I am going to chime in here as one LC who does not tell moms to nurse on 
one side and pump the other. I might tell them to try pumping on side 
one when baby has finished that and gone on to side two. I mostly 
suggest pumping some after nursing and collecting the little bits into 
one larger amount. I suggest starting giving bottles about week 3-4 to 
get baby used to them (once or twice a week given by someone other than 
mom). I suggest mom start pumping for extra stored milk a week or two 
before she goes back to work. I am also one of those LCs who only 
encourage some extra stored milk, not a month's worth!

For those moms with a huge milk supply, who can pump out 4 ounces from 
one side, the single sided nursing bit will mostly likely work. The 
ladies with huge milk supplies need to be careful with pumping too much 
because they then make more milk and baby often gets fussy from a 
foremilk/hindmilk imbalance.

I also tell moms to limit the amount in the bottle to 2-3 ounces, 
depending on the age of the baby. And to limit their caregiver to about 
12 ounces in the bottle total for each day. So for a 6 week old, 
something like 6 bottles of 2 ounces, 4 bottles of 3 ounces, etc. for 
the time away from mom. Too many caregivers feed too much to quiet the 
baby, mom can not keep up, and baby loses interest in nursing.

The other thing is once they start back to work and get on a schedule of 
pumping, things will even out. Her body will get used to making milk and 
releasing it to the pumping schedule. From the pumping moms chat list, 
I've learned that many moms pump again after the last nursing of  the 
night, or get up in the middle of the night to pump if baby doesn't wake 
to nurse anymore. Some pump at home after the baby nurses first thing in 
the morning because they have a larger supply then.

The reason I do not tell moms to nurse on one side and pump on the other 
is that I have seen many test weights were baby gets 1.5 to 2 ounces on 
the first side and maybe one ounce on the other. Total together is fine 
for the necessary caloric requirements but take away the second side and 
you've got a hungry baby. Some babies will demand more to eat, others 
are way too passive and accept the lack of food and don't gain weight. 
This was most likely our example baby.

Kathy Eng, BSW, IBCLC

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