I'm late in catching up on the Lactnet overflow in my inbox, but had to
chime in one more time in response to Jennifer Tieman's lovely post. I too
was a "just enough" pumper with my two - and I have found in my teaching
that Peter Hartman's work on storage capacity is the most helpful thing I
can pass on to moms. They ask me "how often do I need to pump" - and this
research is very helpful in formulating an answer. I explain that a woman
with a large storage capacity will be able to pump less frequently -
approaching the every 4 hour mark - without reducing her supply. For women
like Jennifer and myself, I had to get closer to every 2 or 2.5 hours to
maximally keep up my supply - and like Jennifer, I very quickly saw a
decrease in supply if I went longer than that. A "full" low-capacity breast
very quickly sends a signal to reduce production, as opposed to a
large-capacity breast, which can hold the milk longer. I'm also careful to
tell moms that they won't know their capacity until they start breastfeeding
and see what kind of schedule their baby settles into, and it might not be
clear until they start pumping.
For women with a small storage capacity, the
pump-one-side-while-you-nurse-the-other isn't going to work, as our babies
usually feed from both sides each feeding. HOwever, our breasts refill quite
rapidly, so I recommend pumping shortly after a feeding to get enough milk.
What worked for me (and many moms I've worked with) is to nurse on demand in
the morning, then nurse at the last possible minute before leaving (for a
'top off' to delay the first bottle of the day), then commute to work, and
pump upon arrival. This is before the stresses of the day have set in,
doesn't interrupt the work flow, and because of high morning prolactin
levels can often yield the highest output of the day - and I reassure moms,
yes, it works even if you "just" nursed before you left.
Jean Cotterman also added some of the times moms add pumping sessions to
make it work - after the baby goes to sleep at night, during the night,
first thing in the morning, extra sessions on weekends - all are great
options that I'm careful to pass on to moms.
I think the most important thing is to be telling moms who are going back to
work that there is no "right" answer or "best" schedule. They need to get to
know their bodies and figure out what works for them. Assure them that it is
100% possible to pump enough - but it may take some experimenting to figure
out their best solution.
That's why on my website, I have about 8 steps to troubleshooting supply
problems. It's not to suggest that every mom needs to do all 8 - but moms
need a lot of options to choose from to figure out what works for them.
I always thing I'm just going to post my $0.02, but it always ends up more
like $1.50 ;-)
Kirsten Berggren, PhD, CLC
www.workandpump.com
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