Exclusive pumping is a big commitment, but it's an crucial breastfeeding option. And exclusive pumping IS a type of breastfeeding. You're still feeding your baby your breastmilk, it's just a different delivery mechanism. 

Reasons for exclusive pumping

There are three main reasons for pumping exclusively.

1. Your baby can’t breastfeed directly for physical reasons or simply can’t figure out how to latch or suck properly, despite getting help from a lactation consultant.
2. Your baby is in the NICU and it isn't safe for him to breastfeed directly, or he's too young to learn. 
3. You still want your baby to get the miraculous benefits of breastmilk. 

So what do you do if you can’t breastfeed directly and don’t want to give your baby formula? You pump exclusively!

Through exclusively pumping, or EPing, your baby still gets all the nutrients of breastmilk, just through a bottle.

Benefits of breastmilk

Breastmilk has incredible benefits. EPing is hard work, whether you're a new mom or not, but the effects are powerful. You’re truly showing your baby that you would do anything for her. Breastfed babies experience:

• Stronger immune systems
• Lower rates of sudden infant death syndrome (SIDS)
• Fewer ear infections
• Fewer gastrointestinal episodes
• Fewer colds and other respiratory illnesses
• Less risk of bacterial meningitis
• Less risk of sickness and hospitalization in general

As a result of all these incredible benefits, breastfed babies have lower mortality rates. And, on a much smaller level, you’ll miss work less often—six times less often—because of a sick baby.

Those are only a few breastmilk benefits. Read more at the Cleveland Clinic about how baby breastfeeding affects childhood, adolescent, and adult health.

The breast pump

Pump quality

First and foremost, you need an incredible electric breast pump. There are a lot of pumps on the market, but you need a serious, hospital-grade, heavy-duty pump if you’re going to pump exclusively. If you want to keep up your milk supply AND not go insane, splurge and get something nice.

Ideally, get a double electric pump--one that can pump both breasts at the same time. If you're an exclusive pumper, which is very time-consuming, this can give you back part of your day.

Pump settings

Your breast pump has (at least) two settings: suction and speed. You don’t have to put the breast pump on high settings in order to get a large amount of milk. If it’s uncomfortable or even painful, then you’re less likely to keep doing it.

Strong suction can even lead to milk blisters (especially if the flange doesn’t fit you right). High speed can suck your areolas in farther than you’d like. Find settings that feel comfortable for your breasts. You’ll make more milk if you’re relaxed!

Flange sizes

It’s so important to use breast pump flanges (aka breast shields) that fit you well. Plastic flange sizes range from 21 mm to 36 mm, which is good because nipple sizes vary quite a bit! Not every manufacturer carries every size, though.

If you have the wrong size, you could have lower milk production, milk blisters or even cuts, and blocked milk ducts or even mastitis. Ask your lactation consultant (IBCLC) to help you find the right size for your nipples.

The nipple itself is the only part you have to fit—not the whole areola. (None of the areola should be sucked into the tunnel when you’re pumping.) You can measure your nipple with a measuring tape to find the right flange size.

Signs of a bad flange fit:

• Pain
• Areola tissue inside the tunnel
• Random firm areas of the breast after a pumping session (that means there’s still some milk left)
• A white circle around the nipple

Signs of a good flange fit:

• No nipple pain
• Your nipple is centered
• Your nipple moves freely in the tunnel

What else do you need for exclusive pumping?

A hands-free pumping bra.

When you pull down the flaps on your nursing bra, wrap the pumping bra or bustier around your chest. The bra has holes at the nipples so you can put the flanges through the holes, and the bra will keep them strapped to your boobs.

Now you can go hands-free! Read a book, pat your dog, even type on your computer. The distractions make the time pass faster, and they keep you from stressing about how much milk you’re making. (Less stress = more milk.)

Breastmilk storage bags.

Get food-grade bags designed for storing human milk. After the pump itself, this is the most pricey part of exclusively pumping. (Gerber Seal-N-Go bags are about 30 cents a bag, for example, which adds up over time.)

Write the date and number of ounces on each bag for easy record-keeping. (Always check the date before feeding your baby, to make sure the expressed milk hasn’t expired.) Freeze the bags flat for best storage.

Also, try storing the little breastmilk bags in bigger, gallon-sized Ziplock containers. They can help you keep the bags organized by date ranges, and they’re a lot easier to find than hunting for individual small bags.

How often should you pump?

