Hello, All.
       I suggest that moms pump after each feeding if mom does not have
enough milk and/or baby is not currently sucking well enough to maintain milk
supply.  I usually suggest 10 minutes of pumping if baby is doing pretty poorly,
and 5 minutes if baby is doing fairly well, but hasn't quite got it, or is doing
it right now (but maybe wasn't initially) but mom still needs to build supply
and baby isn't willing to just stay at breast and suck, or wears out too
much.
       I always suggest that moms pump as close to the end of the feeding as
possible.  If mom has a helper who can feed any necessary supplement, then I
suggest that mom pump while helper is feeding baby, to save time.  As Kristeen
has said, *correct* sucking on an "empty" breast will increase supply (so we
need either a baby with the correct suck or a *good* pump).  So even though the
breast is "empty" (I know, the breast will produce milk on demand, but it's
pretty slow once the storage areas have been emptied), appropriate sucking will
help increase supply.
       There are two main reasons I suggest to moms that they pump right
after the feeding.  One is that not only is *amount* of stimulation important, but
so is *timing*.  I explain to moms that *when* they pump tells the body
*when* they want the milk.  It doesn't do a lot of good to pump at 3:30 if baby is
hungry at 2:00, because the body will be getting the message that the bulk of
the milk should be ready by 3:30.  That is also why I tell moms who are only
pumping for a baby who is not latching, to pump whenever the baby eats, rather
than some arbitrary other schedule. (This is assuming that mom still
wants/plans to get baby to come to breast.  It's a moot point if mom has decided she
will just pump and bottle-feed for the duration.)  I came to this conclusion
about *timing* for a couple of reasons.  One was the mothers who finished pumping
20 minutes before baby woke up, and then he gets upset when brought to breast
because "nothing comes out".  The other was personal experience.  When my
daughter turned 9 months old, she suddenly started sleeping through the night,
when she had been nursing 3 times every night.  The first three mornings, I woke
up brick hard and soaking wet.  (But I felt *so* good, not feeling like a
zombie.)  By the fourth morning, my body had gotten the message that all we
needed was breakfast, so I woke up heavy but comfortable (and not wet).  But my
daytime supply stayed as it was.  The missed nighttime feedings only dropped
nighttime supply.  Then, when she turned 10 months, my daughter just as suddenly
*stopped* sleeping through the night!  (30 nights of sleep definitely spoiled
me, and it was harder for me to accept those night feedings at 10 months than
it was when she was a newborn!  But I got used to it again.)  Those first three
nights, she nursed practically all night, because my body had learned that it
only needed to supply a large quantity of milk for breakfast, and it didn't
have enough for middle-of-the-night feedings.  By the fourth night, my body
really believed she wanted the extra milk and started making enough for her 3
nighttime feedings again, as well as breakfast.  But all that nighttime sucking
during those 3 nights didn't cause my daytime supply to swell.
       The second reason I suggest pumping right after the feeding is to
prevent burnout in the mother.  Way too often I get moms in my office who are
trying to feed baby every 2 hours, but someone in hospital or dr. office told them
to pump every 3 hours.  Even if they aren't trying to follow this pattern,
but they are waiting some certain amount of time after the feeding to pump, they
are worn out.  They are overwhelmed because, all day long, they are
*constantly* dealing with feeding issues.  Usually, they are pumping because
breastfeeding isn't going well.  So feedings take up more than the average amount of
time.  Often they are offering the breast, then following up with supplement.
When they finally finish, they think to themselves, "OK, but in another 30
minutes I've got to pump."  Many times, someone told them to pump for 20 minutes.
(Which I never recommend unless it's a mother of multiples.)  By the time they
finish pumping, they're thinking, "OK, that's done.  But in 20 minutes [if
they're trying to breastfeed every 2 hrs.] it's time to feed the baby again."
These poor moms never get a break from *thinking* about feeding issues.  I
explain that we'll group everything feeding-related into a single time frame, and
then they'll have another "block" of time that isn't related to feeding.  I
suggest they breastfeed (and often, I limit it to a certain number of minutes
because there is no point in having baby at breast for an hour if he's not
sucking right!), supplement, and then pump, because that way they could have an
hour or more "off", where they don't have to think about feeding at all.  I can
usually see the mom smile and physically relax a bit at the thought of having a
"break".
       I have seen this plan rejuvenate a number of mothers who were about at
the end of their rope.  And I explain to them that the pumping is *not* to
get out milk, although they might see a little; the pumping is to *stimulate* t
he milk supply.  And as milk supply increases and/or baby does a better job at
breast, they won't necessarily see any more milk when they pump, but they'll
see that baby takes less and less supplement because he's getting more and more
milk at breast.  They seem to easily understand this (the part about not
seeing much milk when they pump), and they like that they can easily tell if baby
is getting more milk at breast by accepting less supplement, so they can cut
back on their pumping as they see things improving.
       Anyway, I always suggest that moms pump right after the feeding, and
these are my two main reasons for doing so.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

             ***********************************************

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