How to Combine Breastfeeding and Pumping

How to Combine Breastfeeding and Pumping

Breastfeeding your baby whenever she’s hungry would be the preferred method for most mothers. However, the reality is that most moms need to return to work while others might be unable to breastfeed due to medical conditions. Some moms would like the dad to become involved in feeding time. But this does not have to mean the end of breastfeeding. Combining breastfeeding and pumping your breast milk is a great way to give your baby the best nourishment without being attached to the breast to feed.

Many healthcare bodies, including the American Academy of Pediatrics, recognize the use of expressed or pumped breast milk for feeding infants when direct breastfeeding isn’t possible. So if you need to occasionally use some expressed breast milk, here’s a guide on how you can combine and balance breastfeeding and pumping:

  • Pump both breasts after you have breastfed your baby.
  • Try to do this in the morning, or at a time when your breasts feel heavier or fuller.
  • You may only get an ounce or less at the beginning, but it will gradually increase as soon as your body adjusts to the increased demand for milk.
  • Remember not to skip more than one breastfeeding session without pumping.
  • You can collect and store your pumped breast milk in the fridge or keep it frozen for future use.
  • Wait for about 4 to 6 weeks before introducing pumped breast milk using a bottle. This will ensure that you will have a well-established breastfeeding routine with your baby. Your baby is also not too old to refuse the bottle nipple.
  • For babies 6 months and older, you may also want to explore other methods of offering expressed breast milk to your baby such as giving it in a cup or beaker.
a breastfeeding mother pumping breastmilk using a breast pump

So it sounds pretty simple, right? However, if you also need to pump breast milk for your baby, there are some tips that will make the experience of pumping while also breastfeeding your baby run a lot smoother.  I will discuss the recommendations with regards to combining breastfeeding and pumping while also answering some of the most common questions parents have during this time.

Can you combine breastfeeding and bottle feeding?

If you would like to breastfeed, but can’t do it exclusively 24 hours a day, then combination feeding can be an ideal option. Some of the most common reasons why parents may want to combine breastfeeding and bottle feeding are:

  • Imminent need to get back to work
  • Health / medical constraints for either baby or mother
  • Initiating breastfeeding for a bottle-fed baby

Should you wish to bottle feed your breastfed baby, here are some important considerations you might need to think about

Your baby may experience nipple confusion. This happens when babies who have been bottle-fed learn a different way of sucking, which may result in him refusing to feed from the breast. It could also be the other way around, where your baby may refuse the bottle and would only want to feed on the breast.

Additionally, here are some tips to effectively combine breastfeeding and bottle feeding for your baby:

Do it gradually

It usually takes a couple of weeks before your baby can adjust to the new routine. It may help if you offer the first few bottles while your baby is relaxed. There will be a greater chance that he will accept milk from a bottle. A very hungry and fussy baby will more likely resist. Never force your baby to finish a bottle and let him tell you when he has had enough.

Allow ample adjustment period

If the reason for bottle feeding is going back to work, then you must give at least 2 weeks to pump some extra milk and introduce the bottle to your baby. This is also to allow your body enough time to adjust to your new feeding and pumping schedule.

Ask for some help

It is common for breastfed babies to resist a bottle when they are close to their mother where they know their supply of breast milk is nearby. Ask for some help from your husband/partner, or you another family member to introduce the first few bottles to your baby. This will lead to a greater chance that your baby will accept the bottle.

Be consistent with the breastfeeding rhythm

When feeding your baby with a bottle, try to make the experience as close as possible to his breastfeeding routine. Let your baby draw the nipple into his mouth rather than forcing it through. Keep him in an upright position and make sure to allow your baby to have some brief pauses while feeding, just like the normal milk-let down he experiences while breastfeeding.

Breastfeeding and Pumping

If you’re a mom who would like to breastfeed but can’t be physically there with your baby the whole time, the next best option is to pump your breast milk for your baby. Making sure that you maintain a good milk supply and that you leave enough breast milk while you are away can be a challenging commitment. Learning how to express your milk effectively will be an essential skill to learn. Here are some questions you may have when you’re planning to both breastfeed and pump for your baby.

