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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
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,
consider buying a pump (preferably a quality double
Double pump for 10-15 minutes after nursing.
• Empty the breast as thoroughly as possible at
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
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.
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
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
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European Journal of Cardio-thoracic Surgery 16 (1999) 469±470Overdose of tetracycline for pleurodesis leading to chemical burnsH. Chaugle*, C. Parchment, D.J.M. Keenan, G.J. GroÈtteDepartment of Cardiothoracic Surgery, Manchester Heart Centre, Manchester Royal In®rmary, Oxford Road, Manchester M13 9WL, UKReceived 27 January 1999; received in revised form 12 July 1999; accepted 4 August