Many infants born prematurely are unable to feed directly at the breast for weeks or even months, so mothers are often fully dependent on the use of a breast pump for both the initiation and maintenance of lactation. Many of these women experience problems with providing adequate amounts of human milk during their infant’s hospital stay in the Neonatal Intensive Care Unit. The purpose of this capstone project was to analyze, synthesis and summarize the research on initiating and maintaining lactation, and then formulate evidence based guidelines for breast pumping for pump dependent women. This project will provide evidence for healthcare providers and families on the best methods of using a breast pump to achieve maximum milk supply. A comprehensive literature search was performed using MEDLINE, CINAHL, EBSCOhost, and the Cochrane Database. The studies with outcomes of interest included pump dependent mothers and pump specific studies. Studies on breast pumping related to initiation, duration, frequency, method, pump type, vacuum settings, rate and sequence were selected. Supportive interventions to increase milk volume during pumping were also reviewed. A literature matrix was created to analyze the information gleaned from the studies. The findings of the studies were synthesized into categories and conclusions from the data were formulated. Five categories for of findings were identified: method of breast pumping; timing of the onset of pumping after birth, frequency of breast pumping, duration of individual pumping sessions, and supportive interventions to increase milk volume such as warming the breast and using guided imagery. The analysis of the findings revealed that the following interventions can increase milk volume: hand expression and breast massage during mechanical pumping; early initiation of pumping after birth; frequent breast pumping; pumping only until the milk flow stops during individual episodes of milk expression; and supportive interventions such as warming the breast before pumping and using guided imagery. The findings of this analysis provide the foundation for evidence based guidelines that can be used in clinical practice.