Hand to Hold's Official Blog: Written by Parents for Parents

Q&A – When Can I Stop Pumping?

Breast Pump 2Question from Katie

– We just had our first preemie in October.  She was born at 33 weeks.  I’ve had pre-term labor with all my babies (had lots of shots/pills to stop labor, etc).  All my other babies have been born at 37 weeks, but each pregnancy has gotten progressively more difficult, and the labor has gotten earlier and earlier.  With my 4th baby, I had a severe hemorrhage in my uterus when I was only 7 weeks along–it landed me on complete bedrest for the entire pregnancy.  We were living overseas at the time in the Philippines, and I had the baby there.  It was really rough having a baby in a third world country, but this preemie stuff is even harder!!

Our preemie girl came home from the hospital about a week ago, and now we are struggling with how to handle her.  I can’t believe how different it is from having a term baby!!  I have 4 other kids…one of whom is only 18 months old.  So it complicates an already tough situation.  I’m trying to breastfed, but the constant pumping and bottle feedings are doing me in.  It is also extremely hard on my 18 month old…and he gets into everything while I am tied up all day with the baby and the pump.  We took our little girl to the doctor for her 1 week check-up only to find that they didn’t even have our records from the hospital yet…so they couldn’t really answer any of our ?s.  Very frustrating!!  About the only thing the doctor did do was tell me that I would be doing the pumping/bottle feeding thing until she was at least 9 months old…or 13-15 lbs.  That was enough to make me cry!  I’m only nursing her twice a day at this point, and he basically told me I could not add another nursing session for a very, very long time because she needs to have fortified breastmilk…and wouldn’t get that through nursing alone.

How have you handled feedings with your preemies?  Did you breastfed?  The stuff I read online says that many preemie moms are nursing their babies exclusively after only a month or two. I would really like to try to get her nursing more, but am worried she won’t gain enough weight and the doctors will make me stop.  We ordered a baby scale, so that I can weigh her before and after feedings and monitor her growth.  But I am just concerned that the doctors will not like what I am doing….and she won’t grow enough.  I just don’t see any way for me to keep pumping like this, and feel like giving up.  I am feeling very discouraged by what the doctors tell me.  But the fact that other moms have had success in breastfeeding more often makes me want to give it a try.  Any advice?  Also, do you have any advice on getting her to sleep better at night.  She is all messed up from the noise level in NICU.  She sleeps lots during the day, and is awake at night.  We tried a fan…and are going to try a noise maker to see if it will help.

Answer from Afton

As if pumping all day and night while your baby is in the NICU isn’t enough, doctors like to torture preemie moms with predicting months of pumping after the baby is home!  Breastfeeding and then pumping and then bottle feeding is sooo exhausting; you spend almost your entire day doing it.  I can understand why you feel ready to give up.

My doctor also said I might have to give fortified breast milk for 6 months or more, but my girl had been home from the NICU for just over two months when I got to switch to breastfeeding only!  It was a wonderful day.  At that time she was over 5 months old actual age and only 2 months old corrected age.  I can’t tell you that your baby will thrive and be able to solely breastfeed a lot sooner than the doctor said, but there is one thing that I learned during my NICU stay with my baby that helped me handle whatever good or bad news doctors gave me after we brought her home:  Intuition that you feel as a mother concerning the care of your baby is worth considering because, after all, you are the mother.  Doctors act on medical facts, statistics, probability, and educated guessing.  There are times when motherly intuition better serves the baby than the doctor’s orders.  There are times when what  you feel is right is just as good an option as what the doctor said and if you speak up they might agree with you or act according to your wishes.  And, there certainly may be times when your baby isn’t quite ready to meet your wishes.

When I was in the NICU with my girl I had tons of questions about everything they were doing to my baby.  At the beginning they basically told me what they had decided to do and I said “Okay, doctor knows best!”  But, by the end of my stay there I had learned that most of the procedures done were educated guesses based on results of other patients.  I now imagine that some of what was done probably wasn’t necessary, and other times there might have been better options for my baby that weren’t taken.  In my last month there I started to suggest some possible causes for my baby’s stuffiness that was making it difficult for her to breath and to eat well.  The OTs worked with me and gave my suggestions to the doctors who considered my insights and let me try some things that they hadn’t planned on.  The OTs and a couple of the nurses encouraged me to act on my motherly intuition and do things that I thought were important for my baby’s care.  It was empowering to me and made me realize that, as my baby’s mother, I had the final say in anything that anyone did to my baby.

One story that truly inspired me during the first year of my baby’s life was a story about a woman who I knew growing up in my hometown.  She had had a preemie baby but she refused to keep her baby in the cold hospital all alone with impersonal care, machines, and robotic routines.  She took her baby, left the NICU, and went home.  She kept her baby on her chest night and day because her preemie breathed well and got enough oxygen as long as it was on her chest following her breathing pattern.  She gave her baby constant love and comfort and her baby thrived and survived without any assistance from oxygen.

