Is pumping just as good as breastfeeding directly?

Since the invention of effective breastpumps in the late 1990s, some women have started pumping breastmilk for the baby but not putting baby to the breast. They have developed an indirect breastfeeding relationship. While breastmilk is lightyears better than formula, breastfeeding is about the whole interaction, not just the milk. But is it just as good to pump as it is to get the baby to feed right from the breast? Lactation experts know how difficult it is to get the baby to latch. Few hospitals provide new mothers with enough time with the lactation consultant so that they can get an effective latch. In addition, new moms tend to go home before their milk comes in at great volume, when breastfeeding gets quite difficult. We suggest enlisting the help of a lactation consultant or at least a woman who has successfully breastfed children to help you once you go home so you can get a good latch.

Feeding directly is important! Here are a few things it does:

The mom's immune system is in charge of protecting the baby until about age 5, when the baby's immune system is stronger. Immune factors are passed to the baby in the uterus and as the baby passes through the birth canal and picks up the family's normal organisms--they help build a strong immune system. But that is only the beginning. Through breastfeeding directly, the mom can continue to protect the baby. If the baby gets sick, through attaching to the mom's breast s/he can transfer the illness-causing organisms to the mom. Then the mom will build anti-bodies--which are immune factors to fight the infection and then transfer them back to the baby in the breastmilk. Without that physical connection, the mom's body won't be able to build those protective anti-bodies (unless she gets infected through a different way).

If the mom does pick up the baby's illness a different way and start building antibodies, many of the cells are broken apart and destroyed with the process of mechanical pumping. The force of pumping, shaking of bottles, and freezing/thawing can all break open the precious immune cells so they can no longer protect the baby. Feeding through a direct connection with the mom many times per day helps the mom's immune system respond immediately to best protect the baby.

What else are moms missing by pumping instead of breastfeeding directly?

That wonderful oxytocin release when your milk lets down that gives you a feeling a love and warmth. It really helps with baby bonding;

The time and energy that she has to put into pumping, storing, thawing, feeding with a bottle and then sterilizing all the equipment and bottles would be helpful to allow the mom time and energy to rest, interact with the baby or get other things done to have less stress;

If the power goes out and she can't use the breastpump and can't latch, it will be an immediate crisis to find a way to feed the baby. Direct breastfeeding is the most secure source of food to get through a crisis;

The baby will likely get sick more often because even when cleaning the bottles, as time goes on, organisms are bound to get missed some times and s/he will get sick more often. Babies in countries where the water is unsafe to drink often die from bottle and formula use--some estimates put it at 3 million per year;

Some moms might be worried that they won't know how much milk the baby has drunk if she feeds him directly from the breast. But don't worry. We do not need to put the milk in a container to know if the baby is being fed enough. Is the baby happy, settled, peeing and pooping frequently, gaining weight and growing? Then the baby is well-fed and there is no need to worry. If the baby is not these things, feed the baby 2-3 times as frequently and things will quickly improve;

Some moms likes to pump so the dad can feed the baby. But he can do that when the mom is out of the house! Also, after the mom feeds the baby, the dad can hold, rock, burp, read to, talk to and explain the world to the baby—these are rewarding and necessary activities and provide at least as much closeness as bottle-feeding;

Because of the burden of exclusive pumping, and the lag-time between baby's demand and the milk production moms who exclusively pump just can't keep up their milk supply as well as a mom who breastfeeds directly. Exclusively pumping moms will have a milk supply that is constantly decreasing, leading to formula being used as a supplement. This is a self-reinforcing cycle of decreased milk supply, and need for formula supplementation that quickly dries up breastmilk. Exclusive and frequent breastfeeding is the most reliable way to keep up the mom's milk supply;

Because the pump is not as effective at extracting milk as the baby's powerful facial muscles, the pump may not extract as much of the high-fat hind milk which is high in DHA, the fatty acid that fuels brain development and a high IQ;

Formula use causes allergies for many babies and if breastfeeding has ceased by the time allergies appear, few mothers persevere long enough to resume breastfeeding and the family can be stuck buying extremely expensive formulas for a baby who is sickened because s/he did not have exclusive breastfeeding;

When lactation experts hear of a mother-baby where the baby is not latching, it is considered a health care emergency, in need of intervention from a lactation expert to help the pair latch and develop a symbiotic relatioship rooted in love that will form life-lasting bonds of health;

We have seen over the past couple decades a lot of American women going this route—pumping only. I think there's a certain amount of discomfort today's women have with another person getting quite so physically attached to them, Don't let "American squeamishness", as The Simpson's once said, get in the way of your and your baby's health. Once we put some effort into getting the baby to latch, the baby and mom will be on a path to sustained health and happiness.

To the moms who are currently pumping instead of latching, I applaud you for knowing that some breastmilk is better than none and doing what you can to get your baby breastmilk! But latching and direct breastfeeding has many benefits and a diet of 100% breastmilk is the healthiest, least-risky path for both mom and baby. I hope you give it another try with the help of a lactation consultant or friend who can guide you.

Best of luck with your breastfeeding! It is the most important way to keep your baby safe and well. Feel free to send me your comments or questions at ssummers@truthaboutnursing.org. If I can help you in any way, please let me know. I would be glad to help.

Also see our other breastfeeding articles:

IIs formula just as good as breastfeeding?

How often should I breastfeed my baby?

Notes on getting a good latch, newborn jaundice, nipple infections

Author: Sandy Summers, RN, MSN, MPH, biography

The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.