Dr Jen I have seen it go both ways. I have seen moms in this situation w/ good supply and those w/ very low supply. Her best chance is to get started right away and do very frequent expressings, 8 or 10x in 24 hrs. I usually get more w/ hand expressing at first, but moms seem to prefer to put the pump on. I would ask her what she would prefer. In the interest of time, double pumping seems to be the fastest. I would recommend she rent a Medela Classic pump. In my experience it yields the best volumes. I have no experience yet w/ the Symphony nor the Ameda pumps in this class. I would feed mom well and give her plenty to drink (not that this makes more milk but I feel it will give her the best health and I think that can have an effect). Be ready w/ herbs and/or galactagogues like domperidone if you are using them, and start by the end of a week if supply is not going up well. Encourage her, as I know you will, as the babies will need very little to eat at first, so for now she should be able to provide. Perhaps they are NPO now and she can get a little head start. I would harvest any and all drops of colostrum w/ a little sterile water or sterile D5W so the babies can get this. Sometimes the neo docs will let the babies take the little drops of colostrum as lip/mouth care, just give them a little swab. I would suggest kangaroo care whenever/as soon as possible. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ FREE pop-up blocking with the new MSN Toolbar – get it now! http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/ *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html