Why Do Moms Need to Pump During the Night?

This was written as a quick reminder to NICU staff in an effort to ensure consistent messages were being provided to moms who are pumping for babies in NICU.

A Little Lactation Science… By Christine Staricka, IBCLC Why do moms need to pump during the night? There are 2 main reasons moms need to pump during the night: prolactin levels and Feedback Inhibitor of Lactation (FIL.) Particularly during the first 10 days postpartum, raising the prolactin levels in the body on a frequent basis is critical to establishing milk supply.

How do you raise prolactin levels? Only through skin-to-skin contact, breastfeeding, and pumping can this be accomplished. The longer the interval of time between these activities, the lower the prolactin level drops in the mother and the higher the risk of compromising milk supply. Even just one long stretch of 6 hours can compromise milk supply. This is why we recommend moms pump every 2-3 hours and take no longer than (1) 4-hour stretch of no pumping or breastfeeding during every 24-hour period. Therefore, it is medically necessary for mothers to set an alarm and wake to pump during the night. ​ What about FIL? Once a mother has experienced the onset of copious production of breastmilk, her body responds not only to the rising and falling of prolactin levels, but to the buildup in the breasts of FIL. FIL begins to collect in the breasts when milk is not removed via breastfeeding or pumping. The accumulation of FIL is what tells the body to decrease milk production – an amazing tool for regulation of milk supply. Again, this predictable chemical reaction in the body makes it medically necessary for mothers to set an alarm and wake to pump during the night. ​ Our compassion for mothers, our sympathy for their fatigue and childbirth recovery, our natural instinct to protect them as we protect their little ones left here in our care – all of these lead us to believe we are helping when we encourage them to get more rest. However, professionally we know and must teach that frequent and consistent pumping is the only way to ensure the optimal milk supply which is critical to their babies’ recovery and growth. Our instinctive response to the statement or observation that milk supply is low or inadequate for baby must be “How many times has mom pumped in the past 24 hours and when was the last time she pumped?” How much mommy eats, drinks, or sleeps is very low on the list of factors which are affecting her milk supply.