For the sake of this article, I will be using the terms breastfeeding and nursing.

Aren’t they the same thing? Well, technically, yes, but I like to think about it this way:

When you nurse your baby, you are feeding her right from your breast. She snuggles in close. The skin of her mouth and her face is right up against your skin. As she gets older, she may pat or stroke your breast, bury her head deep into your breast, or wrap her arms around your breast in a big boob hug. Regardless of how much milk is coming out of your breast, if your baby is suckling, you are nursing. I often explain this analogy to mothers who have a low milk supply and need to supplement with a bottle after breastfeeding. In no way does supplementing lessen your nursing relationship. Those mothers have a nursing relationship and a partial breastfeeding relationship.

Breastfeeding, however, is providing breastmilk for your baby either directly from your breast or via bottle. Some mothers do this when they are separated from their infants while at work. Some mothers choose to pump and bottle feed for personal reasons. Some mothers are forced to exclusively pump because their babies are not able or not willing to nurse.

What a gift it is to be able to breastfeed and nurse your baby. If you are reading this and you are able to latch your baby directly on to your breast and provide her with 100% of her daily nutritional needs, stop, take a deep breath, and have gratitude for this gift.  Some women get to nurse, some get to breastfeed, but you get to have it all.

Some women may identify themselves as “EPers” or Exclusive Pumpers. These mamas don’t directly nurse their babies at all. Here are a few reasons why a mom may become an EPer.

  1. Her baby was born with special needs and is not able to effectively suck at the breast.

A few examples of this are cleft lip and palate, Down’s Syndrome, or another chromosomal error that often leads to a weak suck. Now, it should never be automatically assumed that a baby born with special needs cannot breastfeed. In fact, once it is deemed safe for such babies to breastfeed, they should be encouraged to breastfeed because it does an amazing job strengthening oral tone. A great example of this is Lily. Her mama fought against all odds to nurse her.

But, if a baby cannot create the suction necessarily to pull the milk out of the breast properly, moms have the choice to pump and give that milk to baby in a bottle.

  1. Her baby is in the Neonatal Intensive Care Unit and is too premature to effectively breastfeed.

This mama may temporarily be an EPer while her baby grows in the NICU and her baby may transition to direct nursing once he is mature enough, or she may never successfully achieve direct nursing.

  1. Personal choice.

Some moms just don’t want to directly nurse. Perhaps they tried it for a few days or weeks and found she preferred the EPing method.

  1. Mama/Baby mismatch.

Big nipples, little mouth. Recessed chin, short tongue, high palate. Or, the ultimate stumper:  the breastfed baby that just can’t get milk out. After extensive work with a skilled IBCLC, nothing is working. After weeks or months, in desperation for some kind of normalcy, we have to make a decision stop trying to make nursing work and embrace breastfeeding.

  1. Breast Refusal aka “stubborn baby syndrome”

Last, but certainly not least is the stubborn baby that Just. Won’t. Nurse. Damnit.

So, if you see a woman feeding her baby a bottle, resist the urge to judge her. Know that there just may be breastmilk in that bottle and she just may have had to pump—a lot—to be able to breastfeed her baby.

In order for you to understand EPing a little more, I want to introduce you to Jackson and his amazing mother Cana.

You can read Cana’s whole story here.  In case you have ever wondered if EPers “just didn’t try hard enough,” read it. You will see that she did in fact try very very hard to be able to nurse her baby boy.

Jackson is one of my favorite babies (okay, I know I say that about all the babies, but he will always hold a very special place in my heart.) Why? 1. He is a super duper fat breastfed baby and I have a thing for fatty babies. 2. He is a very, very happy go lucky boy (unless Cana put her nipple in the general proximity of his face) 3.  He beat me. People like to call me “the boobie whisperer” or a miracle worker. But, the truth is, I don’t have magical powers and I can’t make babies do anything they don’t want to do. But I can help mothers accept what is. For Cana, that meant letting go of her attempts at being a nursing mother and embracing her role a as breastfeeding mom. Cana discovered a whole new world of EPing and found community amongst them.

Most importantly, and I will say this again and again, each and every baby is a person. Some babies have much stronger personalities than others and to deny this is to ignore your baby’s uniqueness. You have the opportunity to learn so much from your child by breastfeeding. He will teach you lessons about how to be his mother that you apply for decades to come. So, ask yourself, “What is my baby trying to tell me about who he is and what he needs?”

Principles of Exclusive Pumping

  1. Set short term goals. EPing is more work than nursing with less reward. It is really hard. Set monthly goals. Celebrate every time you hit a major milestone.
  2. Start as strong as possible in the first two weeks after you deliver your baby.
  3. Focus of daily total pumping sessions, not intervals between pumping sessions. It is more important for you to get in eight or more pumps in 24 hours than for you to perfectly space them to every two to three hours. That said, ideally you shouldn’t go longer than five to six hours overnight without pumping if your baby is waking up at night.
  4. Be willing to improvise and have a lot of tools at your disposal. Hand pump (I like Medela Hand Pump), Hands Free Pumping Bra (Simple Wishes is the best one!), a car adaptor to pump while driving or while someone else is driving. A nursing cover so you can pump in public or in front of others.
  5. Know what to do if your supply tanks. Accept the fact that it will Don’t freak out about it, just ride the wave, pay attention and make efforts to boost your supply as soon as you see your supply decreasing.
  6. Know your daily total output. Focus a little less on how much you get from each individual pumping session and a little more on how much you get from all of your pumps combined. Once you know this number and find it is fairly consistent within an ounce or two, you can start to mess with how many pumps you have to get in each day.
  7. Consider experimenting with decreasing the number of times you pump per day. Once you feel confident about your daily total output, drop one pump in a 24 hour period. For three to five days, watch your total daily output closely to make sure it doesn’t decrease. For some women, they will put out the same daily total with one fewer pump. For others, their supply dips. If it dips, put that pump back in. If it stays the same, keep that pump out. When you are feeling brave again, drop another pump. At some point you will hit a threshold where you can’t decrease your total daily pumps any further without affecting your milk supply.
  8. Be a good bottlefeeder.
  9. Seek Community. Often times EPers feel like they don’t belong at breastfeeding support group, which makes me really sad. A well run support group should make all moms feel welcome, no matter if they are nursing, supplementing with formula, or pumping and bottle feeding. You need community as much as, if not more than, every other new mama. You may also enjoy being a part of online EPing communities.