Jan -

In your response to Carol, you ask what others are doing about post-feed
pumping to increase supply.

I have been telling moms to pump after feedings when it is convenient:  Get
the baby settled, supplement if needed, get a drink of water, a bite to eat,
go to the bathroom, whatever, then pump 15 - 45 minutes after feeding.  I
also tell parents the object of pumping after a feeding is not necessarily
to get more milk but to tell the breasts that they need to make more.  The
emptier the breast is, the faster it makes milk even if none ends up in the
bottle.  If they get some milk, it is a bonus.

In the past, I did not specify when to pump.  Either mom would put down the
baby who was not settled and listen to the baby cry while they pumped
(definitely NOT good for Milk Ejection Reflex in my experience.)  OR mom
would pump a lot later and baby would wake up 15 minutes after pumping and
mom would not put baby to breast because "it was empty anyway."

When Hartmann & company put on their show at the Boca conference about 11/2
years ago, I was able to get to a microphone and ask when after feeding to
pump to most effectively increase milk supply.  His response was "there is
no data on that at this time."  I have chosen the time I suggest based not
only on the reality of having a baby and double or triple feeding but I am
also trying to get mom to pump soon enough that we see prolactin levels stay
elevated.

I am ready to change my recommendations in a heartbeat if science proves a
better way.  For now, this seems to work in my client population.

Linda Pohl, IBCLC
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www.eBESTFed.com

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