I would be very surprised if mom had an abundance of milk one day and 
then "no milk" the next. Depending on what kind of pump this mom is 
using, it is very likely her supply dropped from exclusively pumping and 
not breastfeeding.

We see NICU moms on a good rental pump make a lot the first few weeks if 
they pump enough, and then it drops in amount "naturally" by the end of 
the first month. We are now telling moms to pumping 10 times in 24 hours 
for the first two weeks to have a really good supply. The old 6-8 times 
in 24 hours just doesn't seem enough to make a milk supply that lasts 
over the weeks. (Thanks to Nancy Mohrbacher for this information.)

My questions would be how often is mom pumping, is she pumping at least 
once during the night, is she pumping with big enough flanges, is she 
pumping long enough time, does her machine work properly, are her valves 
in good shape? Someone who is not breastfeeding needs to pump at least 8 
times in 24 hours for at least 15 minutes, I see they need to keep going 
until the milk drops absolutely stop and don't come back -- often 20-25 
minutes double. Single pumping works best if mom does it 5 minutes per 
breast, back and forth 3-4 times per breast for a total of 30-40 minutes 
pumping -- not 15-20 minutes on each side before switching.

I have also worked with several mothers who did better on the 
non-computerized rental pumps. Once they switch to a non-computerized 
model, they start making more milk a week later.

What I find with my WIC moms is that they stop pumping enough and go 
down to about 4-5 times in 24 hours which drops their supply down 
drastically. The other thing is that sleeping all night is another milk 
supply killer. When my clients start doing this, they drop down to less 
and less milk.

This is why I don't understand the myth that pumping and bottle feeding 
is easier!!! It is so much harder to keep the supply going and to 
dedicate the time and effort.

Kathy Eng, BSW, IBCLC

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