Carrie Mehi has been feeding her daughter expressed breast milk for nearly all her six months of life. Before having her baby, Mehi says she tried nursing, but found it a psychological struggle. “This is a part of my body that’s always been reserved for sexual activity,” she said, gesturing toward her breasts. “And I sort of assumed my brain would make whatever necessary adjustments it had to do to make [breastfeeding] not a completely creepy experience for me.” She was determined to overcome her aversion, because she wanted the health advantages for her daughter. But after a bad hospital experience – cancelled breastfeeding classes, brusque or unavailable lactation consultants – Mehi, a lawyer in Cambridge, Massachusetts, turned to the pump. She and her husband gave their baby a bottle the first night they were home from the hospital.

Even though she figured the pump and bottle regimen was only temporary, Mehi said, “I really don’t think we tried breastfeeding after the first day we left the hospital. I was not interested in having my sweet baby crying at my breast for one more minute. I just wanted her fed. [Breastfeeding] was an unpleasant sensation to me, and I thought, you know what, if I’m flinching, I might as well flinch to a machine instead of to my girl.”

After a couple of months, Mehi’s supply caught up to her daughter’s appetite and from the second month on, she’s been an exclusive pumper. Efficient and organized, she has created a smooth system: a pump at work and another at home, a stash in the freezer, and a baby who will take milk even when it’s not warm. For the next baby, Mehi said, she won’t even try to nurse; she’ll go straight to the pump.

Mehi is one of a new generation of mothers who feed their babies exclusively breast milk but never nurse them directly. While no reliable statistics exist on whether more women are exclusively pumping, and the breastfeeding activist organization La Leche League declined several requests for comment, there’s been more and more talk about it in recent years – especially online.

“The great thing about the internet is that it allows women to connect with each other to share information and experiences,” said Jennifer Laycock, a Columbis, Ohio, mother who blogs about her exclusive pumping on thelactivist. “Now that I’ve been writing the site for a few years, I’m amazed at how much email I get from readers who are thankful to have finally found someone who understands their choice,” she said.

A champion pumper – she donated twenty-seven gallons to a milk bank during her daughter’s first year – Laycock advocates for women she says are breastfeeding, just not nursing, and sometimes getting flack from what she called “hard core breastfeeders.” As she sees it, mothers who pump are trying to do right by their babies, often with very little support and compassion. And she’s eager to raise the profile of pumping, just as many nursing mothers have tried to remove the stigma of nursing in public: “I’ve pumped on planes, on subways, on tour buses, in amusement parks, on a rifle range. You name it; I’ve probably pumped there,” said Laycock.
“I would opt for breast milk in a bottle rather than no breast milk at all.” – Dr. Ruth Lawrence

If some pumpers sound vaguely defensive, it’s because they’re tired of explaining their choice. Women who have only nursed their children can have a hard time understanding exclusive pumping, which many see as an overly mechanized chore to achieve a natural end. Others, including husbands and relatives, urge these women to use formula rather than embark on a grueling pumping schedule. Even doctors may be less supportive of pumpers, who nevertheless feel they’re making a medically responsible choice.

“I don’t think there’s any question” breast milk is superior to formula, said Dr. Ruth Lawrence, a professor of pediatrics and expert on breastfeeding at the University of Rochester. “I would opt for breast milk in a bottle rather than no breast milk at all.”

Still, she said, drinking pumped breast milk from a bottle differs considerably from nursing. “Babies who suckle at the breast – that’s the physiological way to feed. The baby doesn’t get the same kind of activity – tongue, mouth, swallow – when it is feeding from the bottle.” And, she added, “it’s been shown that the die is cast for obesity in the first year of life, and we tend to overfeed babies when we bottle feed them.”

The balance of foremilk and hindmilk that helps nursing babies first satisfy their hunger, then feel full is missing when pumped milk mixes in a bottle. And psychologically there can be more pressure to finish a bottle when expressed breast milk represents so much work for the mother.

