Do I Really Need to Pump and Dump?!?

“Do I need to pump and dump?”
I hear this question countless times a week from concerned moms who get conflicting (or sometimes just plain wrong) information about what’s safe for a breastfeeding baby. But this week, I heard something I’d never heard before! A massage therapist told a breastfeeding mom she’d need to pump and dump after getting a massage to clear out toxins.

I guess I have a lot more myth busting in the lactation world to do.... so... now's time for this blog post to help you figure out what to do in some of these common reasons parentss (and doctors, and dentists, and pharmacists, and apparently massage therapists) think they need to throw out their milk. Milk is precious and we want to keep you from wasting it!

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I provide effective, telehealth lactation support to modern families.

When you're done with this post check out our other most popular blogs!
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Ok... so let's dive into it. Here's the most common questions I get about pumping and dumping. 

“I started a new medication.”
This is the big one. Research shows up to 99% of new moms will be offered medication of some kind in their first week postpartum. Do medications sometimes make it into the milk? Absolutely. Are most medications moms will be offered dangerous to their babies? Usually not. Some moms are told to pump and dump after being put on medications that are routinely given directly to babies! Always check with a lactation professional if you start a new medication. Though it's true risks and benefits to medications may vary based on your individual circumstances, most safe for nursing (that even includes some antidepressants, antipsychotics, antibiotics, and pain medications), but they can also tell you things to watch for in your baby or might advise to avoid something completely (Sudafed is safe for babies but notorious for hurting milk supply). The only big “absolutely not, you have to wean right away” medication is chemotherapy.

“I’m having a procedure.”
Moms are told to pump and dump after everything from getting a cavity filled to major surgery under general anesthesia. The good news is that this is almost never the case. The physical and emotional stress of surgery takes a toll on a mom’s body and sometimes their milk supply will temporarily dip as a result. The last things she should do if she can avoid it is keep her baby away from the breast and throw out her milk! Again, call a lactation expert and they can help you make a post-op plan that will be best for you and your baby. An exception would be having a procedure that involves radioactive iodine. Some kinds concentrate in breast tissue and weaning is required.

“I’m getting a vaccine.”
I’ve heard of pharmacies refuse to give nursing moms flu shots because they were nursing. The only vaccines you can’t get while nursing are smallpox and Yellow Fever.

“I’m planning on having some wine with dinner.”
Breastmilk is similar to blood in a lot of ways. Alcohol stays in your milk just like it stays in your blood - until your body filters it out. It doesn’t get “trapped” in your milk, where the only way to get rid of it is to throw out your milk. Give it some time. I always suggest moms who are extra nervous pick up some breastmilk test strips (yes, they exist!). It will give you peace of mind to see if there’s anything detectable in your milk before you feed your baby. On average, if you feed your baby, then have a drink, it will be out of your system before it’s time for baby to feed again.

"I want to drink coffee."
Who wants to live in a world where you can't parent and drink coffee at the same time? I think most of us would give up breastfeeding/chestfeeding instantly if we were told coffee wasn't an option. It is true that caffeine intake should be limited heavily during pregnancy, but the same isn't true for breastfeeding/chestfeeding. In most cases caffeine is fine while breastfeeding, and yes, even more than 1 cup a day. Just make sure that you take it slow if you gave it up during pregnancy, and make sure you're not overdoing it for your own sanity's sake. (Caffeine can increase anxiety, so if you're prone to it, test the waters first before diving in to multiple cups.)

“I can see blood in my milk/baby spit up blood.”
While it makes some moms squeamish to hear, a bit of blood in breastmilk doesn’t hurt a baby at all. Sometimes bruising inside the mammory tissue or tiny blood vessels bursting can cause milk to appear pink, orange, or brown tinged from blood, especially in first time moms. It’s not a reason to pump and dump your milk, and it won’t hurt your baby. It can even make baby’s poops test positive for digested blood!

“I have a virus.”
Whether it’s a stomach bug or a cold, sometimes parents are afraid to nurse their babies. They’re afraid being close to them will get them sick, or that their milk will pass the virus along to their babies. This is where your amazing milk comes in. Your body knows you’re nursing and knows you’re sick. Your milk will actually change to protect your baby. It’s not a guarantee your baby won’t get sick, but it’s much more protection than staying away from them would provide. The few exceptions would be the herpes virus if you have blisters on your breasts, Hepatitis B if your nipples are bleeding, HTLV, ebola, chickenpox if mom gets it within 5 days of birth, and HIV.

“I cut out dairy because it’s bothering my baby.”
Click here to read a whole post just dedicated to this, because it’s such a hot topic. Removing dairy from your diet can take time. The risk of continuing breastfeeding/chestfeeding greatly outweighs the risk of pumping and dumping during the time you're waiting for the dairy proteins to leave your milk. This process can take weeks, and in that time your baby may loose their ability to transfer milk from you, and/or you may suffer a loss of milk supply from relying on a breast pump in place of nursing. 

Breastfeeding is hard enough without spending time and energy pumping to throw your milk away for no reason. If you’re told you need to pump and dump, seek an expert opinion first. It will probably save you a lot of time and stress. As a lactation expert, it’s my job to know the facts so I can help moms navigate conflicting advice they get so they can keep doing what they do best - taking care of their babies!

Author

This post was originally written by Allison Alexander, LPN, IBCLC (a prior contributor to the SB blog) in October 2018, and has since been revised and reworked by Kelly Maher Carvell, CLC, CLE in October 2020.