When to Use the Pump and Dump Method for Lactation

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 breastmilk if the breasts are stimulated, mothers needed some way of continuing to keep their bodies producing breastmilk for future breastfeeding, even while they were unable to breastfeed for medical reasons.

How Lactation Works

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

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

Maintaining Breastmilk Production

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

The pump and dump method requires some discipline on the part of the mother, to continue to pump, even without the immediate benefits of breastfeeding, 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 breastmilk. The exact amount that goes into your breastmilk depends on several different factors. 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 period of taking a medication that may be harmful to your baby, but that you are not intending to continue long term.

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 breastmilk 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.

However, if you do not pump and dump, you may not be able to regain your milk supply, and 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 many 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 be sure of whether there is a "safe window" for breastfeeding. When in doubt, pump and dump.

Exceptions to this are drugs that 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.

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.

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

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Article Sources

  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.

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