The pump and dump method is a way of maintaining lactation, during times when your breastmilk could be contaminated with drugs or medications.
Why Pump and Dump?
Lactation, or the production of breastmilk, is a physical process that is maintained by frequent stimulation of the nipple and breast by the baby breastfeeding or by pumping your breasts. The stimulation, along with removal of the milk from your breasts, is what tells your body to produce more breastmilk. If you take a break from breastfeeding, your body slows down and eventually stops production of milk.
When you drink alcohol, smoke cigarettes or marijuana, take medications or use recreational drugs, potentially toxic substances enter your breastmilk. The exact amount that goes into your breastmilk depends of several different factors, and some substances are more toxic than others, but in general, most drugs are potentially harmful to your baby. However, given the vast physical and psychological benefits of breastfeeding, choosing not to breastfeed your baby isn't straightfoward.
Pumping and dumping involves removing the milk from your breasts artificially, using a breast pump, then discarding the milk. This tells your body to keep producing more breastmilk, but does not expose your baby to the potentially harmful substances in your milk. When you are no longer using harmful substances, you can resume breastfeeding, whereas if you do not pump and dump, you may not be able to regain your milk supply.
When to Pump and Dump
Even if you are regularly using drugs or medications that could be harmful to your baby, you may not have to pump and dump all the time. In many cases, you can breastfeed before smoking, drinking or taking the drug or medication, and simply pump and dump until at least three hours after your last substance intake.
Exceptions are marijuana, which stays in the body much longer than most other drugs, and opiates, which increase the baby's risk of apnea -- stopping breathing. Even codeine, an opiate medication commonly prescribed to women following childbirth, has been fatal to newborns, when it has built up in the baby's system over several days.
For more detailed information on combining breastfeeding safely with substance or medication use, check out the following articles:
American Academy of Pediatrics "Policy Statement: Breastfeeding and the Use of Human Milk." Pediatrics 129:e827-e841.
Academy of Breastfeeding Medicine Protocol Committee. "ABM Clinical Protocol #21: Guidelines for Breastfeeding and the Drug-Dependent Woman." Breastfeeding Medicine 4:225-228. 2009.
Astley, S. & Little, R. "Maternal marijuana use during lactation and infant development at one year." Neurotoxicology And Teratology 12:161-8. 1990.
Berger, M.D., M.P.H., L., "When Should One Discourage Breastfeeding." Pediatrics 67:300-302. 1982.
Cook, P., Petersen, R. & Moore, D. Alcohol, Tobacco, and Other Drugs May Harm the Unborn. DHHA (ADM) Report No. 92-1711. 1990.
Liston, J. "Breastfeeding and the Use of Recreational Drugs -- Alcohol, Caffeine, Nicotine and Marijuana." Breastfeeding Review 6:27-30. 1998.
Madadi, P., Moretti, M., Djokanovic, N., Bozzo, P., Nulman, I., Ito, S. & Koren, G. "Guidelines for maternal codeine use during breastfeeding." Can Fam Physician 55:1077-1078. 2009.
Madadi, P., Ross, C., Hayden, M., Carleton, B., Gaedigk, A., Leeder, J. and Koren, G. "Pharmacogenetics of Neonatal Opioid Toxicity Following Maternal Use of Codeine During Breastfeeding: A Case–Control Study." Clinical pharmacology & Therapeutics 85:31-35. 2009.
Koren, G. "Drinking alcohol while breastfeeding. Will it harm my baby?" Can Fam Physician 48:39-41. 2002.
Wilton, J. "Breastfeeding and the Chemically Dependent Woman." NAACOG's Clinical Issues in Perinatal and Women's Health Nursing 3:667-7. 1992.