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"Is pumping and dumping still a thing?" We asked a lactation consultant all your feeding questions.

If you’re pregnant or a new mum, and you still have a million questions about breastfeeding, bottle feeding and the gamut of information out there, we hear you.

Which is why we asked around our pregnant pals for their most common feeding questions, then handed them over to certified lactation consultant Kristy Newnham to weigh in.

Kristy tells Mamamia her aim is to eliminate the doubt new mums feel that’s brought on by unrealistic expectations placed on child development and breastfeeding. Instead, she wants to empower mums through education and most important of all, “build their confidence to listen to their intuition.”

Of course, the opinions expressed in this piece won’t apply to all situations. As Kristy says, there is no ‘one size fits all’ approach to feeding your baby and every parent will have a different experience. We’re firmly in the fed is best campand breastfeeding won’t necessarily be an option for all new mums.

But if you want to know what other women are asking about feeding, pumping and managing your milk supply, read on.

If your boobs aren’t leaking before you have your baby, does it mean you have less chance of creating milk? Heaps of mums in this group I’m in on Facebook are already leaking colostrum… 

Many women do leak colostrum before they have their baby but a lot don’t, and the amount of colostrum that you can express before you have your baby plays no part in your ability to make milk once you have had your baby.

During your pregnancy, the hormones oestrogen and progesterone help to grow and develop your breast tissue and the structure of your breasts to enable you to breastfeed. From as early as the 16th week of pregnancy your body has the ability to make colostrum (baby’s first milk jam-packed with immune building properties) but until you birth your baby and your placenta the pregnancy hormones hold back your body’s ability to make copious amounts of milk.

After you have birthed your placenta and with your baby frequently sucking and stimulating your breasts, the breastmilk hormones prolactin and oxytocin kick into gear and start to bring your milk supply in. So really the amount of colostrum that you can express before you have your baby plays no part in your ability to produce milk.

Psst, there’s a really good pod on this subject. On Year One, the team discuss expressing, bottle-feeding and what to do when everything goes tits up. Post continues below.

Should I pump before I give birth to help get my boobs ready and stimulate milk supply?

There is no current research that looks into using a breast pump before you have your baby so it is a practice that isn’t recommended. Some women with risk factors such as gestational diabetes may be recommended to hand-express before they have their baby so that can have some colostrum to give their baby if they experience problems with their blood sugar levels after birth.

Milk supply is brought in by hormones and the frequent feeding of your baby at your breast, so pumping or hand expressing won’t help stimulate your milk supply

If I want to breastfeed but also want my baby to take a bottle, what’s the best day to introduce a bottle (with breastmilk or formula?) If I introduce the bottle too soon is it true that they won’t take the breast properly?

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It is always important to establish your milk supply before you offer your baby a bottle. Your supply builds quickly over the first month from regularly feeding your baby and a newborn baby feeds a minimum of 8-12 times in a 24 hour period.

The regular stimulation and emptying of your breasts helps to ensure that you develop an adequate supply. Introducing a bottle before you have fully established your supply could disrupt this process.

Most women have fully established their supply after the first 4-6 weeks so I would recommended that you wait until then to introduce a bottle. You and your baby are also getting the hang of breastfeeding during this time so you want to give you and your baby the best opportunity to get off to a good start.

If you do decide to give your baby a bottle feed, it is important that you also express for that feed. After the first month or so the hormones responsible for making milk start to back off and feeding becomes supply and demand. The more milk you remove from your breasts the more milk you will make. If you skip a feed your body will think that it doesn’t need to make milk for that feed and your supply will start to reduce.

What’s the latest advice around drinking and breastfeeding? Like, is pumping and dumping still a thing? I’ve heard it’s not.

A lot of mothers want to know if alcohol can get into their breast milk. The short answer is yes. Alcohol is one of the most readily absorbed drugs known and alcohol does pass from your bloodstream into your milk.

