free App, Lactapp for Android or iPhone.