Now, most preemie babies probably do need medical attention to survive, but what inspired me was her confidence in her motherly intuition and her confidence in her ability as the mother to provide what was most needed by her baby.

So, what I would suggest to you is that you consider the doctor’s orders but also consider your intuition on the subject.  Maybe you feel strongly that your baby doesn’t need fortified breastmilk right now.  Maybe you could experiment for a week or two with only breastfeeding and monitor your baby’s weight to see how she’s handling it.  Now, I am in no way suggesting to you that you disregard your doctor’s orders.  I have no idea what other complications your baby has right now or what she really needs, but don’t get too discouraged.  Preemies are a lot of work, but the extra attention and time that they require of you creates a special bond between you that you may not have with any other child.  Your girl needs you, and you alone can provide the nourishment that is the very best for her.

Hang in there, love your preemie, and tell yourself that you’re willing to do whatever it takes to help her thrive and grow strong.  Preemies are so vulnerable and anything that can be done to give them extra strength to fight off sickness when they are so tiny is so very important.  I suggest you take it one day at a time and get into a routine.  Everything is easier when it becomes habit.  I imagine that simply having your girl home now is a bit frightening and stressful, not to mention your lack of sleep and your own recovery from birth.  It will get easier, I promise.  You will get stronger, she will get stronger, and you will have to fortify less and less, and finally the day will come when the doctor says she looks great and you can stop fortifying!  Yeah!

Okay, as far as helping your preemie sleep better at night.  I remember having the same problem with our girl.  She woke up every three hours, she could sleep through any loud noises we made when she was sleeping, and liked to be awake at night and asleep during the day!  I remember simply making a point to keep her where it was bright during the day and making sure the house was dark at night and that I didn’t turn on bright lights when she needed me in the night.  Our bodies really do respond to sunlight and the lack thereof and so I tried to help her feel and experience the night and day difference that she never encountered in the NICU.  I’m pretty sure it got much better after only a month or so.  She would still wake up in the night for feedings but after some training she would go back to sleep after I fed her.  I think white noise is a good idea if it helps her sleep better.

Good luck to you!  I really hope that what I had to say helped you out a bit.  Please send me an update so I know how everything is progressing.

To my readers: do you have any further insight on these subjects for Katie’s sake?  Please share!

Related Posts:  Pumping:  Your Greatest Commitment

Afton Mower About Afton Mower

After Mower (UT) lost her firstborn son at 21 weeks.  Her daughter was born a year and a half later at 27 weeks.  The NICU was overwhelming and isolating and it was through those two experiences she was led to found this social hub for parents to find the support they needed. Afton also gave birth to another daughter, born two days overdue after four months of strict bedrest. She believes it is a tender experience to hold a special baby in your arms when his spirit returns to his heavenly home, a miracle to watch tiny babies survive the risks of prematurity and a blessing to hold a healthy full-term baby after months of difficulty and sacrifices.


  1. My son was born at 33 weeks too. I pumped like a madwoman because it was the only thing that made me feel like I was doing something, for him. This led to an oversupply…which I think I have done the best thing with that I can think of. Check my blog entry out…


  2. I have a son born at 33W5D and I pumped the entire time he was in the NICU (3 weeks). He came home on formula supplemented milk and started to do really well once he was home. When he hit 10 pounds last week I called the pediatrician and asked to take him off the formula and solely nurse him. She said ok! So follow your gut and kep asking your doc. It can be earlier than they initially tell you. Hang in there, it’s tough, but you are doing the best thing for your baby.

  3. I had a 32wkr who was in the NICU for 4 weeks, most of that time was because of feeding issues, they kept pushing the bottle on her, they like the security of measuring exactly how much she got. I pumped about 4 times a day and still had a very large supply. We were able to do non nutritive nursing and let her practice latching at 32wks+2days. She was a champ at latching from the start, but my large supply was something We had to learn to manage and eventually she came home EBFing because she just could not handle the bottle, she was very disorganized at the bottle and her vital signs reflected the issue as well. When I had my 27wkr I knew it would be a different experience but from the beginning I knew that a she could come home EFBing and NICU staff knew that was my plan as well. She was able to practice nursing during her tube feedings right after I had pumped, but I responded to her so well I would still let down and she would get over full. I noticed this before most of the nurses and then we started the weighing. She had a day where she lost like 60g and the NNP immediately said she wanted to supplement her during her nursing sessions again, but i knew what that did to my baby who was still having breathing issues (tummy too full means she can’t take full breaths) When I found this out I explained to the NNP as she had explained to me that they look at the weight over a period of time and not one day and that I didn’t not think it was a good idea to compromise her breathing or take away the progress she had made nursing. That day was a fluke, she gained a lot that weeks actually, more than enough to make up for the loss. She too cam home EBFing at 37wks. After a couple weeks home she started gaining about an oz a day. She is doing amazingly. Preemies can thrive with breastfeeding, every baby is different but if you follow their cues and your intuition amazing things can and will happen.

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