Duke Medicine: Common questions answered about breast milk pumping

I wrote about WakeMed's Mothers' Milk Bank yesterday. I featured local mom Maria Sealey, who spoke about her experience donating breast milk to the bank, which distributes it to sick infants.

Go Ask Mom: When should a nursing mom start pumping and offering her newborn a bottle of expressed breast milk? Should nursing moms worry about "nipple confusion?"

Murray: There is no right time to begin pumping and offering a bottle. Many resources recommend starting or not starting a bottle at different ages, but these are opinions. Each family needs to decide based on their specific situation. In the first weeks, if the baby is feeding well at the breast and gaining well, moms only need to pump to reduce their breast fullness, or if they need to give milk by bottle for a supplement. I recommend that moms feel comfortable with the baby latching, and get their supply established before offering a bottle for convenience. In most cases, babies are able to alternate between breast and bottle feeding without problems.

GAM: There are all kinds of ways to pump - from hospital grade pumps to pumps you can buy at the store to hand expression. What do you recommend for home use?

Murray: I would recommend the least expensive and easiest form of pumping that works for the mom and baby. Some moms are able to hand express easily, or pump a good volume with a manual pump. Other moms need a stronger electric pump. Some of this may depend the mom's experience, milk volume and milk flow.

GAM: When is the best time to pump during the day? After a nursing session, in place of a nursing session?

Murray: If you are trying to accumulate milk for a bottle to offer later, it's best to pump just after the feeding, to pump what is left over. Pumping an hour or more after the feeding is not recommended, as that is refill time for the breasts, and you are taking away milk for the next feeding. If someone else is giving a bottle to your baby at feeding time, then you can pump at that time in place of nursing.

GAM: How much milk should you expect to pump? Does it change over the course of nursing your baby?

Murray: The amount of milk that a mother is able to express depends on many factors including her overall supply, the time of day, as well as her health, fatigue and stress. As the baby's feeding needs change, the amount of pumped milk varies. Babies go through growth spurts that may cause the milk volume to go up. At other times, when mom is tired or stressed, the pump volume may be lower. As a baby grows and gets stronger, her body makes more milk to meet his needs, and pump volumes might rise.

GAM: About how long should a pumping session last?

Murray: After breastfeeding is established, after the first few weeks, mothers usually find that it takes around 20 minutes, pumping both breasts simultaneously, to mostly empty the breasts. If pumping after feeding, ten to fifteen minutes is usually sufficient. Some moms will "letdown" several times during a pumping session, and know the amount of time that this takes. I find that mothers need to "get used" to the pump - as they use it more and become more relaxed, the milk flow improves.

GAM: How long does pumped milk last in the refrigerator? How about the freezer?

Murray: For a healthy, full-term baby breast milk may be stored in the back of the refrigerator for up to 8 days. It can be stored in regular refrigerator freezer for 3-6 months and in a deep freezer for 6-12 months. You should not put fresh milk onto frozen milk. Fresh milk is preferred, but freeze your milk if you are not going to use it within eight days of pumping.