Pretty darn often.

Newborns usually eat about 8 to 12 times a day, so that’s what you should shoot for—in other words, about every 2 hours, at least during the day. Definitely don’t go more than 3 hours without a nursing session. Giving your body regular please-make-more-milk signals is the best way to boost your supply.

Breastmilk production works by supply and demand. The more you demand milk from your body (by pumping), the more milk it will make.

Pump at night, too.

It’s ok to go longer at night, but if you’re still establishing your milk supply or if you’re struggling with it, then try to pump at least twice a night. I know, getting up in the middle of the night when your baby isn’t even crying sounds wrong, so try to coordinate your pumping sessions with baby wake-ups. Take care of your little one, then sit down and pump for 20 minutes.

Definitely pump in the early morning.

That’s when your prolactin levels are highest. Prolactin is the hormone that your body produces when you pump (or breastfeed)—it triggers additional milk production.

And by early morning, I mean really early… like 1 a.m. to 5 a.m. Sounds miserable, but it works.

Pump 7+ times a day.

Overall, shoot for at least 7 pumping sessions a day—more if you can swing it. If you can’t fit a larger number of times, be kind to yourself. You’re doing the best you can.

Try to stick to a pumping schedule so that it brings structure to your day rather than feeling like chaos.

Keep track of your pumping sessions.

You’ve got a lot on your mind. You don’t need to mentally keep tally of 7+ sessions a day. You’ll lose track. So write it down on a notepad—physical or digital—or try an app (we have a bunch of suggestions a few sections down).

How long should you pump?

Shoot for 15-20 minutes per pumping session. This is a good balance between stimulating milk production, and not spending your entire life pumping.

But more important than the total amount of pumping is the amount of pumping you do after the milk stops flowing. Shoot for 2-5 minutes post-flow. This nipple stimulation tells your breasts that you actually need more milk than it has provided, and that increases your milk production.

Also, some experts say the continued pumping post-flow can actually trigger a second let-down, leading to more breastmilk output during that session.

The most important thing is pumping until your breast is soft. This indicates that you have removed all the milk.

How much milk do you need per pumping session, per bottle, or per day?

Every baby is different, of course. But the average breastfed baby (1-12 months) drinks about 26.8 oz per day. After the baby starts eating solids, breastmilk consumption reduces proportionately.

If you pump 7 times a day, that means you need approximately 3.8 ounces per pumping session. But you shouldn’t set a specific goal for each individual session, because your output varies throughout the day. Look at daily totals instead. And keep in mind that every baby differs.

Babies who exclusively eat breastmilk need to drink more often than their formula-fed counterparts, but they eat less volume per feeding. This is because breastmilk is digested faster, and it’s more nutritionally rich. If your baby eats 8-12 times a day, this means you need approximately 2.7 ounces per bottle, but that amount will vary quite a bit.

If you know how much and how often your baby eats, you can do the math yourself; total ounces divided by total number of bottles (or pumping sessions).

How do you establish a strong milk supply?

Pump, pump, pump again.

After the first few weeks of the baby’s life, your breastmilk production is just supply and demand. Your pump is the demander, and if you use it right, it turns your breasts into very impressive suppliers.

When is the supply established?

Breastfeeding moms usually stabilize their supply between 6-12 weeks postpartum. This is after the initial waves of postpartum hormones, which start with making colostrum and then keep your milk churning for a few weeks. After that, it’s all on the supply-and-demand cycle.

You might notice a decrease in your milk supply. Although that can be frustrating, it sometimes just means that your body has reached a good rhythm and isn’t overproducing anymore.

As a result, you’ll probably experience engorgement less often. Your breasts will likely feel softer even before a feeding. You’ll also leak less frequently (hooray!).

Your supply might regulate all of a sudden, or it might happen gradually.

What if your supply gets established, but it’s not enough milk?

Try power pumping or read about what you can do to increase your milk supply. Once your supply is established, that doesn’t mean it’s set in stone forever. It just means it’s following your cues. Change your cues, change your supply.

You can also try galactagogues (supplements that help increase milk supply), like Maade’s coconut water hydration powder.

Best exclusive pumping apps

These apps are golden—they keep track of how often you pump, how long you pump, and how much you produce. They help you make sure you’re hitting your goals, and they can even help you identify times of day when your breasts are most prolific. Once you identify those times, take advantage of them!

