Difficulty Pumping Breastmilk


While many of our surrogates are experienced breast feeders, most have not relied exclusively on a breast pump for milk extraction. It is not uncommon for surrogates who use a breast pump to extract milk for the child they birthed to encounter difficulty pumping or trouble attaining desired results. When this happens, it can leave you feeling confused and disappointed.

We can assure you that your efforts and intentions are highly admirable. No matter the outcome of your attempt, you are righteous with your dedication and concern for pumping. As with many situations in surrogacy, the key to success will again be patience and education.

Causes of Low Supply:

According to the Mayo Clinic, low supply can be caused by a variety of factors. Common causes can include:

  • Ingestion of medicines containing pseudoephedrine. Common examples include Sudafed, Zyrtec D, and other allergy medications
  • A return to hormonal birth control before a firm supply has been established
  • Alcohol or nicotine use

Other culprits of low milk supply can include a hormonal disorder, thyroid problems, or previous breast augmentations.

Things You Can Do to Help:

There are a variety of ways to work on increasing your supply. Perhaps the most important and effective thing is to begin pumping immediately after birth and continue to pump regularly. While your job as a surrogate is completed at the birth, a good rule of thumb is that you should mirror your pumping schedule with the baby’s feed schedule. This is a lot of work, and represents a continued commitment on your part. However, mimicking actual nursing as closely as possible will establish a solid supply and demand.

Just as important as early and frequent pumping is the use of a good pump. Consider renting a hospital grade pump for the duration of your pumping window. Using the highest quality product double pump is a proven way to increase supply.

Many lactation experts will advise that you should continue to pump, even if you’re getting little to no results. The continued draw on the breast signals the body to begin producing more milk. During your pumping, you should also remember to massage the upper quadrant of your breast, in order to stimulate the milk sacs to release more milk.

Additionally, there may be herbal supplements you can experiment with to try and increase supply. Many mothers swear by red raspberry tea, Fenugreek supplement, blessed thistle, or brewers yeast (containing B vitamins). While these herbal supplements do not boast scientific evidence of an increased supply, they have been used by mothers for hundreds of years.

If all else fails, your doctor may be able to prescribe you a medication that can aid in production.

Things you should look out for:

Mastitis- This is an infection caused by a clogged milk duct. This condition can be incredibly painful and, if not treated, can lead to further infections and even the need for surgery. You’ll want to watch for a sudden decrease of supply in just one side accompanied by additional tenderness, a hard lump on the side of the breast, redness, and heat to the touch. If you suspect a clogged milk duct, let your lactation specialist or OBGYN know immediately.

Breast tenderness is also common. A common problem is that women will avoid pumping due to pain. This not only causes further supply depletion, but it can also lead to a clogged duct, and potentially mastitis. It is important to use a nipple balm or lanolin as well as other soothing treatments in the early weeks of pumping to avoid pain and continue with your steady routine.

Understand that it is OK to ask for help, and that in most cases, a low supply can be overcome. If you find yourself in need of assistance, you can reach out to a lactation specialist or other experts at the La Leche League. Most hospitals will employ a lactation specialist who is available at no cost to you. You usually meet this person before you’re discharged from the hospital and can ask preliminary questions and gather contact information at that time. Don’t be afraid to call this person after being discharged from the hospital. The service is still available and, in many cases, still free. Additionally, you can reach out to experts at the La Leche Leage for support. You can find a center near you by visiting www.llli.org.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.