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Image credit: Mrs. Flinger on flickr IntroductionMilk supply normally varies somewhat throughout the day and over weeks and months. As long as baby is allowed to nurse on cue, your milk supply will typically accommodate baby’s needs. However, when you are pumping part-time or full-time, pumping output can become an issue due to a few factors:
What is normal when it comes to pumping output and changes in pumping output?It is typical for a mother who is breastfeeding full-time to be able to pump around 1/2 to 2 ounces total (for both breasts) per pumping session. Mothers who pump more milk per session may have an oversupply of milk, or may respond better than average to the pump, or may have been able to increase pump output with practice. Many mothers think that they should be able to pump 4-8 ounces per pumping session, but even 4 ounces is a rather large pumping output for a mom who is breastfeeding full-time. Now infants can get It is not unusual to need to pump 2-3 times to get enough milk for one feeding for baby (remember that the pump cannot get as much milk as a baby who nurses effectively). Many mothers are able to pump more milk per session when they are separated from baby or if they are exclusively pumping. Milk pumped when you are breastfeeding full-time is “extra” milk — over and beyond what baby needs. Don’t get discouraged if you are trying to build up a freezer stash when breastfeeding full time and don’t get much milk per pumping session — this is perfectly normal and expected. It is very common to have more milk than baby needs in the early weeks, which regulates down to baby’s needs over the first few weeks or months. When your milk supply regulates (this change may occur either gradually or rather suddenly), it is normal for pumping output to decrease. For moms who have oversupply, this change often occurs later (6-9+ months postpartum rather than 6-12 weeks). It is normal for pumping output to vary from session to session and day to day. Having an occasional low volume day is not unusual. During a growth spurt, don’t be surprised if baby drinks more expressed milk than usual, making it harder for mom to provide enough expressed milk. Growth spurts are temporary – try increasing nursing and adding a pumping session or two until the growth spurt is over. Menstruation or ovulation can result in a temporary drop in milk supply. You might also notice cyclical dips in milk supply before your period returns, as your body begins the return to fertility. Hormonal changes also cause milk supply to decrease during pregnancy. Remember that the amount of milk that you pump is not a measure of the milk supply available to your baby at the breast! What can cause a decrease in pumping output?First, consider the possibility that baby is being overfed by bottle when you and baby are separated. If this is the case, you may actually not need to be expressing as much milk as is being requested. This is certainly not always the case, but it is not at all uncommon. See How much expressed milk will my baby need? for additional information. Image credit: Jerry Bunkers on flickr When you do need to pump more milk, the first thing to check is your pump:
Supply-demand cycle:
Hormonal causes of decreased milk supply:
Taking care of mom:
See also Hidden Hindrances to a Healthy Milk Supply How can I increase pumping output?To speed milk production and increase overall milk supply, the key is to remove more milk from the breast and to do this frequently, so that less milk accumulates in the breast between feedings. Increasing frequency
Removing more milk from the breasts
Galactagogues
Other things to tryThe following things are useful for maximizing nursing and minimizing the amount of expressed milk that baby needs while you are away. Nurse right before you leave baby and immediately after you return from work. Make sure your care provider does not feed baby right before you are due to return. Has your baby started solids? If so, have your care provider offer all (or most) solids, and only (or mainly) breastfeed when you are with baby. By doing this, baby may need less milk when you are apart (due to the solids) and will nurse more when you are together. This can both help your supply (more nursing) and decrease the amount of pumped milk you need to provide. Encourage baby to “reverse cycle” – reverse cycling is when baby nurses frequently when mom and baby are together (usually at night) and takes little milk when mom & baby are separated. One study has shown that the moms of hospitalized babies who listened to guided relaxation or soothing music while pumping had an increased pumping output. When mom listened to a recording that included both music and guided relaxation while pumping, in addition to looking at photos of her baby, pumping output was increased even more. In this study, the interventions led to moms producing 2-3 times their normal pumping output. Milk fat content also increased for these moms in the early days of the study. Additional informationIncreasing Low Milk Supply @KellyMom Let-down Reflex: Too slow? @KellyMom How Much Milk Should You Expect to Pump? by Nancy Mohrbacher, IBCLC, FILCA What to Expect When Pumping by Paula Yount How much expressed milk will my baby need? @KellyMom To Pump More Milk, Use Hands-On Pumping by Nancy Mohrbacher, IBCLC, FILCA Breastpumps – troubleshooting and general info @KellyMom Ouch! What If Pumping Hurts? by Nancy Mohrbacher, IBCLC, FILCA Working & Pumping Tips @KellyMom See the Working, Pumping, Bottle Feeding menu for information on formula and other foods Keith DR, Weaver BS, Vogel RL. The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by mothers of premature and critically ill infants. Adv Neonatal Care. 2012 Apr;12(2):112-9. How long should I pump per session to increase milk supply?A pumping session will take 15-20 minutes ideally pumping both breasts at the same time. Full milk production is about 25-35 oz. per 24 hours.
Will pumping once a day increase supply?Start by pumping once a day to begin storing milk. Most women find that they are able to pump more milk in the morning because the supply tends to be more abundant at that time of day. Pumping before a feeding will enable you to get more volume, but this volume may consist of more watery foremilk, which has less fat.
Can I pump every 4 hours and maintain supply?At work, you should try pumping every three to four hours for around 15 minutes a session. This may sound like a lot, but it goes back to that concept of supply and demand. Your baby takes in milk every few hours. Pumping that often will ensure that you're able to keep up with their needs.
How much should I pump to build supply?A good goal might be 15-30 ounces to start, keeping in mind that your baby will typically take 2-4 ounces for a feed.
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