Anecdotal information - well, observational anyway. When I have assisted
women to pump within 2-8 hours of delivery, on at least 50% of the occasions,
5-10cc of colostrum was obtained. I can recall at least one or two that got close
to 15cc.  When moms pumped later, after 12 hours they got less (2-3 cc) and in
some cases only wet the flange of the pump for the next several pumpings.
However, when they continued to persevere, pumping regularly and at least every 3
hours, respectable amounts of 5-10cc were obtained by 24 hours and
thereafter.

My own theory, which I have debated with several colleagues and good friends,
is that single pumping in the first 24-48 hours keeps the prolactin levels
elevated for longer periods of time and helps increase milk supply. It also puts
all the colostrum in one bottle rather than splitting the minute amounts in
two different containers. Double pumping is ithen nitiated by the 2nd day
(48-72 hours) and moms are very happy with the increase in supply. The choice to do
this was born of necessity when I worked at an inner city hospital with
limited resources and we only had a single electric kit to use.  It worked so well
at subsequent jobs that I just kind of stuck with it and have seen mothers
feel more comfortable starting out pumping one breast at a time and feeling like
they "grow" into pumping.

I have not been able to find any research that addresses this, however I have
not closely examined Pam Hill's latest findings which were presented at the
LLLI Physician's Seminar last year or the year before.  If I had the patient
base, time and energy, I'd do some research myself and include hand expression
into spoons.

Mary Kay Smith, RN, IBCLC
Canton MI

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