Tips for Pumping After Surrogacy

After four surrogacy journeys, I have a lot of experience pumping breastmilk for my intended families.

Whether or not you pump milk is a personal choice and should include a conversation with your intended parents. The details of it will be outlined in your contract, but even if you agreed to it in the contract, you are not contractually obligated to pump. Pumping should be beneficial for both parties involved, although pumping for your health is always an option. (Fun fact: lactation decreases your risk of several illnesses including breast and ovarian cancer.) Please note I am not a doctor, and this reflects my personal opinions. This is for informational purposes only and does not substitute professional medical advice with healthcare professionals.

While some will produce more milk than others, you are not a failure if you can’t produce 80+ ounces per day. You should aim to produce the amount of milk that feels right to you. I nursed my son and pumped for donation for 3 years; I also pumped after all four of my surrogate babies. 

If you hit a snag in your milk production, these are some things that I have found to increase my milk output…

Make sure you have a good pump:

A good pump is one of the most important tools to meet your pumping goals. Unless your pump is designed for long-term use (i.e., Medela Symphony), the motors of pumps often wear down with time and many are designed for use with a single baby. So, if you have an old pump that you would like to reuse, you absolutely should, but be aware that the pump probably won’t be as powerful as it was when you first bought it.

Here are my personal recommendations for smaller, more portable pumps:

• Elvie
• Willow
• Baby Buddha
• Pumpable Genie Advanced

Here are my recommendations for good, at-home pumps (these also travel, but they are larger):

• Spectra S1/2
• Spectra Gold
• Medela Sonata
• Medela Pump in Style

So, remember that the pump(s) you choose are significant, but what is most important is to get the one that you are most comfortable with. Check both your insurance and your contract for coverage of the cost of a pump. Most insurance policies will pay for a new pump with each delivery.

Change your parts:

Along with a good pump, parts (such as bottles, tubing, flanges, etc.) are also important. I personally have a bin of parts that I use after each baby because I don’t want to wash parts every day. I just carried and delivered a human, there is no way I’m washing my parts more than once every three days. Having said that, some parts wear out and can decrease the suction of your pump. Make sure to check with the manufacturer of your pump to see when these need to be changed out.

Pump schedule:

For a lot of us, the last thing we want to do after delivering a baby is to think about pumping but establishing a schedule as quickly as possible is important. (Some surrogates chest feed in the hospital. If you are open to this, you should maintain an ongoing discussion with your intended parents before the delivery.) The first several days of pumping sessions will probably feel very unproductive. However, keep in mind what you just went through and allow yourself some grace. Consistent pumping will signal your body to produce more milk, and it will. I suggest talking to an IBCLC at the hospital. Tell them you will be exclusively pumping, and they will help you figure out a schedule that works for you. They can also show you how to hand express colostrum (which can be a great help in those early days), and how to make sure your flange is the right size (a mid-sized flange can reduce milk output).

After a few weeks of pumping, I also suggest scheduling another outpatient appointment with an IBCLC to go over any questions or concerns. Bring your pump and parts so they can look at flange sizing again. It’s not uncommon to have a change in size due to a decrease in postpartum swelling.

The schedule I followed was to pump every 2-3 hours for at least 20-30 minutes. You don’t want to go much longer than 20-30 minutes because you could damage tissue in your nipples. At night, I would go 4 hours between pumps so I would only need to wake up once. My last delivery had complications, and I had to stop pumping at night because I felt that my healing and recovery took priority. I had some guilt when I made this decision, but my IPs were supportive.

A lot of surrogates and intended parents ask about direct feeding in the few days after delivery. This should be part of the discussion between both parties when preparing for the delivery and should include what everyone’s boundaries are.

Get rest:

Rest is vital to milk production, not to mention healing from delivery. The hormones released during sleep can trigger the production of more milk while also helping to decrease stress (which can be harmful to your supply).

Ask for help:

Asking for help includes both with lactation and in your personal life. Asking for help from peers and medical professionals is always helpful. Pumping can be a lonely experience at times, so making those connections can help. When it comes to your personal and professional life there is nothing wrong with asking for extra help. Have family/friends pick up an extra chore, get groceries delivered, or have someone else assist with a project at work. Recovering from childbirth while pumping around the clock can be exhausting! Go easy on yourself.

Stay hydrated:

There is a lot of misinformation and confusion about hydration and milk supply. Most medical professionals, including IBCLCs, agree that you should just drink to thirst. There’s no reason to drink much more than that and generally, you don’t need special sports drinks either. If you are eating a balanced diet and drinking water whenever you feel thirsty, you should be fine. Having said that, adding an extra cup of water or two isn’t going to hurt. However, you should not drink twice your body weight in ounces, as is often recommended on social media.

Returning to work:

Returning to work after a surrogate pregnancy should be like any other postpartum person returning. The main difference is that, compared to those who were not surrogates, we will be returning much sooner. Communication with your employer is essential and you should consult your organization’s policies on lactation. In addition, learn about the federal laws on lactation in the workplace, as well as your state’s laws. State law can sometimes give more protection than federal law, but it absolutely cannot give less. So, if you find that something is not covered under federal law, check your state’s laws. If you have any questions about lactation in the workplace or if you feel you are being discriminated against, I urge you to contact your local BOLI office. Many have departments that specialize in lactation.

Be gentle on yourself:

You have just created a human and given the gift of a family. This is your time to recover, heal, and reconnect with yourself. Don’t compare yourself with others. Some people produce 100 oz per day, while others produce 20 oz. Don’t stress out over each ounce. You are doing the best that you can, and the baby’s parents will find a way to feed them. If you choose to pump, remember that you’re not just pumping for the baby, you’re also doing it for yourself.