Pumping Breast Milk for Premature Babies

Breast pumping equipment.
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Establishing a milk supply by pumping breast milk for a preemie is a challenge for many moms. Babies usually establish their milk supply by nursing frequently at the breast, but many preemies are born too early to breastfeed. In these cases, moms must pump breast milk in order to establish (and maintain) their milk supply.

The Goals of Pumping

Pumping breast milk for a preemie accomplishes two things: First, premature babies often have difficulty breastfeeding at first and with expressed milk, they can still receive the benefits of breast milk without having to nurse. Breast milk produced by mothers of premature babies has a different composition that is optimal for preemies. It is higher in protein and minerals and contains different types of fat that are more easily digested and absorbed.

Second, pumping breast milk when your baby can't breastfeed will help establish your milk supply.

Babies usually establish their moms' supply by nursing, but when your preemie can't effectively nurse, you will have to turn to pumping for the same effect.

How Often Should I Pump?

Full-term babies breastfeed often in the early days, sometimes as often as every hour or two. More breastfeeding makes more breast milk, so these frequent feedings help mom establish a good milk supply. To establish a good milk supply when you pump breast milk for your preemie, you need to pump often enough to mimic a newborn baby's feeding patterns. Early on, you should pump breast milk about 8 to 10 times per day or about every 2 to 3 hours.

When you time pumping sessions, time them from the start of the last session. If you start pumping at 8:00, your next session should start between 10:00 and 11:00. Pump around the clock until your supply is well established, including overnight.

Middle of the night pumpings may feel like a burden, but they help you prepare for midnight feedings after your baby comes home!

After your milk supply is well established, you can slow your pumping sessions down. To maintain your supply, pump breast milk at least 7 times per 24 hours, or every 3 to 4 hours through the day and night. If your supply starts to dwindle, or when your baby starts taking more milk, increase your pumping sessions back to 8 to 10 times daily to increase your milk supply.

How Much Time Should I Spend Pumping Breast Milk?

In the first couple of days after your baby is born, you won't express much milk. In order to establish a good supply, pump for about 15 minutes per session. If you are pumping one breast at a time, pump each breast for 10 to 15 minutes.

Once your milk comes in, use its flow to tell you how long to spend when you pump breast milk. When you turn the pump on, it will usually take a couple of minutes for the milk to start to flow. You want to completely empty your breasts, so pump for about 2 minutes after the flow stops completely.

2 Sources
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  1. Stanford Children’s Health. The Benefits of Mother's Own Milk.

  2. Gleason C, Juul S. Avery's Diseases of the Newborn (10th Edition). Elsevier. 2017.

Additional Reading
  • Hurst, N. "The 3 M's of Breast-feeding the Preterm Infant." J Perinat Neonat Nurs July-Sept 2007. 21; 234-239.
  • Mohrbacher, N and Stock, J. The Breastfeeding Answer Book, 3rd Revised Edition. January, 2003; La Leche League International, Schaumburg, IL.

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.