Milk Maid ($2.99, Apple, 3.8 stars)

Milk Maid has been featured in Parenting, the New York Times, and Babytalk magazine. In addition to covering the basics, this app tracks:

• How much milk you have stashed away—in multiple locations (indoor freezer, garage chest freezer, daycare, and grandma’s house? Yes please!).
• How long your stash will last.
• Individual bags or bottles of frozen breast milk, including date pumped. It will even track when each one expires, depending on where it was stored.
• How many bottles or bags you feed your baby each day.
• Time spent per left breast / right breast.
• You can even export all the data to a spreadsheet or word processor to share with your pediatrician or lactation consultant (IBCLC).

And here’s my favorite feature: If you have an upcoming trip where you’ll be away from your baby for an extended period of time, Milk Maid will calculate how much milk you’ll need based on past patterns.

Milk Stash (free, Apple, 4.4 stars)

Designed by a pumping mom for other pumping moms, this app does all the basics plus you can:

• Keep track of your frozen breastmilk across different locations.
• Get a notification when a bag or bottle is going to expire soon.
• Coordinate with your childcare providers.
• Pinpoint food allergies by tracking what you eat and how your baby responds to that milk.

Even though it’s free, it doesn’t have any ads. And even though it’s an Apple app, there’s also a browser-based version so your caregivers can access it even if they don’t have an iPhone.

Pump Log (free trial then $9.99, Apple, 4.7 stars)

This app does all the basics, plus:

• Reminds you when it’s time to pump.
• Suggests supplements and foods to increase your milk supply.
• Shows you where you can drop a pumping session, after your supply is firmly established.
• Lets you track production by high/average/low output, helping you notice when you have a dip in your supply.

Awesome feature: a Countdown Calculator that tells you when you’ve stashed enough breastmilk that you can stop pumping, and your supply will last your baby through the planned end of your breastfeeding (if you have a planned time for weaning).

Baby Log (free then $8.99, Android, 4.4 stars)

This app is a lot more robust than the previous apps on this list because it tracks your baby as well as your boobs. It lets you track pumping time, output, and stash, AND you can:

• Log wet and dirty diapers.
• Log your baby’s growth and weight gain.
• Log your baby’s sleep patterns.
• Log your own hydration! (Favorite feature.) It even reminds you when you need to drink more water.
• Share an account.
• Customize the colors and fonts.
• Keep track of multiple children separately—great for multiples and toddler/infant.

Although it’s a complex app, the features are all insanely useful—and if they annoy you, you can turn off the features you don’t use.

Breastfeeding Newborn tracker, pump and baby diary (free or up to $29.99 in-app purchases, Android, 4.6 stars

This app offers tons of useful features (but it’s missing a way to track your stash).

• Track left and right breasts separately.
• Track wet and dirty diapers.
• Track baby’s height and weight gain.
• Copy your past feeding and adjust it for your current feeding (instead of filling out a whole fresh entry).
• Automatic shut-off after a set period of time—useful if you’re always forgetting to turn it off.
• Leave comments for yourself and your baby’s caregivers.
• Track solid foods, too, and your baby’s reaction to them.
• Track your baby’s sleep.
• Track multiple children.

How to bottle-feed with breastmilk

Bottle-feed on demand.

Just like with direct breastfeeding, feed your baby when he’s hungry. This is healthiest for the baby, and it also helps you dial in your milk production. Watch for your baby’s hunger cues and offer a bottle.

It takes about an hour and a half to digest breastmilk, so your baby may need to eat that frequently, especially if he’s a young infant. If he’s getting closer to 6+ months, he might go 3 hours between feedings.

Don’t overfeed the baby.

When nursing, the baby can control the flow of milk by the way he sucks. With a bottle, the flow is more constant. This can lead to overfeeding (and a grumpy baby).

Use slow-flow or newborn nipples.

Seriously, get the smallest ones on the market for your bottles. This mimics direct breastfeeding and helps you avoid overfeeding the baby.

(As he gets used to bottles, and if he doesn’t tend to gorge, you can slowly increase nipple sizes. As he gets older, he might grow frustrated with the low flow.)

Go slowly and be patient.

Offer the bottle gently and wait for the baby to take it—don’t shove it in his mouth. (Try running the tip of the nipple on his lower lip. This tells your baby that he has the opportunity to eat, and he may reflexively open his mouth.)

Also, don’t stress about rushing the feeding. Babies take time to eat, especially with low-flow nipples. If you’re stressed, your baby might feel your tension and not eat as well.

