By Sonya Fehér, leader for South Austin API (Texas, USA) and blogger at MamaTrue.com

If we’re staying at home to be with our babies full-time, we don’t have to pump milk or offer bottles. We can delay extended separations until our children are older, take our babies with us to run errands, go to appointments, or when we meet friends. And most of the time, we do. We spread out activities, so we can avoid taking Baby in and out of the car for multiple stops. We keep the volume low on the car stereo. We prioritize what we need to get at the grocery and find ways to entertain or distract Baby, so that we can get everything on the list. And we likely plan it all around when Baby may take a nap. That’s what stay-at-home moms do.

What differs for attached moms is that we are likely also sleeping with or near our babies during the night, wearing them during the day, and nursing them every hour or so. Being an Attachment Parenting (AP) stay-at-home mom is an intense 24-hours-a-day/365-days-a-year job.

Why Stay-at-Home Breastfeeding Mothers Pump

While all of the mothers that I interviewed agreed that breastmilk from the breast is best, AP stay-at-home moms have many reasons to pump:

• Medical emergencies — Kristine Kovach, a board-certified lactation consultant with 15 years experience, instructs moms to introduce a bottle by six weeks in case of an emergency. Kovach says you’re living in denial if you don’t accept the possibility that on a grocery run, Mom could get into a car accident: “It is medically dangerous to see a baby who can’t get its needs met, because it doesn’t know how to eat from any other source but its mother.” When Sarah Kerver was in the Emergency Room with a kidney stone, she was grateful that she had milk in the freezer: “Not only for the time I was laying curled up in pain, but for after when I had morphine pumping through my veins. Or when I got the stomach flu and was barfing every few minutes. You are lucky if you never need it, but if you do, I would rather not have to go buy formula.”
• Giving mom a break — Beyond emergencies, pumping can give Mom a break, whether it is to sleep in, exercise, have time for herself, or the ability to go on a date and give time to her marriage. Joy Schindler explains, “Since Daphne doesn’t really eat on a schedule and often likes to nurse every hour during the day, I really wouldn’t be able to leave her with my husband at all if I didn’t have a stash in the freezer.”
• Encouraging secondary attachment — Regular bottle nursing by another caregiver can help establish a secondary attachment figure and would allow someone besides Mom to satisfy a child’s primary needs for food, sleep, and comfort. When there’s a second, third, or subsequent baby in the picture, it may not be realistic for Mom to sit still for extended nursing sessions, making it even more important for mom to share feeding tasks.
• Physical considerations — Pumping can unclog milk ducts and help relieve the pain of mastitis. If lack of supply is an issue, pumping will increase demand for the milk. When Baby has a breast preference, nursing from one side and pumping from the other will keep up supply until the baby will nurse from either. For oversupply, pumping can reduce engorgement.
• Pumping for older babies and toddlers — When introducing solids, breastmilk can be mixed with cereals, mashed vegetables, or fruit and can even be used when making smoothies. Being able to offer expressed milk in a bottle or sippy cup means that a crawling or toddling child too busy to nurse can still get the best nourishment possible. Once a child is a year old, breastmilk in a sippy cup is a great alternative to cow or goat milk.
• Opportunity to help others — Even if you pump and never find the need to use the milk yourself, you can donate it. “When a dear friend donated her spare frozen breastmilk to me to supplement Roman, she gave me about 200 ounces. It was a blessing to be able to give him breastmilk instead of formula,” says Heather Salaz.

This Circumstance Calls for Unique Pumping Advice

Because stay-at-home AP moms are likely not pumping for frequent and prolonged separations from baby, how frequently we need to pump and how much milk we need to express differs from most pumping advice. Kovach, also known as the Mobile Mama, recommends the following strategies for pumping and bottle-nursing:

• When to pump — First thing in the morning, pump an ounce from each side. Hormones rise during sleep and supply is highest first thing in the day, even if Baby nurses all night. Nurse from one side while pumping on the other or nurse then pump.
• Age to introduce bottle — So that Baby gets four weeks to learn how to drink from the breast, wait to offer the bottle until his one month birthday.
• Teaching Baby to drink from a bottle — Mom should leave the room, take a cell phone, and walk around the block. This is a new skill for both the caregiver and Baby to learn, so they need the time and space to do it. If Baby refuses bottle or starts to get upset, the caregiver can call Mom to come back and nurse for five minutes, then they can try again.
• Time to bottle-nurse — At the end of a typical workday, around 5 or 6 p.m., Baby usually wants to be on the breast constantly from late afternoon until bedtime. This is a great time to offer the bottle, as Mom is likely exhausted and needs a break.
• Frequency of bottle feeds — Offer a two-ounce bottle every other day, so baby remembers how when you may need to bottle-nurse to replace a full feeding.
• Building back-up supply — If you’re pumping every day but offering the bottle less than daily, you will generate a reserve you can use for longer separations or in an emergency.

Mothers usually have several concerns regarding pumping, such as:

• Nipple confusion — Nipple confusion is usually flow confusion. Drinking out of a bottle is immediate gratification, and if a bottle is offered in the first few days of a child’s life, the baby may only want food without work. (Premature babies are an exception.) If Baby has nursed for a month and learned to suck until letdown, bottle-nursing should not cause flow confusion. If mom is still experiencing nipple pain, Baby is breaking the latch, or breastfeeding is not well established, wait to introduce a bottle.
• Bottle refusal — This may occur because the baby doesn’t yet know how to drink from a bottle, needs a different type of bottle or nipple, or needs a different environment (like a bright public place where she’ll be distracted and take the bottle without noticing), or drinking source (like a sippy cup).
• Physical discomfort and pain with pumping — Comfort and fit of a pump can be affected by the type of suction and the size of the flange, both of which can be altered.
• Too long of a break between bottles — Once you’ve introduced the bottle, success is more likely if a bottle is given on a regular basis so Baby remembers how to bottle-nurse. If Baby keeps refusing bottles, try a sippy cup instead.
• Concern about lack of supply — Even for mothers breastfeeding every hour, pumping will not take milk away from the baby. Set up one daily pumping session with the goal of producing an ounce from each breast, and your body will increase supply to meet demand.
• Bad-smelling or bad-tasting breastmilk — This can be caused by high lipase levels, which make the milk taste like plastic or metal. Scald the milk immediately after pumping.
• Not producing for pump — Some women just don’t produce for a pump, and no matter what they do, letdown won’t happen unless there’s a baby sucking from their breast.
• Mother’s mixed feelings — AP mom Tara Seth admits, “It makes me sad and a little, dare I say it, jealous.” Mothers of newborns are still gaining confidence and a bottle can feel like a mother-substitute. A bottle can’t replace a mom, as there is so much more to breastfeeding than just milk.

Giving a child the means to get breastmilk without the breast means we can have time to take care of ourselves, so that we’ll continue to have the energy to take care of our families. Rather than risking burnout, stressed marriages, breastfeeding with resentment, and the other problems that come when a family gets out of balance, stay-at-home AP moms have the option to give themselves a break. Pumping can be that option.

For More Information

AttachmentParenting.org – for information on bottle-nursing

AskDrSears.com – for information on picking a pump, pumping, storing and freezing milk

BreastfeedingBasics.info – for information on the effect of high lipase levels on breast milk

LLLI.org – for information on helping your baby drink from a bottle and resolving milk supply issues

MilkShare.BirthingForLife.com and HMBANA.org – for information on donating breast milk