Many Lactnetters have already provided thoughtful responses to Karleen's original question of why mothers would find themselves "pumping to maintain their milk supply."  The assumption seems to have been that these mothers choose to pump, or are impelled to do so, even though their babies are physically capable of maintaining their milk supply by exclusive breastfeeding.  Maybe it's because I spend most of my work time in the NICU, but when I read Karleen's post, my initial thought was that many (most?) of the mothers pumping to maintain their milk supply were probably doing so because they had premature or sick babies who were not yet able to stimulate a healthy milk supply on their own.  I've worked with countless mothers who needed to pump for weeks, or even months, to maintain their milk supply until their babies were able to exclusively breastfeed.  While pumping, a number of these mothers amassed so much expressed milk that it was clear their now- exclusively breastfeeding babies would never be able to drink it all, and/or they would not have enough room to store it all in their home freezers once their babies went home.  I referred many of these "NICU moms" to the nearest milk bank, which is in another state, or to the nearest milk depot, which opened in our city last year.  The coordinator of the milk depot recently told me that one such mother has been their single largest milk donor to date.

On a separate note, as a LLL Leader, I once fielded a call from a mother who was concerned that her milk supply had dropped.  She had twins who were 4 months old at the time.  When her twins were born, she was instructed to pump after breastfeeding.  Apparently, nobody ever told her to *stop* doing so once her twins were gaining adequate weight by exclusively breastfeeding.  So she kept breastfeeding, then pumping...even after her kitchen freezer and a separate chest freezer were full of expressed milk.  Based on the numbers she provided, I calculated that she had driven up her milk supply to the point that she would have been able to exclusively breastmilk-feed quadruplets.

Lisa Lostetter, RN, IBCLC, LLLL
Albuquerque, New Mexico, U.S.A.  

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