Mom is not nursing during this test, the expressed milk can be given to
her infant.
This sort of test is useful when we want to explore the efficacy of a
treatment for low milk production in the laboratory. The mother does the
4x hourly expression before the intervention, then uses the
intervention, then does another 4x hourly expression to see what changes
the intervention made. There needs to be a control group who just does
the 4x hourly expression at the same interval to eliminate the effect of
just pumping hourly for a few hours, which can increase milk production
on its' own.
We know that pumps are not equally effective for all mothers. In one of
the Hartmann groups studies of the Medela Symphony pump, 1/3 of mothers
of thriving bf babies were unable to remove half the milk from their
breasts (as measured by changes in the fat content). But if we are using
the same pump (or manual expression) for each expression, at least we
have that variable controlled for.
Again, we don't do these things to every mother, the most important
variables are can the baby transfer milk and is the baby allowed
sufficient access to the breast to grow optimally.
Catherine Watson Genna BS, IBCLC NYC cwgenna.com
On 7/10/2013 6:27 PM, Ingrid wrote:
> What is the date of that that recommendation, Emily?
>
> I would think that research that has found a huge variation in the amount of milk taken by healthy, thriving babies (between babies, and between nursings for individual babies) would have made us realize that the kind of mathematical gymnastics you're describing don't yield much useful information.
>
> So you find out that baby takes in X amount over 24 hours, based on calculations from the pump test. But there's such a wide range of 'normal' intake - as much as a 10-ounce difference in 24-hour intake (I think I remember that in some instances even larger variations have been found), we don't really know (in the abstract) how much is enough for any particular baby.
>
> Other questions that come to mind: is mom also nursing during this test time? If not, how is the baby being fed and what impact is that having on breastfeeding and milk supply? If mom is nursing, what effect is that having on what she can pump? How effective is her pumping regime - is manual expression also used, or is she just relying on the pump?
>
> When talking moms and babies, I'm always cautious about approaches that recommend machines and measurements - not always helpful and can undercut a mother's confidence.
>
> Ingrid
>
> Ingrid Tilstra
> La Leche League Canada Leader
> International Board Certified Lactation Consultant
>
> -----Original Message-----
> From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Emily Waight
> Sent: Wednesday, July 10, 2013 2:50 PM
> To: [log in to unmask]
> Subject: Re: Pumps are not a complete test of milk production
>
> Hi,
>
> I did find the information I was looking for. I'm currently studying for my lactation consultant exam and it is the recommended test per the literature (yes, designed by Thomas Hale) to get a rough estimate of a mother's milk production in 24 hrs. The way you do it is to have a mother pump with a hospital grade pump every hour for 15 minutes for four consecutive hours. You add the the totals she pumps for hours 3 & 4 and divide by two. Then you multiply by 24 hrs. This gives you an estimate of her hourly production and her daily production. Of course it's not a perfect design, but it is what's recommended in the lactation consulting literature for daily milk production when assessing a woman with a potentially low milk supply.
>
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