Dear Friends,
I do agree that more frequently for shorter periods of time is probably 
better for increasing milk supply than less frequently for longer, but 
10 times a day is a lot for a mother with a baby to fit into her life.
I know this is all theoretical at this point but just some thoughts on 
this subject.
Rather than focusing on a number per say, maybe focus on making pumping 
(or suggesting hand expression?) as easy as possible so it is as 
convenient to do as possible, will end up with better results. I often 
have mothers hand pump for short periods of time and just put the whole 
hand pump in the refrigerator between pumps and wash it well every 12 
hours or so. Hopefully by her partner or someone else.
I would love my mothers who have low supply to pump 10 times a day if 
milk removal and breast stimulation seem to be the culprit, but I find 
most of my moms can't do this while taking care of their baby. It is not 
realistic for most.
I know this isn't really what this thread has been about but I feel we 
need to be very careful what we "tell" mothers to do. My hope is to keep 
them in the game for the long term. Pumping 10 times a day can create 
burnout fast which leads to ending breastfeeding.
Talk to your mothers to see what is most likely to actually happen in 
their lives.
I do love Cathy Watson Genna's (and others I am sure) idea of having a 
pump like crazy day. One 12 hour period where the mother pumps 
frequently and often as she can manage. Hopefully 8-12 times for short 
periods of time. Most of my mothers feel that if they do this on a 
weekend with partner support it can happen. And it seems to help.
I also do like to have moms mix up how long they pump if possible 
because babies don't always nurse the same and it is easier for the 
mothers to get some longer and then shorter pumps in. I have found that 
moms might be able to get six 15ish minute pumps in but then squeeze in 
a few 2-5 minute pumps.
Just ideas.
I think our job is to share all the possible ways to increase milk and 
what research we know about different methods and help the mother create 
a plan that fits into her life. Make sure she understands the basics of 
making more milk and then she will do what she can.
Again, I know this is a theoretical discussion, but I remember when I 
first started as an IBCLC, telling mothers of healthy, term babies they 
had to nurse every three hours. Now I know that I want a minimum of 8 
feeds, that is it more normal to have 10-15 in the first few days, but 
most babies feed in clusters and then take longer breaks. My parents 
were trying so hard to be "compliant" but I had set them up to waste 
time and look at the clock, not the baby. Setting them up for failure. 
We want our mothers to feel successful, no matter how much milk they make.
Thank you!

-- 

Barbara Robertson, MA, IBCLC, RLC
The Breastfeeding Center of Ann Arbor
bfcaa.com

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