Dear Lactnetters,



Since my colleagues and I were responsible for the "100 minutes a day"
number through a publication so very many years ago (Pediatrics 1988;
81(6):815-820), I feel an obligation to clarify how that number can be
applied in a clinical setting.  It is not magic, and there is no valid
evidence that dividing it by 2 for double pumping will bring similar
results. Some reduction in time is logical, but that study does not tell us
how much.

However, the same study did indicate that a minimum frequency of pumping
(five pumpings/ breast/ day) as well as a minimum duration were associated
with maintenance of milk production between 2 and 4 weeks postpartum.  The
conclusion (p819) states "optimal milk production is achieved most often by
women who express milk five or more times per day and whose pumping duration
exceeds 100 min/d" (single pumping).

While the calculations are based on pumping patterns between 2 and 4 weeks,
these mothers did not initiate pumping every 2-3 hours around the clock and
then decrease the intensity of pumping.  Their pumping patterns were much
the same or less intense in the first two weeks.  In fact, I have seen no
scientific evidence to support the recommendation that mothers of premature
infants must pump every 2-3 hours around the clock to initiate lactation.
If any of you have knowledge of a controlled trial that demonstrates the
efficacy of that recommendation, could you send it to me?

Thanks very much,

Judy Hopkinson

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