How to Establish a Full Milk Supply with a Breast Pump Nancy Mohrbacher, IBCLC, Lactation Consultant, Ameda Products, Hollister Incorporated After birth, many mothers feel great sadness when faced with a breast pump instead of their breastfeeding baby. Think of the pump as a useful tool. It is a friend whose mission is to help you establish and maintain your milk supply until you are ready to breastfeed your baby. YOUR GOAL: Pump a full milk supply, 25-35 ounces (750-1050 mL) per day, by Day 10 to 14 after birth, no matter how much your baby is taking. Your body is primed and ready to produce milk now, and if you wait too long, it may be difficult or impossible to increase your supply to this level later. As soon as possible after birth, start pumping at least 8-10 times every 24 hours (as many times per day as your baby would be breastfeeding). More pumpings per day equals more milk produced. Use a rental hospital-grade automatic pump with a double pumping kit. • Until your milk “comes in” on Day 3 or 4, pump at least 10-15 minutes per breast per pumping. • When your milk increases, as often as you can, pump longer, until 2 minutes after the last drop of milk or 20-30 minutes total, whichever comes first. (Drained breasts make milk faster.) Focus on the number of pumpings per day, not the time between pumpings. • If you think in terms of the time between pumpings (i.e., every 2 to 3 hours), when pumping is delayed it is too easy for the total number of pumpings (the most important factor) to drop without you realizing it. • When planning your day, think: “How can I fit in my 10 or so pumpings?” • If you can’t pump during part of the day, pump every hour when you can to meet your goal. • Before you reach 25-35 ounces (750-1050 mL) per day, pump at least once during the night and don’t go longer than five hours between pumpings. (Full breasts make milk slower.) Once you’re pumping 25-35 ounces (750-1050 mL) per day, you may be able to cut back on pumping and still maintain supply. • Cut back to 5-7 pumpings per day – at this number of pumpings, most women can maintain their supply. If you notice your supply starting to decrease, see the next section. • You may not need to pump during your normal sleeping hours. With a full supply, many exclusively pumping mothers can pump as the last thing they do before bed and the first thing they do when they wake in the morning. If you can do this without too much breast fullness and discomfort, go ahead. • For most mothers, once supply is established, 10-15 minutes of pumping is long enough. • Monitor your supply at least once a week by keeping a written record of your daily milk yield. Hollister and logo, stylized heart, and "Attention to Detail. Attention to Life" are trademarks of Hollister Incorporated. ©2006 Hollister Incorporated. 907280-A506
If you need to increase your milk supply, the sooner you work on it, the faster you’ll see results: • Increase the number of pumpings to 8-12 per day, which is enough to boost milk supply, for most women. • Increase pumping time to 2 minutes after the last drop of milk or 20-30 minutes, whichever comes first. • Have your pump flange fit checked. Many women get better results with a larger nipple tunnel. Fit can change over time. • Use breast massage during pumping. This yields more milk. • Ask your lactation consultant to talk to your doctor about prescription medications and/or medicinal herbs such as metoclopramide (Reglan), domperidone (Motilium), or fenugreek (natural plant product) capsules. When you wean from the pump (human milk is recommended for a minimum of one year), you can do it comfortably and safely by cutting back on pumping gradually. • Start by eliminating one daily pumping, give your body 2-3 days to adjust, and then eliminate another pumping, leaving your first and last pumpings of the day until the end. Repeat until you’ve weaned. • Keep the number of pumpings the same and stop pumping sooner. For example, if you normally get 4 ounces (120 mL) at a pumping, stop after 3 ounces (90 mL). Give your body a couple of days to adjust and then decrease by another ounce. Repeat until you no longer feel the need to pump. NOTE: If you feel full at any time during weaning, pump to comfort – not a full pumping, but long enough so that your breasts feel comfortable. Leaving your breasts full increases your risk for pain and infection. No matter how long you've been pumping, it is nearly always possible to transition to breastfeeding, but you may need help to make it happen. • Sometimes all that's needed is an adjustment in how the baby takes the breast. Sometimes special tools may help. Lactation consultants know all the tricks and have access to any needed tools. • Just because you haven't done it on your own doesn't mean it's impossible. Seek help. It is well worth it for both you and your baby.
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