Dear June, I work for a WIC agency and we loan mostly Elite and some 
Lactinas to moms with premature babies who are on our program. Most of my 
job is setting them up with a pump (the initial consult with me) and then 
calling every week to encourage them. I have about 15-20 moms with loaner 
pumps in the summer time and about 8-10 pumps loaned out in the winter time 
each month.

I tell moms to pump 8 times in 24 hours, I have recently started saying 
every 2-3 hours in the day, every 3-4 hours in the night. When the moms stop 
pumping in the middle of the night, their supply almost always drops.

I would hope mom would be pumping about 3 ounces each time by now (meaning 3 
ounces combined from both breasts). I would also want to know what pump she 
is on.

What the most recent Medela research showed was that most moms pumped 5-6 
times a day and make about 16-17 ounces in 24 hours. I may have the numbers 
a little wrong but this was the general gist of it.

Most of the mothers that I work with start losing their supply when they 
drop below a certain number of pumpings per day. For women who have a huge 
supply, they can cut back to 5-6 times and still make 3-4 ounces total each 
pumping. For moms with a normal supply, at 5 times a day they are usually 
down to 2 ounces total per pumping.

Some things slow down a milk supply, like maternal illness, getting started 
pumping after 48 hours postpartum, and some medications. So I might not 
worry at 7 days postpartum, but I would go over how often, how long, and 
what kind of pump with this mother.

From my experience working with pumping mothers of premies, when moms make a 
low amount on day 10 things don't usually improve much and these mothers are 
at risk of quitting early. There are exceptions to this rule and I do work 
with a low income, often life stressed population, lots of single mothers. 
Sometimes Reglan helps increase the milk supply. Reglan is all they can 
afford and get a prescription for - most do not have internet or money, nor 
will they purchase herbs.

Kathy Eng, BSW, IBCLC
In Houston where we are being told to expect Hurricane Rita on Friday 
night!!

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