How soon should I pump after breastfeeding?

Pumping after breastfeeding is done primarily to create an increased demand for milk. The more demand, the more your body will produce an additional supply to meet it. It’s recommended that you should pump within 15 to 30 minutes after breastfeeding your baby. You may also pump in between feeds, but make sure it is at least 1 hour before your baby’s next feeding. Pumping too soon before your baby’s next feed may prevent him from getting enough milk from the breast.

Can you pump and breastfeed at the same time?

Pumping while you breastfeed your baby on the other side may feel a little awkward, but it can be a valuable skill to master. In fact, there are many moms who find it easier to pump and breastfeed at the same time. Your baby suckling at the breast will stimulate your milk ejection reflex. This will make it easier to get the milk flowing and in turn easier to express extra milk.

With skin to skin contact along with nipple stimulation by your baby feeding at the breast, oxytocin will be released. This, in turn, induces your body’s “milk ejection reflex”. In the first six weeks, you may experience milk from your other breast leaking. Use a breast pad to collect any excess milk. Better still, collect in a sterile bottle or use the Haaka pump where you can collect extra breast milk that can be refrigerated and used later. This is a great way to save and store breast milk which may otherwise have been lost.

To pump while breastfeeding:

  • First, you need to set up the pump and its accessories so it is ready to be used.
  • Latch baby on your breast.
  • Place the pump on your other breast and turn it on.
  • You may also place the pump before you latch your baby depending on your personal comfort. However, many moms find securing the pump with one hand a lot easier than latching their baby with one hand.

Can I mix breast milk from one day to another?

You can combine breast milk from one day to another provided that they are properly labeled and stored. However, mixing breast milk isn’t recommended for high-risk infants. If you have a premature baby or an infant with a medical condition, it is better to ask your health care provider for their guidelines on pumping and storing your breast milk.

Can I combine breast milk from different pumping sessions?

Similarly, combining breast milk from different pumping sessions is generally fine as long as you make sure they are appropriately labeled and stored.

Here are some important reminders when you plan to mix breast milk from several pumping sessions or days:

  • As much as possible, combine breast milk that you’ve collected at the closest possible intervals. For example, combining breast milk you pumped from the morning to evening, or from Monday to Tuesday.
  • The container must be labeled using the date and time of the first breast milk you stored.
  • If you are going to mix a fresh collection of breast milk to refrigerated or frozen milk, make sure to cool the fresh breast milk in the fridge first before you pour it into the stored milk.
  • Store it in small amounts of 2-4 ounces, which is just enough for your baby’s single feeding. This is to avoid wasting breast milk from an unfinished bottle.  
  • Mixed breast milk must be consumed within 5 days from the date when the original milk was stored.

Pumping into previously expressed milk is really only suitable if you’re doing it in a single session. For example, when you have pumped from one breast to the other simultaneously. According to CDC’s breast milk storage guidelines, breast milk can only stay up to 4 hours in room temperature not exceeding 25 °C. So if you’re planning to let your breast milk stay at room temperature while using the same container for your next pumping session, you must make sure that the temperature and the length of time in between do not exceed the guidelines as stated by CDC. It should also be immediately consumed within 4 hours from the time you expressed the original milk, to prevent milk from spoiling.

Can I pump into the same bottle twice?

The temperature, proper labeling, and storage are some of the most important factors to be considered when pumping breast milk. If you’re pumping into the same bottle containing previously expressed milk, remember the conditions that were mentioned earlier. This is to ensure that your breast milk stays fresh and not contaminated by the time you offer it to your baby.

On the other hand, if you are just using the bottle as a medium to collect breast milk which you intend to transfer to a storage bag or another container, then using the bottle twice will be absolutely fine as long as it stays clean and not contaminated. A used bottle can be easily rinsed using cold water to remove any milk debris from your previous collection.

