Know When to Pump and Dump

Mom and baby with breast pump and bottles in background

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The pump and dump method was developed in recognition of the great physical and psychological benefits of breastfeeding to both mothers and babies, along with the knowledge that sometimes, mothers consume substances which can be harmful or even lethal to the baby.

Because a woman's body will only continue to produce breast milk if the breasts are stimulated, mothers needed some way of continuing to keep their bodies producing breast milk for future breastfeeding, even while they were temporarily unable to breastfeed for medical reasons.

How Lactation Works

Lactation, or the production of breast milk, is a physical process that is maintained by frequent stimulation of the nipple and breast by the baby breastfeeding or by pumping the breasts. The stimulation, along with the removal of the milk from the breasts, is what tells the body to produce more breast milk. If you take a break from breastfeeding, your body slows down and eventually stops the production of milk.

But once lactation has been established, the pump and dump method is a way of continuing to stimulate breast milk production during times when breast milk could be contaminated with drugs or medications. Pumping and dumping can also relieve pressure on the breasts when they are full of milk, and reduce complications that can result from incomplete feedings, such as mastitis.

Maintaining Breast Milk Production

To maintain breast milk production, the nipple and breasts need stimulation several times a day. In addition, the mother needs adequate fluids and nutrition to produce breast milk.

The pump and dump method requires some discipline on the part of the mother to continue to pump while not using the breast milk (as in "dumping" it). But it can be invaluable if you want to breastfeed in future. For some mothers, breastfeeding at a future time can be sufficient motivation to address a long-standing substance use issue.

Why Pump and Dump?

When you drink alcohol, smoke cigarettes or marijuana, take medications, or use recreational drugs, potentially toxic substances enter your breast milk. The exact amount that goes into your breast milk depends on several different factors, particularly the quantity of the substance ingested or smoked.

Furthermore, although some substances are more toxic than others, in general, most drugs are potentially harmful to your baby. However, given the vast physical and psychological benefits of breastfeeding, choosing not to breastfeed your baby is not usually a straightforward or easy decision for any mother.

This is important if you are trying to quit alcohol or drugs, or during a short-term period of taking a medication that may be harmful to your baby.

Pumping and dumping involves removing the milk from your breasts artificially, using a breast pump, then discarding the milk. This tells your body to keep producing more breast milk but does not expose your baby to the potentially harmful substances in your milk. When you are no longer using harmful substances, you can start breastfeeding again.

If you do not pump and dump, you may not be able to regain your milk supply if you stop breastfeeding. You may not be able to share the benefits of breastfeeding with your baby later.

When to Pump and Dump

Even if you are regularly using drugs or medications that could be harmful to your baby, you may not have to pump and dump all the time. In some cases, you can breastfeed before drinking or taking certain medications, and simply pump and dump until at least two hours after your last substance intake.

Check with your doctor, nurse, or lactation consultant to find out whether there is a safe window for breastfeeding with the particular drug or medication you are taking. When in doubt, pump and dump.

Some drugs could be harmful to your baby in any amount. This includes a group of drugs known as opioids. Opiates increase the baby's risk of apnea—stopping breathing—so if you are using any opiates at all, including heroin, methadone, and many prescription painkillers, don't take the risk. Pump and dump for the entire time that you are taking the drug.

There is no safe window during which breastfeeding, or giving your baby your pumped milk, is okay. Even codeine, an opiate medication commonly prescribed to women following childbirth, has been fatal to newborns when it has built up in the baby's system over several days.

Codeine and other harmful substances are sometimes found in prescription painkillers, so be sure to read the label of anything you are taking, and when in doubt, pump and dump.

Breastfeeding Options While on Medication

If you are prescribed any medications (or are taking other substances), always tell your doctor if you are breastfeeding. If they tell you to stop nursing due to the hazards of a specific drug, find out more.

  • Are there other options that might be safe for the baby?
  • Can I pump and dump instead of quitting breastfeeding?
  • If yes, for how long? Are there any safe windows for breastfeeding while I am on the drug? Can I resume breastfeeding after I am no longer taking the drug?

You should also completely avoid breastfeeding, or expressing and feeding your baby breast milk if you are using marijuana. Marijuana, or cannabis, stays in the body much longer than most other drugs and it can take weeks or months of abstinence to completely clear out of your system.

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  1. Reece-Stremtan S, Marinelli KA. ABM clinical protocol #21: guidelines for breastfeeding and substance use or substance use disorder, revised 2015Breastfeed Med. 2015;10(3):135–141. doi:10.1089/bfm.2015.9992

Additional Reading
  • Astley S, Little R. Maternal Marijuana Use During Lactation and Infant Development at One Year. Neurotoxicology and Teratology 12:161-8;1990.

  • Haastrup MB, Pottegård A, Damkier P. Alcohol and breastfeeding. Basic Clin Pharmacol Toxicol. 2014;114(2):168-73. doi:10.1111/bcpt.12149

  • Hothma N, Hotham E. Drugs in breastfeeding. Aust Prescr. 2015;38(5):156-159. doi:10.18773/austprescr.2015.056

  • Liston J. Breastfeeding and the Use of Recreational Drugs -- Alcohol, Caffeine, Nicotine and Marijuana. Breastfeeding Review 6:27-30;1998.

  • Madadi P, Moretti M, Djokanovic N, Bozzo P, Nulman I, Ito S, Koren G. Guidelines for maternal codeine use during breastfeeding. Can Fam Physician 55:1077-1078;2009.

  • Madadi P. Ross C, Hayden M, Carleton B, Gaedigk A, Leeder J. Koren G. Pharmacogenetics of Neonatal Opioid Toxicity Following Maternal Use of Codeine During Breastfeeding: A Case–Control Study. Clinical Pharmacology and Therapeutics 85:31-35;2009.

  • National Center for Biotechnology Information. Cocaine. Drugs and Lactation Database (LactMed). Revised October 31, 2018.

  • National Institute on Drug Abuse. Substance Use in Women: Substance Use While Pregnant and Breastfeeding. Updated April 2020.

  • Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #21: Guidelines for Breastfeeding and the Drug-Dependent Woman. Breastfeeding Medicine 4:225-228. 2009.