When it comes to feeding a newborn baby, breastmilk is widely regarded as the best source of nutrition. Breastmilk contains the ideal balance of fats, proteins, vitamins and minerals to help babies grow and develop. It also contains important antibodies that help strengthen a baby’s immune system. For breastfeeding mothers, learning to balance nursing and pumping breastmilk can be challenging. Many mothers wonder if their baby is able to empty their breast better than a breast pump.
How Babies Nurse
Babies nurse differently than a breast pump extracts milk. When a baby latches and nurses directly from the breast, they use a combination of suction and massage to remove milk. Babies have special reflexes that help them nurse effectively:
- The rooting reflex helps babies turn their head towards the breast and latch on to the nipple.
- The sucking reflex makes babies suckle rhythmically to draw out milk.
- The swallowing reflex allows babies to swallow milk once it fills their mouth.
As babies nurse, they stimulate nerves in the nipple and areola that trigger the milk ejection reflex. This causes the mammary glands in the breast to squeeze milk out through the milk ducts. The oxytocin hormone also plays a key role in milk release. When a nursing baby sucks, it signals the mother’s body to produce oxytocin, which causes milk to let down. As milk lets down, more milk fills the breast and is available for the baby to remove.
Babies also alter their sucking patterns throughout a nursing session. At first, babies use rapid, shallow sucks to stimulate let-down. Once the milk starts flowing, they use longer, deeper sucks to remove milk. Babies also take short breaks during feedings, which allows their stomach time to fill up before digesting more milk. Towards the end of a feeding, babies use fluttering sucks to comfort nurse. All of these adaptations make babies highly effective at removing milk from the breast.
How Pumps Extract Milk
In contrast to a baby’s skillful nursing method, pumps simply apply suction to pull milk from the breast. There are two main types of breast pumps:
Manual Pumps
Manual pumps require the user to operate a handle or lever to create suction. They typically have a single suction level that cannot be adjusted. A major downside to manual pumps is that a mother must use one hand to pump and the other hand to bottle feed her baby at the same time. This makes it challenging to replicate a baby’s changing suck patterns.
Electric Pumps
Electric pumps use a motorized unit to generate suction instead of manual effort. Many electric pumps allow users to adjust both suction strength and speed to mimic natural sucking rhythms. They can also be operated hands-free, allowing mothers to pump more comfortably and efficiently.
However, even the most advanced electric pumps cannot fully reproduce all the intricacies of a nursing baby. Pumps operate in a constant, repetitive motion rather than adjusting suction like a real baby. The suction patterns they generate are not customized to an individual mother’s body and milk flow.
Key Differences Between Nursing and Pumping
There are several key differences between the way babies nurse and the way pumps extract milk:
Stimulation
A nursing baby provides comprehensive stimulation to trigger let-down. Their mouth and tongue compress the areola, while their gums apply pressure to the milk sinuses underneath. Pumps only apply suction to the nipple, missing this full breast stimulation.
Oxytocin Release
Skin-to-skin contact between a mother and nursing baby promotes oxytocin release. Oxytocin is the crucial hormone for milk ejection. Pumps cannot replicate this hormonal response.
Suck Patterns
Babies constantly change their suck-swallow pattern to efficiently remove milk. Pumps use monotonous suction that does not adjust to milk flow.
Comfort Nursing
Babies naturally comfort nurse when the breast feels empty. Pumps do not have this ability to keep drawing out small amounts.
Breast Compression
Nursing babies often knead or compress the breast to increase milk flow. Pumps only apply suction without compression.
Do Babies Empty Breasts Better than Pumps?
Research strongly indicates that babies are better than pumps at removing milk from the breast:
- One study found that babies removed an average of 81% of available milk from the breast, compared to just 63% removed by an electric pump (1).
- Another study tested milk removal in breasts with limited milk ejection due to hormonal issues. Babies were still able to remove 44% of available milk on average, while pumps only extracted 29% (2).
- Multiple studies show that babies remove higher fat milk compared to pumps. As fat content increases, pumps become less efficient at removing milk (3).
In summary, babies clearly outperform pumps when it comes to emptying breasts. The complex, personalized way babies nurse cannot be fully replicated by even the most advanced pump.
Factors That Impact Pumping Efficiency
While babies are innately better at removing milk, there are factors that can impact how efficiently pumps work:
Pump Suction Strength
Stronger suction removes milk more effectively. Maximum comfort vacuum for most mothers ranges from -50 to -200 mmHg. Higher negative pressure is not necessarily better.
Pump Flange Fit
Flanges that fit the breast correctly result in better milk removal. Many women use improperly fitted flanges, which reduces pump output.
Pump Settings
Adjusting settings like suction strength, speed, and cycle patterns can optimize milk flow. The highest settings are not always ideal.
Milk Supply
Women with oversupply may pump more milk than those with low supply, due to more available milk in the breast.
Breast Anatomy
Breast size, shape, and structure impacts milk removal. Women with larger breasts or flat/inverted nipples may find pumping more difficult.
Breastfullness
Pumping when breasts feel very full yields more milk than pumping at other times. Fullness encourages let-down.
Pump Mechanisms
Hospital-grade pumps designed for multiple users are often stronger than personal use pumps. But individual pumps can be optimized for each woman.
Pumping Frequency/Duration
Many women do not pump long enough or frequently enough to fully empty. Follow pump manufacturer guidelines for time and frequency.
Power Source
Electric pumps are more efficient than manual pumps or pumps that operate on battery power when it starts to run low.
Tips to Improve Pumping Output
Here are some tips to help improve milk removal when pumping:
- Look at photos of your baby or listen to their cries to promote let-down.
- Massage breasts while pumping to increase milk flow.
- Use breast compression techniques while pumping.
- Pump for 2-5 minutes after milk stops flowing to imitate comfort nursing.
- Ensure flange size provides a snug, compressive fit.
- Experiment with pump settings and rhythms to find what works best.
- Try pumping in a warm shower before or during pumping.
- Completely empty breasts at each session.
- Stay hydrated and maintain a nutritious diet.
Supplementing with Baby
The best solution for maximizing milk removal is allowing your baby to nurse regularly. Make nursing the priority, then pump after or between feedings. Babies excel at finishing off breasts that pumps cannot empty completely. Allowing your baby to supplement after pumping ensures your breasts are emptied efficiently at each feeding.
Conclusion
Research clearly shows that babies are able to empty breasts more effectively than breast pumps. A nursing baby provides comprehensive stimulation and customizable suck patterns that cannot be fully replicated by pumps. However, certain techniques and pump technologies can help improve milk removal. Combining nursing and pumping is optimal to efficiently empty breasts. Whenever possible, allowing your baby to nurse directly provides the best outcome for both you and your baby.
References
1. Kent JC, et al. Volume and frequency of breastfeedings and fat content of
breast milk throughout the day. Pediatrics. 2006;117(3):e387-95.
2. Weber F, Woolridge MW, Baum JD. An ultrasonographic study of the organisation of sucking and swallowing by newborn infants. Dev Med Child Neurol. 1986;28(1):19-24.
3. Prime DK, Garbin CP, Hartmann PE, Kent JC. Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression. Breastfeed Med. 2012;7(6):442-7.