The importance of breast milk for a baby’s development can never be emphasized enough. However, there are times when mothers may decide that breastfeeding may not be a good idea — if they have been drinking alcohol or too much caffeine, or if they are under medication for example. During such times, mothers may try pump and dumping, the practice of expressing milk (pump) and then discarding it (dump). Many questions about pump and dumping remain. Is it really necessary?
Both the World Health Organization (WHO) and American Academy of Pediatrics (AAP) recommend exclusive breastfeeding until a baby reaches six months of age. They also recommend continued breastfeeding along with complementary foods for a year or longer. What does this mean for pump and dumping practices?
What Is Pumping and Dumping?
To pump and dump was initially defined as breast milk being expressed then discarded for a period after a mother had been given anesthesia. That way, she would not be passing the effects of the anesthetic to the baby. Doctors, nurses, and midwives used to inform mothers to pump and dump breast milk 24 hours after receiving anesthesia.
Pump and Dumping Practices Today
While cautious, this practice is no longer consistent with current recommendations. Research from 2015 concludes that lactating mothers should avoid certain anesthetics altogether, while some medications may be acceptable. For example, while breastfeeding mothers should avoid codeine and meperidine, they may use hydromorphone with caution. Low-dose morphine, on the other hand, is safe during the postpartum period. Your doctor will be able to give you advice on what is safe and what is not.
Today, mothers use pump and dumping practices to avoid possibly harmful effects from alcohol and caffeine consumption, as well as side effects of medication. However, in some cases, pump and dumping may not be necessary at all. And instead, it may interfere with regular breastfeeding.
Anesthetics and Analgesics
Regarding anesthetics and analgesics taken by the mother, doctors have noted that relatively small amounts of these drugs enter into breast milk. This means it is perfectly safe to breastfeed as usual. Still, some mothers may opt to pump and dump after weighing the benefits of breastfeeding against the potential risk to the baby.
A study from 2020 notes that pump and dumping underestimates the impact on mother and child. Interrupting regular breastfeeding may lead to:
- perioperative anxiety
- mastitis
- decreased milk supply
- undesired early weaning
It is important to note that discarding expressed milk is necessary on a few occasions. Medications with long half-lives, variable metabolism, and some radioactive isotopes make discarding breast milk a necessity. It’s a good idea to consult a doctor if you have any questions.
Caffeine
Your baby eats what you eat. So should you pump and dump if you’ve had one cup of coffee too many? Will drinking too much coffee keep your baby awake?
Studies have shown that it’s safe to drink 2-3 cups of coffee a day, and your baby will suffer from no ill effects. Some studies even say that lactating mothers can consume up to 5 cups of coffee a day. But to be extra cautious, it’s a good idea to breastfeed before consuming any caffeine.
Drugs and Alcohol
It should go without saying that cocaine use is frowned upon for many reasons. Using cocaine during pregnancy may have harmful effects on the baby. A study in 2015 concluded as much when it stated that mothers who snort cocaine should pump and dump breast milk for 24-48 hours.
When it comes to alcohol consumption, one to two drinks a week can be harmless. But lactating mothers should still avoid alcohol in general. Alcohol can interfere with let down and decrease milk production. What’s more, pumping and dumping breast milk doesn’t speed the elimination of alcohol from your body. Only time can lower blood alcohol levels. However, if you’ll be missing a breastfeeding session, a pump and dump should help you maintain your milk supply and avoid engorgement.
As for marijuana, there is little research that studies its effect on breast milk. However, we do know that marijuana can pass into breast milk. And it stays in the body longer than alcohol does, making pump and dumping ineffective. If you smoke marijuana, you shouldn’t breastfeed. But if you do it only once, you may pump and dump for 24 hours before resuming breastfeeding.
Weighing the Pros and Cons of Pump and Dumping
Data remains limited and there isn’t enough clear evidence on the safety of breastfeeding after anesthetics, as well as many substances. Today, the general principle is that a mother can resume breastfeeding once they become awake, stable, and alert after anesthesia has been given.
To err on the side of caution, mothers should closely monitor their infant for signs and symptoms of behavioral changes after consuming any medication.
Key Takeaways
Pump and dumping began as a practice of expressing and discarding breast milk after receiving anesthesia. Recent years have seen an evolution of this definition. Certain anesthetics should be avoided by mothers altogether while others are acceptable with careful management.
There are a few occasions when discarding expressed milk is actually necessary. Lactating mothers should ideally do neither drugs nor alcohol, but when they choose to pump and dump, it can be helpful to allow them to continue with breastfeeding while safeguarding their baby’s health.
Click here for more on breastfeeding.
[embed-health-tool-vaccination-tool]
