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Don’t Dump Your Milk (Yet)!

By May 9, 2017 No Comments

There are a number of different circumstances when a breastfeeding mother may be told to abstain from breastfeeding her baby and discard any milk she has pumped. Sometimes “pumping and dumping” is necessary and sometimes it is not. Oftentimes, this recommendation is given as a CYA—cover your ass—by a healthcare provider and not as an evidence-based recommendation.

If you are told to pump and dump,

Don’t Dump It, Mark It!

Mark your milk with:

  • Date milk was expressed
  • Time milk was expressed
  • Drug/food that makes this milk questionable and date and time when you last ingested it
  • A big symbol or colored sticker that clearly marks the milk as questionable

Stash this milk in a separate part of your freezer, possibly in its own Ziploc bag. Then, get to researching.

Remember, doctors who don’t specialize in Obstetrics, Pediatrics, or Lactation may not have the most recent evidence-based information on the drug they have given you. They may think it isn’t safe for the breastfed baby, when in fact it may be.

Here are some of the most common circumstances I hear about when mothers are pumping and dumping unnecessarily:

  1. After having anesthesia
  2. After having radiocontrast dye for MRI or other studies
  3. While taking certain medications
  4. When concerned about infant intolerance to a food that mother has eaten
  5. During or after alcohol consumption

Let’s take these one-by-one.

  1. Anesthesia for surgery: Only dump milk you pumped shortly after surgery, when you are still feeling groggy. Once you are feeling more yourself, you can nurse your baby or keep any milk you’ve pumped. From the Academy of Breastfeeding Medicine: “Mothers with normal term or older infants can generally resume breastfeeding as soon as they are awake, stable, and alert.”
  2. Radiocontrast dye for MRI or other studies: KellyMom.com has a nice round-up of evidence to support that lactating mothers do not have to discard milk following a diagnostic test that uses contrast.
  3. Medications: This is where it is really important that you understand lactation ratings, and have an app on your phone so you can be your own best advocate. Lactmed and MommyMeds are both good apps. If a health care provider is prescribing you a medication that he or she believes is incompatible with breastfeeding, make sure that pumping and dumping is truly Ask your provider, “Is there another medication you could prescribe that may be compatible?” If the provider says no, take your prescription and do your own research. In the meantime, pump and clearly mark your milk. Save this milk until you can get an evidence-based answer from your app, your lactation consultant, your OB, or your child’s pediatrician.
  4. Foods: There are certain circumstances when your pedestrian or GI specialist may recommend you eliminate a certain food from your diet. If the food is dairy or soy, it takes two weeks or longer to completely leave your system. You may be tempted to dump this milk and any milk you have pumped prior to eliminating the particular food. Don’t! Mark it and save it. Having milk with a potential allergen in it can be really useful when you are instructed to reintroduce the food back to the baby. Rather than eating the food yourself and setting yourself up for another two weeks of elimination, offer the baby the marked milk! That way, you can see how baby responds to the allergen without re-exposing yourself. If it seems like you will never be able to reintroduce the food into your milk, consider donating that milk.
  5. Alcohol: You should actually dump any milk that you pump while drunk. If you are expressing at a time when you wouldn’t feel safe to drive, that milk is definitely spiked. However, if you are sobering up or only feeling a little tipsy, you may opt to save and mark the milk. This is a good time for the alcohol tester strips. If it tests positive, dump it. Negative, keep it! If you feel sober enough to drive when you are pumping, your milk is perfectly fine to keep.

Your milk is precious, but not everybody treats it that way. If you are told to pump and dump,

Don’t Dump It, Mark It!

http://www.infantrisk.com/content/alcohol-and-breastfeeding

http://pediatrics.aappublications.org/content/129/3/e827

http://www.bfmed.org/Media/Files/Protocols/Guidelines%20for%20Breastfeeding%20and%20Substance%20Use%20or%20Use%20Disorder.pdf