Extended breastfeeding fact sheet

Establishing and maintaining milk supply when baby is not breastfeeding
It is important to express your milk to establish and • When pumping during the night, milk yield tends to maintain milk supply if your baby is not breastfeeding at be better if you pump when you naturally wake (to all or not breastfeeding well. By expressing, you will also go to the bathroom or because your breasts are have your milk available to feed baby—every bit of
uncomfortably full) than if you set an alarm to wake mother’s milk that your baby gets (even the tiniest • If you are having a hard time getting in enough pumping sessions, adding even a short pumping When should I start pumping?
session is helpful (increasing frequency even if milk • If baby does not nurse immediately postpartum, you should begin pumping within 6 hours of baby's How long should I pump at each pumping session?
birth—starting early makes a difference for future milk production. • If baby does not breastfeed at all:
In the first few days (before your milk comes in) What pump is best?
hand expression is often the most effective way • If baby is not nursing, seriously consider renting a to express colostrum. Double pump for 10-15 hospital-grade pump (such as those made by minutes per session for additional stimulation. Ameda or Medela) that will allow you to pump both After your milk is in, pump for 20-30 minutes per breasts at the same time. A hospital-grade pump is session, or for 2-5 minutes after the last drops of the best choice for maintaining or increasing milk • If baby breastfeeds but does not soften the
• If you are not able to rent a hospital-grade pump, breast well:
consider buying a pump (preferably a quality double Double pump for 10-15 minutes after nursing. • Empty the breast as thoroughly as possible at
each session. To ensure that the pump removes an
How much milk should I be pumping if baby is not
optimum amount of milk from the breast, keep nursing?
pumping for 2-5 minutes after the last drops of milk. • Aim for pumping 750-800 mL (25-27 oz) per day by Use breast massage prior to pumping, and massage 7-10 days postpartum. If you have twins or higher and compressions during pumping to better empty order multiples, aim for pumping 800-950 mL (27-32 the breasts and increase pumping output. Additional tips
It is useful to evaluate your 24-hour pumping output at 10 days postpartum. If supply is borderline (350- • Rest & relax as much as possible. 500 ml / 11-17 oz) or low (less than 350 ml / 11 oz), • Skin-to-skin contact with baby (Kangaroo care) can then galactagogues (herbs or prescription make a significant difference in pumping output. medications to increase supply) or other • If double pumping is difficult to coordinate, then single pump, alternating sides. Move to double The research tells us that milk production at 2 weeks is an indicator of breastfeeding outcome, so it is important to get a good start. Even if milk production Avoid any medications that might interfere with milk doesn't start out well, however, don't get supply (for example, hormonal birth control, discouraged—many moms will see an increase pseudoephedrine, ethanol/alcoholic beverages, (even as late as 9-15 weeks after birth) if they bromocriptine, ergotamine, cabergoline). • If supply is not increasing as expected by 7-10 days after birth, consider the use of galactagogues. How often should I pump?
domperidone (Motilium) can be helpful for increasing 8-10 times per day: Until supply is well established,
it is important to get at least eight good nursing and/or pumping sessions per 24 hours. Ten C o n t ac t Nu m b e rs
sessions per day is better, particularly if you have twins or higher order multiples. • These sessions don't need to be evenly spaced, but La Leche League
you should be nursing or pumping at least once during the night in the first few months, or anytime Lactation Consultant
you notice a decrease in supply. Avoid going longer than 5-6 hours without pumping during the first few Health Care Provider
Establishing & maintaining milk supply when baby is not nursing
Copyright 2005 Kelly Bonyata, BS, IBCLC

Source: http://www.kellymom.com/store/handouts/expressing/establish-supply-pump.pdf