“I made the mistake of reading Dr. Sears and I felt like such a failure as a parent.” – Lisa Strong Dr. Lawrence worries that most women aren’t getting the proper support when they set out to nurse their babies, and that some women find the idea so distasteful they don’t try. “Some women do it because they can’t envision the baby suckling at their breast. I suspect it has to do with our whole modern attitude about the breast. It’s become such a sex object.”

Although there are certainly some women who exclusively pump because of such attitudes, most come to it accidentally, through a combination of a bad start at nursing and a conviction that breast milk is best, even if it doesn’t come “straight from the tap.”

Many exclusive pumpers find that a second baby offers a new chance to nurse. It worked out that way for Lisa Strong, an art historian from Maryland. Five years after exclusively pumping for nine months for her son, Strong was able to nurse her daughter. “I still sit back sometimes and say, oh my god, she nurses. It’s great, so great. I still feel that sense of relief.”

Like Mehi and Laycock, Strong felt unsupported at the hospital, and worried about her son’s weight loss. When he was one day old, she agreed to let him have a bottle, but began pumping right away too, so that he would benefit from breast milk’s immunological properties – especially important to Strong because of a family history of ulcerative colitis. Even though Strong was able to feed her son with a less rigorous pumping schedule than some other mothers I spoke with, the memory still brings pain.

“It’s a huge source of regret and guilt, even now,” she said. “The books are so cruel. I made the mistake of reading Dr. Sears and I felt like such a failure as a parent.” She still wonders if a better lactation consultant could have gotten her son to latch on, and she wonders whether her difficult pregnancy and delivery put her at an instant disadvantage. “I’ve heard that women who’ve been on bedrest, and women who’ve had C-sections, can often have trouble nursing,” she said, “because you feel your body has failed at these basic natural things and expect it to keep failing at these things, and so you don’t have much confidence, and I think that was very true for me.”

“You’ll never find me putting down moms who don’t breastfeed.” – Jennifer LaycockWhile Strong said she was devastated not to nurse her son, she added that “there was this whole other side to me that didn’t even want to nurse. I was afraid of the commitment, afraid of being tied down to him.”

When her second child was born, Laycock also found that, after a few minor nipple problems, she was able to nurse without incident. “Looking back,” she said, “I have mixed feelings on nursing instead of pumping. I’m so thankful for the experience and the bonding I got from direct nursing, but this time around, I ended up with a baby who wouldn’t take a bottle. I also have a baby who still doesn’t sleep through the night. Everything has its pros and cons, I guess.”

Many of the women I spoke with mentioned the freedom they enjoy because their babies will bottle-feed with other caregivers. Jessica Barie, a mother in the Boston suburbs, said she felt tied down to the pump during the day, “but if I wanted to go out at night with friends, I could pump really intensely during the day and then go out, be able to drink alcohol, and just throw it out.”

Inverted nipples and the hassle of nipple shields drove Barie to the pump. Her daughter was happy and healthy, and she figured that pumping eight to nine times a day was just her “mother sacrifice.” While she regretted not being as flexible as her nursing friends, and felt that pumping left her more exhausted than they were, she appreciated the benefits of feeding her daughter breast milk for as long as she did. Still, she says, next time around “We’re going to try to breastfeed again. We’re hoping that it will work.” If it doesn’t, she said, “I would pump exclusively as long as I could. She was so healthy, and I really think it had to do with so much breast milk for so long. And the formula is so expensive; there’s that, too.”

All the women I spoke with would agree on one thing: mothers who wish to breastfeed would benefit from better support and information. Inconsistent, inconsiderate nurses and lactation consultants, doctors who either push formula or ignore mothers’ requests for help with nursing, and rigid hospital policies regarding babies’ weight need to change. As Dr. Lawrence points out, babies have been losing weight in the days after birth since the beginning of the human race: it’s a feature, not a bug. By fetishing weights and measures, the modern healthcare establishment borrows from the formula industry while paying lip service to breastfeeding – a recipe of mixed messages that sets mothers up to fail.

“You’ll never find me putting down moms who don’t breastfeed on my blog,” said Laycock. “Having been on the receiving end of that type of judgment, despite getting breast milk into my kid, I would never take part in piling on moms who have tried and failed at breastfeeding.”