The decision not to breastfeed a baby directly requires careful management of the body’s milk production system. Some parents choose to provide breast milk by exclusively pumping, while others suppress lactation and feed with formula or donor milk. Whether maintaining or suppressing the supply, the body needs a signal to either continue or cease the process. Each choice requires a different approach to managing the physical changes postpartum.
Understanding Milk Supply and Demand
The process of lactation is governed by a sophisticated biological system. Initially, milk production is controlled by hormones (endocrine control), beginning after the placenta is delivered and hormone levels rapidly shift. This signals the body to begin producing a copious supply of milk.
Around ten days postpartum, the system transitions to autocrine control, meaning milk production becomes a local, supply-and-demand process. Milk removal is the main signal the body uses to determine how much more to make, managed by a protein called Feedback Inhibitor of Lactation (FIL).
When the breast is full, a higher concentration of FIL slows down milk synthesis. When the breast is emptied, the FIL concentration drops, and production speeds up. The body interprets milk removal—by nursing or pumping—as demand, while a lack of removal signals the body to slow down and eventually stop.
When Exclusive Pumping is the Choice
For various reasons—such as prematurity, latch difficulty, or separation—some parents provide breast milk solely through exclusive pumping (EP). This requires a significant time commitment to maintain a full milk supply. The goal of EP is to mimic the frequent, efficient milk removal of a nursing baby to signal consistent demand.
In the initial weeks, establishing a stable supply requires frequent milk removal, often 8 to 12 times in a 24-hour period. This means pumping approximately every two to three hours, including at least one session overnight when prolactin levels are higher. Each session should last 15 to 30 minutes, or until the breast feels empty. This consistency is necessary to build up prolactin receptors on milk-making cells.
To manage this schedule, many parents rely on a hospital-grade double electric pump for efficiency. Once the milk supply is well-established (usually after 10 to 12 weeks), the frequency can often be gradually reduced to five or six times a day. Missing sessions or being inconsistent quickly signals the body to reduce production.
How to Safely Stop Milk Production
If the decision is made to suppress lactation, the process must be managed carefully to avoid complications. Stopping milk removal abruptly is not advised, as the resulting engorgement can lead to painful, swollen breasts and increase the risk of blocked milk ducts or mastitis. Instead, gradual suppression allows the body to slow production naturally over several days or weeks.
The primary method involves gradual weaning, where the frequency and duration of milk removal are slowly reduced. This means expressing just a small amount of milk only when the breasts feel uncomfortably full, aiming to relieve pressure without completely emptying the breast. By removing only enough milk for comfort, the high concentration of FIL remains in the breast, sending the necessary signal to the body to decrease supply.
Comfort measures can help manage the discomfort of the drying-up process. Applying cold compresses or ice packs to the breasts helps reduce swelling and inflammation. Some individuals find that chilled green cabbage leaves placed inside the bra can provide soothing relief for engorgement. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) may also be used to manage pain and inflammation during this transition.
It is important to monitor the breasts closely for signs of infection, such as a fever, chills, body aches, or a warm, red area on the breast. If these symptoms occur, or if pain and fullness are not relieved by comfort expressing, consulting a healthcare provider is necessary to rule out complications like mastitis.