When does pumping interfere with (rather than help you move towards) direct breastfeeding your baby?
Pumping is often recommended as a compensation for health system blind spots
Breast milk pumping, for all its benefits at times, can also disrupt the possibility of direct breastfeeding, and might make life with your baby a lot harder than it needs to be. As with all machines, we need to use them wisely, in a way that doesn't do harm to biological systems such as the precious and complex biological system of you and your breastfeeding baby.
Unfortunately, mechanical pumping of breast milk is often recommended as a compensation for health system blind spots concerning
-
Fit and hold, and the devastating impact nipple and breast tissue drag can have on your and your baby's breastfeeding. You can find out about this here.
-
The importance of frequent and flexible breastfeeding for the maintenance of a milk supply which meets your baby's caloric needs. You can find out about frequent and flexible breastfeeds here.
It can be hard to transition away from pumping to direct breastfeeding
There are a number of reasons why it can be hard to transition away from pumping to direct breastfeeding. One reason depends on whether your baby is receiving formula, and how much. You can find out about this here.
Another very important reason is that an unintended side-effect of using a lot of milk from a bottle, regardless of whether it is your expressed breast milk or formula, is that your baby's appetite drive to the breast is affected. It is normal for a baby who is 'triple feeding', for instance, to enjoy being at the breast - but to quickly drowse off into sleep. As a result, women who offer the breast first before using the bottle in a triple feeding regime very commonly state that "baby isn't doing anything at the breast".
You might be told that your baby doesn't transfer much milk at the breast when you're triple feeding because the baby has a weak suck or a dysfunctional suck or restricted oral connective tissues. There are three situations in which a baby's suck can be affected by a true medical condition.
-
A very small number of babies have a true, classic tongue-tie, which requires a frenotomy.
-
Babies who are born prematurely typically have an undeveloped capacity to suck. If your baby is preterm, you and your baby will need special support. Expressing your breast milk usually becomes an important part of caring for your little premmie baby.
-
Occasionally little ones are born with medically diagnosed neurological conditions which impact on neuromuscular strength and integrity.
However, those conditions aside, drowsing off at the breast or not transferring much milk at the breast is to be expected when most of your baby's caloric needs are met through the use of the bottle. A lack of vigorous and effective milk transfer is normal when the bottle is being used, not because the baby has learnt abnormal neuromuscular sucking pathways with the teat, but because predominantly receiving milk through bottle feeding dials down a baby's appetite drive at the breast.
Because of our health system blind spots about important elements of breastfeeding support, women who are feeding their baby mostly expressed breast milk can also often find themselves locked into pumping when, with the right help, they could return to direct breastfeeding (which is so much easier). You can read about Jenny and her preterm baby here.
-
You can find out about 'triple feeding' and how to transition back to direct breastfeeding here.
-
You can find out about predominantly expressed breast milk feeding and how to transition back to direct breastfeeding here.
-
You can find out about health system blind spots in breastfeeding support here.
Recommended resources
When does pumping of your breasts help with breastfeeding?
What timings work best if you're pumping your breast milk?
How to protect your nipples and breasts from injury during pumping
Why triple feeding andthe top-up concept can get in the way of successful breastfeeding
How to transition from formula use to exclusively or predominantly direct breastfeeding
You can find out about expressing and storing your breast milk on the Australian Breastfeeding Association's website, here.
Selected references
Gridneva Z, Warden AH, McEachran JL, Perrella SL, Lai CT, Geddes DT. Maternal and infant characteristics and pumping profiles of women that rpedominantly pump milk for their infants. nutrients. 2025;17:366.
Rosenbaum K, McAlister B. An integrative review of exclusive breast milk expression. Journal of MIdwifery and Women's Health. 2024:doi:10.1111/jmwh.13713.