MER happens simultaneously on both sides as the circulation carries oxytocin to all areas of the body, including both breasts. I sounds as if the reduced amount currently being removed is due to some sort of "less than efficient" angle of inner breast compression that is not allowing milk to move forward efficiently to try to neutralize the vacuum in the current flange.


The same type of experience happened to my granddaughter after about 6-8 weeks, and l thought she should try a bigger flange. I had advised her to pause after 5-7 minutes when the milk slowed and massage more milk forward, then pump again, which did work, though took more time. Hand expression worked too.


However, several of the list members suggested it might have to do with reduced, inner-breast postpartum size changes or forward shift in lactiferous sinus locations that  now required a smaller size flange on that side. She tried it, and it worked beautifully. 


Since this mom is "time-challenged" at work, until she can get some different sizes to try, it's important to hand express often enough while home, for milk removal enough to keep up supply. More frequent short removals on that side would be important to maintain supply. Also, maybe always nurse baby on the least-well draining side first, then the other side, and then maybe "switch nurse" if he will, until she gets more flanges to try. Also, teach her RPS as a quick way to trigger MER every 5-7 minutes, along with a minute of alternate breast massage before resuming pumping, when she is trying to return things to normal.


K. Jean Cotterman RNC-E, IBCLC

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