Cleaning the breast pump

Take it apart completely—separate the tubing, flanges, membranes, valves, connectors, bottles—anything that touches the milk.

Handwash.

Wash the parts with hot, soapy water—but don’t do it in the sink. Sinks are germier than you would think. Instead, use a dedicated wash bin. (Don’t use the bin for anything else.)

Similarly, don’t use your regular dishes sponge. Use a sponge or brush that you have dedicated to pump parts and bottles ONLY.

Rinse very thoroughly, then air-dry.

Use the dishwasher.

Only do this if the pump manufacturer recommends it. You can use a mesh laundry bag to keep the smaller parts together. Use hot water and a heated drying cycle.

Sanitize

You don’t have to sanitize, unless your baby is medically vulnerable. But if baby needs extra care or you want to be extra careful, the use steam (microwave is fine) or boil the parts on the stove (5 minutes with plenty of water so no parts touch the pan).

Life hack

Some women put the pump parts in a ziplock in the fridge after a simple rinse. Breastmilk is food-safe in the fridge for up to 4 days according to the DCD. If it’s safe in a bottle, why not on pump parts?  This way, you can wash the parts just once a day, instead of 7-12 times a day, which gets very tedious very fast.

Avoid these things (if you want to keep a healthy milk supply)

Birth control pills

 The hormones in the pill can wreak havoc on the hormones stimulating your milk supply. If you want to or have to go on birth control, try non-hormonal methods or ask your doctor for a progestin-based pill instead of the regular one, which is heavy on the estrogen. Even the “mini-pill” can influence your milk production, though.

(Keep in mind that breastfeeding usually delays ovulation, but it can come back at any time, so don’t depend on it as your primary form of birth control.)

Sudafed (and generic brands containing pseudoephedrine HCl)

Sudafed can provide relief for common cold symptoms including congestion and sinus pain. But it also tanks your milk supply. Try other alternatives, like decongestants and antihistamines.

Caffeine

This doesn’t reduce your supply, but it can make your baby a little crazy. Very few people wish their infant would sleep LESS (and even if you do, there are healthier ways to achieve that goal).

That doesn’t mean you need to cut it out completely. Just keep it limited, and then your body metabolizes most of it and very little gets into the milk. One cup a day is fine. If you usually chug seven mugs, it’s time to scale back.

Dealing with judgment and criticism

Exclusively pumping is a huge commitment. It takes a lot of time, and it can feel frustrating or limiting. Friends, family, and even healthcare providers may see how hard you’re working and look down on your choice.

You may even feel excluded by both breastfeeding moms (after all, you’re feeding your baby through a bottle) and formula feeding moms (after all, you’re feeding your baby breastmilk). Don’t let that hold you back. Look at it a different way, and you have something huge in common with each group. 

EPing is difficult, but it’s absolutely possible. You just need the right information and support.

Breastmilk is so good, it’s worth any delivery system. You’re a hero to your baby’s immune system.

So don’t feel bad AT ALL. You’re a great mom to go through all this work and hassle just to keep your baby as healthy as you can.

Dealing with your own exhaustion or frustration

First, let me say something very important: You don’t have to pump. If you feel like it’s getting you down or messing with your quality of life too much, it is perfectly ok to hop off the EP train and give your baby some formula. Sane and happy mamas are the best mamas.

This is a very personal choice. Do what’s right for your family.

Sometimes just knowing that it’s a choice makes it easier to keep going. You’re not trapped. You’re doing this for your baby.

If you want to keep pumping, but you feel discouraged, it may help to remind yourself  that you’re making a huge difference. Reread the article from the Cleveland Clinic about the 25+ benefits for the baby’s health. Plus, check out these benefits for YOU (also from the Clinic). Breastfeeding, which includes pumping,

• Promotes weight loss
• Releases stress-reducing hormones
• Reduces postpartum bleeding
• Reduces UTIs
• Lowers the risk of anemia
• Lowers the risk of postpartum depression!!
• It also lowers many health risks, including the risk of:
• Breast and ovarian cancer
• Cardiovascular disease
• Lupus and rheumatoid arthritis
• Endometriosis
• Diabetes
• Age-related osteoporosis
• Hypertension

You already know you’re helping your baby--he's lucky to get his mother's milk. But look how much you’re helping yourself, too. It’s a time-consuming but temporary commitment that can have both temporary and lifelong benefits—for you and your little one.