Registered Nurses' Association of Ontario

Considerations for Pumping

  • Pumping can be used to support or enhance breast milk supply.
  • Types of breast pumps include manual or electric; they are available as either a single or double model. There is insufficient evidence to support a specific type of breast pump for the initiation or maintenance of breast milk supply: manual pumps or lower cost pumps may be as effective as electric or hospital-grade ones.
  • More studies are needed to determine the type of pump, timing, and frequency of pumping to most effectively support breast milk production.  
  • When pumping is indicated to initiate, maintain, or enhance breast milk supply, breastfeeding persons must be taught skills such as the mechanics of a breast pump, the frequency and duration of pumping, the cleaning and maintenance of equipment, and the safe storage of EBM.
  • Observation of one or more pumping sessions can provide helpful feedback to the breastfeeding person and reinforce teaching concepts.  
  • Education also will support breastfeeding persons to avoid pumping-related complications that result from insufficient or excessive breast stimulation. For example, pumping too frequently or for too long can lead to nipple pain or engorgement. Conversely, insufficient pumping reduces breast stimulation and milk supply, decreases the likelihood of exclusivity and increases the risk of early breastfeeding cessation.
  • To be effective as an intervention, pumping must be appropriate to the needs of the breastfeeding dyad. These needs can change over time and must be regularly re-assessed.
Women and Children
Breastfeeding Best Practice Guidelines for Nurses
Point of Care Resources