This was mentioned in passing in some of the recent posts, but I
want to emphasize the importance of nipple stimulation before
pumping.  Remember nerve endings connect to the part of the brain
where the oxytocin and prolactin are produced and delivered.  Those
nerve endings are concentrated in the nipple.  Baby's mouth
stimulates them beautifully, but pump flanges don't.  I always
encourage moms to roll or brush the nipples for 5-10 seconds or so
before pumping or hand expressing (and during breaks in pumping).
This is, of course, in addition to the other great suggestions that
have been offered.
Every mother should learn hand expression even if she will be using
a pump.  Even brief hand expression is more like baby's action at
breast than any pump so it should help stimulate let-down and
production.
Winnie Mading, RNC, IBCLC

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