Have you been expressing and giving your baby extra breastmilk and/or formula, perhaps due to weight gain or milk supply issues?

Is your baby feeding more effectively at the breast, with good weight gain and nappy output now? If so, then hopefully your days of pumping and supplementing your baby with extra milk can begin to come to an end! But how can this be done in a way that is comfortable for your breasts, protective of your milk supply and protective of your baby’s feeding?

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Some people find that once their baby is breastfeeding effectively, and therefore taking ever decreasing breast milk or formula supplements, they are then in a situation where they are still tied to frequent expressing, and expressing more than their baby is taking. This might be resulting in 'feeding the freezer' (!), giving an excess of milk that isn't required and keeping them tied to the pump.

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If you find yourself in this situation you might like to consider decreasing the overall time spent on the pump. Whether you are mixed feeding or exclusively breastfeeding then hopefully this guide will support you to make an informed choice about how to move away from frequent pumping when the time is right.

 

Gradually moving away from pumping:

• Avoid being too prescriptive, as each situation is unique, so the following information is a guide and it is recommended to make such changes with the support of your Breastfeeding Specialist.

• It is very important that weight gain and nappy output (see below) are consistently appropriate before reducing top ups and pumping.

• It is essential to continue to monitor weight gain and output, and continue to check in with your healthcare provider frequently.

• UK families can plot their baby's growth on their weight chart, found in their My Personal Child Health Record ( “the red book”). Weight gain should be steady, and approximately track within one centile space (this is the space between two centile lines).

• If baby’s weight isn’t roughly tracking their predicted curve then seek support from your GP, and access breastfeeding support from an International Board Certified Lactation Consultant (IBCLC) or Breastfeeding Counsellor (BFC). For information on how to read your baby's weight chart see: https://breastfeeding.support/understanding-babys-weight-chart/

 

APPROPRIATE NAPPY OUTPUT:

• Your baby should be passing a minimum of 2 poos a day. By day 5 of life, the poos should be yellow and loose.

• Contrary to popular belief, it is not normal for babies to not poo each day, at least twice daily, from birth to approximately 6 weeks old.

• From around 6 weeks, some breastfed babies do not poo each day. As long as when they do, it is soft and easy to pass, and they are still producing a lot of heavy wet nappies, where the urine is pale and not strongly smelling, then this alone is not a concern. If urine is reduced or more concentrated, then contact your GP.

• Wet nappies:

 

Day 1 - 1 wet nappy

Day 2 - 2 wet nappies

Day 3 - 3 wet nappies, getting heavier!

Day 4 - 4 wet nappies, getting heavier!

Day 5 - 5 heavy wet nappies

Day 6 and onwards - 6 heavy wet nappies

 

These are the minimum amount of wet nappies expected - more is great!

 

Starting to reduce pumping:

• Be confident that the time is right for you and baby to reduce pumping sessions.

• Reduce pumping gradually (this helps to guard against engorgement, blocked ducts and mastitis). If you are someone that pumps for 10 minutes but gets 80-90% of your volume off in the first say 6 minutes, then reducing from 10 to 9 minutes probably won’t make much difference for you so trial reducing from 10 to 6 minutes. If that is comfortable then the next time you drop down do it in 1-minute increments.

• Continue to keep an eye on baby’s weight gain and nappy output.

• Consider avoiding weighing more than weekly, but no longer than fortnightly (unless this contradicts advice from your Health Care Provider)

• Listen to your body and be led by your comfort levels. Are your breasts comfortable? We want to avoid blocked ducts and mastitis!

• Listen to your baby! Are they content, settled after feeds, with appropriate nappy output and weight?

 

Example scenario:

• Sarah and baby Finn have been triple feeding (feeding at the breast followed by expressed breast milk and formula, and Sarah frequently expressing her breastmilk)

• Breastfeeding is now consistently effective

• Finn continues to take breastmilk supplements, however these are getting smaller and smaller, and some supplements he is refusing entirely

• He is no longer taking any formula supplements

• Finn is gaining weight and nappy output is appropriate for his age

• Sarah is pumping more than Finn is taking as a supplement and is freezing the extra milk

• Sarah is double pumping for ten minutes, after breastfeeds, eight times per day

• Now that breastfeeding is going well, with good milk transfer, appropriate weight gain and nappy output, Sarah wants to reduce pumping

 

What does Sarah do?

• Reduces each pumping session to 8 minutes after all breastfeeds.

• Stops one of the pumping sessions.

  • She is therefore now pumping seven times per day for approx eight minutes each time.

• After the initial reduction, all is well with Finn and Sarah’s breasts, so Sarah chooses to reduce pumping more after a couple of days.

• She decreases all pumping sessions by another couple of minutes and drops one further session

  • She’s now pumping six sessions per day, for approx six minutes.

• Continues with gradual reduction of sessions one by one, alongside dropping further minutes, over the coming days/weeks, in line with what feels comfortable for her breasts.

• Continues to monitor Finn’s breastfeeding, weight, nappy output and behavior.

 

TIPS:

• Avoid being too prescriptive about the minutes dropped at each session, be flexible in response to your breasts - it may be that you need to slow down the reduction due to feeling uncomfortably full or noticing a blocked duct developing.

• Some parents will not be able to manage dropping minutes AND a session and need to go slower. Others may be able to reduce quicker.

  • For example, It’s possible that at most pumping sessions you are able to pump for your ‘new’ length of time, but at one or more sessions you need to pump for a bit longer due to feeling uncomfortably full. In this case, pump a little more as needed for comfort. See ‘Troubleshooting’ below.

 

*Of course if you have any concerns that nappy output is reduced, feeding doesn't seem effective, or weight gain is a problem then seek support as soon as possible.*

 

Troubleshooting:

Further information on:

Engorgement

Blocked ducts and Mastitis

Dropping Top Up’s Gradually

Breast lumps: https://breastfeeding.support/breast-lumps/

 

*Please see your Healthcare Provider if you have any breast lump or changes that lasts longer than a few days*