Alcohol levels reach their highest in breast milk about 30-60 minutes after drinking or after 30-90 minutes if you have had something to eat while you are drinking. If you don’t have another drink, the concentration gradually falls and a couple of hours after having a single drink the alcohol will have mostly left your breast milk.

Alcohol is not stored in the breast so as your liver metabolises the alcohol causing your blood alcohol level to drop, so does the alcohol level in your breastmilk.

There is no benefit in “pumping and dumping” your breastmilk unless you are uncomfortable and need to express to relieve the discomfort. As your blood alcohol drops so will the level of alcohol in your breast milk and pumping and dumping will not speed up this process.

Any breast milk that you express during the time that it takes for your blood alcohol to drop will still contain alcohol. The alcohol will not work its way out of the milk, once outside your body, and any milk pumped while you are affected by alcohol will need to be discarded.

How long do I have to not pump if I go out before sh*t gets real or mastitis comes to town? 

Everybody is different in how often they need to express but as a general rule, when you are away from your baby you need to try to express as many times as your baby would feed if you were together. This helps keep you comfortable and helps to ensure that you maintain your supply.

How do you know if the baby’s had enough milk – can you overfeed a baby on breastmilk?

There are no hard and fast rules when it comes to breastfeeding and every baby is different, so learning your baby’s cues will help you to understand when your baby is full. Many new mums are amazed by the voracious hunger of this little person. 

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So how do you know when your baby has had enough to eat? Some signs that your baby may be full are the slowing down of sucking and falling asleep at the breast. As your baby finishes feeding, they begin to change their sucking pattern to quicker, lighter suckling with longer pauses in between. Often they will fall asleep once they are done.

It is important to distinguish between a baby that is sleepy at the breast from a baby that is falling asleep because they are full. A baby that is getting enough breastmilk will have  5+ heavy wet nappies per 24 hours (from day 5) and 2+ yellow, watery poo’s per 24 hrs for the first 1-2 months.

Your baby may stop sucking and let go of your breast when they are satisfied. If they fall asleep without releasing your nipple, place your clean finger into the corner of their mouth to break the suction and remove them from your breast. Sometimes when you do this your baby will wake up and ask for more milk and this is ok. It is always good if you can offer your baby both breasts but don’t worry if they don’t take it- they will stop when they are full.

Another sign that your baby has had enough breastmilk is a change in the way that they hold their body. As they become full they may relax and begin to appear drowsy and content.

It isn’t possible to overfeed a breastfed baby. Regular feeding is a natural behaviour and breastfeeding is not just about nourishment. Your baby may want to feed for comfort, bonding, warmth, pain relief or affection so feed your baby on cue and let them lead the way.

Are there certain foods, drinks and meds that can impact the amount of milk you make?

You may have heard that there are certain kinds of foods, herbs or medicines that can help boost your supply these are called galactagogues. There is little research on the effectiveness of foods as galactagogues but many mums swear that when they ate a lactation cookie or drank lactation tea that it did help to increase their milk supply. 

Even though there isn’t a great deal of evidence on how certain foods boost supply like anything that you take or eat it is important to be aware of the risks. Fenugreek, for example, is a common herb that is recommended to boost supply but there have been reported cases of mothers being allergic to it and it may have the potential to reduce blood glucose levels. 

Your doctor may suggest that you take a medication such as Domperidone to boost your supply. Domperidone increases the amount of the breastmilk making hormone prolactin so that you make more milk, but it is important to understand that any Galactagogue will only work when breastmilk is being removed frequently and effectively from a mother’s breasts.

It is vital to address the cause of the low supply as taking a galactagogue alone will not fix the cause of the problem.

Kristy is a Registered Nurse specialising in Neonatal Intensive Care as well as an International Board-Certified Lactation Consultant. She is the Education Manager for MedelaShe is also a busy mother to three energetic children who always keep her grounded and practical in her approach to breastfeeding and lactation support.

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