"Dear Shondra,

I had my baby three days ago, and my milk finally came in. In the hospital, I didn't pump at all, except for the little I hand expressed for his jaundice. The doctor said that his jaundice is improving and that he's already starting to gain weight, but my breasts still feel extremely full after he eats. I've decided to start pumping, but if I'm breastfeeding on demand, for how long should I pump?"

I so appreciate this question even though many people may find your decision quite controversial. There's this concern about creating an oversupply with early pumping- which in some cases is a founded concern- but in other cases, the restriction on early pumping due to concerns can create its own set of problems.

It sounds as though breastfeeding is going well, so frequent pumping may not be needed, but it all depends on your goals.

And how long you should pump for depends on your goals as well.

At three days postpartum, the breast fullness you're experiencing may not be due to milk per se, but rather swelling (physiological engorgement) of the breast. Post-delivery fullness/heaviness is a physiologically normal process that occurs as a result of increased blood flow and an increased volume of milk. For some parents, especially if they've received a lot of IV fluids, breast fullness, or even edema (fluid accumulation in the interstitial space) can persist for many days.

Because the onset of breast fullness typically occurs between day 3-5 it sounds like things are right on track. His weight gain is also reassuring that things are going as expected.

Some parents decide to pump because they feel they need to in order to breastfeed successfully. I like to let everyone know that expression (be it by an electric pump, hand pump, or hand expression) is not a requirement for breastfeeding unless indicated. Any amount of pumping is a commitment, and it's not a journey you're embarking on alone, though pumping journeys vary and look different for everyone.

For how long should I pump?

Pumping duration will differ depending on what route you go for milk expression.

One option -which can be super helpful in the early days once your milk begins to increase in volume- if you want to express milk and save time, (assuming you leak while feeding as is common in the early weeks/months) is collecting milk in a passive collection device like milk savers, Kindest cup or a 'pump' such as Naturebond. You could collect milk for as long as it drips or for however long the feeding session lasts. Once your baby finishes on side A if he is still hungry, remove whatever passive collection device you've chosen from side B and offer that breast.

If you notice that your babe gets a bit frustrated on the "milk collection" side, it may be due to frustration as a result of a slower flow (typical as breast pressures change). If this is the case, please contact your local lactation professional to assess his oral function. Most babies will have no issues with getting adequate milk on less full breasts, but for some babies, early frustration at the breast when breast pressures are decreased my be the first sign of feeding challenges.

Additionally, if you have very large or bifurcated (nipples with two or more parts) nipples or if you have a herniated areola, a milk collection device like the Kindest cup may be better suited that the Naturebond or ‘haakaa’ style "pumps."

Another option is hand express after a nursing session for five or so minutes to ensure complete breast drainage. Hand expression is a good option if you're not looking to create an enormous milk stash but do want a bit extra milk saved for time away. It can also help to reduce any engorgement that may occur from incomplete breast drainage- something that is common in the first weeks when milk volume is high and babies are sleepy. Hand expression is a learned skill that is challenging for many parents at first, but over time it can be a rapid expression method.

If you're looking to donate or have a large stash to utilize after you've stopped direct breastfeeding, using a double electric pump for 10 minutes or so after feeds might be an option. Typically, our bodies naturally make more than our baby needs, which later down-regulates to meet close to what our baby takes in a 24 hour period. Because you're "demanding" extra milk by pumping after your baby has nursed, your body most likely will get the memo of "more milk" and "skip" the down-regulation process. The additional pumping should result in your breast producing a volume geared toward both baby's and the pump's demand.

Note: Extra stimulation to increase production is the same method used for increasing supply. Over time the additional stimulation should result in higher output, even if no additional milk is removed.

You may choose to do one of the options above one day and another a different day- some days you may express after feeds more often, others less. The good news is there's no right or wrong way to add pumping to your breastfeeding journey.

Overall, the best answer to how long should you pump if you're breastfeeding is, "what are your goals?"

There's a benefit for working with a lactation professional to help you navigate your specific set of circumstances to reach your particular goals. I encourage anyone who can to seek out lactation support in the week following birth and the subsequent weeks as they establish lactation and breastfeeding.

Get pumping duration advice from pumping-supportive lactation professionals

Not every lactation professionals out there, be it in the hospital or in private practice, is super supportive of pumping, especially in cases where a baby is breastfeeding just fine. If you do seek out local breastfeeding support, please ensure that:

they have extensive experience supporting pumping parents in the first six weeks
have helped parents who have chosen to pump without a medically indicated need (baby with oral restriction or low supply for example)
fully understand and support milk donation and
won't try to persuade you to "dump the pump."

Want to read more about how some lactation professionals fail families and the mindsets held by lactation professionals that increase the odds of support failure? Check out this blog post!

Additionally, I encourage you to download my FREE flange sizing guide. Doing so will ensure you know how to properly size your flanges, which will not only make for a more comfortable pumping experience but may increase your pump output- regardless of the duration of sessions you choose to pump.

Happy breastfeeding (and pumping!)