It is important to note that these recommendations are intended for mothers and babies who do not have any medical conditions. If you or your baby have special needs, contact your health care provider for a more appropriate guideline on pumping breast milk for your baby.

Do you have to wash pump parts after every use?

According to the CDC guidelines, it is ideal to wash your pump parts immediately after every use to prevent any bacteria from forming on the pumping equipment.

However, if washing after every use isn’t possible, the Australian Breastfeeding Association, in accordance with the National Health and Medical Research Council’s breast milk storage guidelines, has the following recommendations:

  • You may just rinse the pump parts using cold water to remove the breast milk and then keep them in a clean and closed container.
  • Make sure that thorough cleaning of the pump parts will be done once every 24 hours of frequent use.
  • If the fridge isn’t accessible and you can’t wash them after every use, then it is better to invest in some extra pump parts to have a clean set every time you pump.

If your baby is sick, if you or your baby has thrush or if you have an infection on your nipples, you will need to clean and even disinfect your pumping parts after every use. Ask your health care provider for any special handling you’ll need in cleaning your pumping equipment.

How to Clean your Pumping Equipment

Learning how to keep your pump parts clean is as important as how you store your breast milk. Breast milk that is trapped in the pump parts and tubing can attract bacteria and molds to grow.

Here are guidelines on how to clean your pumping equipment:

  1. Wash your hands thoroughly using soap and water.
  2. Use a basin that is obtained specifically for cleaning feeding bottles and equipment. Do not place them directly on your sink to minimize the risk of contamination.
  3. Remove all the pump parts (flanges, valves, membranes, connectors, and milk collection bottles) and rinse with cold or running water to remove the milk debris.
  4. After rinsing, fill the basin with hot water and add a few drops of dishwashing liquid.
  5. Use a brush to scrub and remove all the milk, grease or dirt that may be trapped in the pump parts. The brush must be used solely for cleaning and the pumping equipment for your baby.
  6. Rinse the pump parts using running water or by submerging them in another basin with clean water. Do it at least twice to make sure there is no remaining soap or dirt.
  7. Let the pump parts sit on a clean dish towel or a paper towel and air-dry. Do not rub or pat the items to prevent the transfer of bacteria.
  8. After making sure there are no remaining water droplets on the equipment, keep them in a closed container or clean plastic bag.

Alternately, you can also use a dishwasher to clean the pump parts depending upon the recommendation of the manufacturer. Just make sure to wash your hands before you remove the pump parts from the dishwasher. Also, allow them to air-dry before you use them.

Situations Where You Are Combining Breastfeeding And Pumping

Each breastfeeding mother will have different reasons and different needs when combining breastfeeding and pumping. Some moms may only need to pump occasionally while other moms may need to constantly pump milk for their baby. Various factors including the amount of time away from her baby, time available to express milk and where she is expressing her milk will have an impact on what type of pump to use and when. The chart below is a guide as to what pump would be suitable for your needs in each situation.

Manual / Electric
hand pump
Battery operated
pump
Double
Electric
pump
Hospital Grade
pump
Occasional
Separations
suitable plus
breastfeeds
suitable plus
breastfeeds
Part-time
work
(6 hrs or
less)
suitable plus
breastfeeds
suitable plus
breastfeeds
Full-time
Work
(8 hrs or
more)
suitable plus
breastfeeds
suitable plus
breastfeeds
baby in
hospital
suitable

Our modern lifestyle means we have less time. However, breastfeeding and pumping for your little one is a priceless gift. It may be challenging at first, but rest assured that all your efforts will pay off with the best nutrition and overall wellness for your baby.

Recommended Topics

References:

https://pediatrics.aappublications.org/content/115/2/496
https://www.nhs.uk/conditions/pregnancy-and-baby/combining-breast-and-bottle/
https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
https://www.breastfeeding.asn.au/bf-info/breastfeeding-and-work/suggestions-using-electric-breast-pump
https://www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/breastpump.html

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