This is funny. Susan, I've never heard of a 4 hour pump test either. I however, was picturing how much a woman could pump in 4 hours, not after 4 hours! Either way, there is so much variability in pumps, and fit of flanges, and in time of day pumping results (morning vs. Afternoon) I cannot imagine how a test of that sort would be valid. Perhaps the question in my mind is "why do you want to know?"
Gail Hertz. Author of the Little Green Book of Breastfeeding Management.
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On Jul 10, 2013, at 8:47 AM, Susan Burger <[log in to unmask]> wrote:
> Dear all:
> I've never heard of a 4 hour pump test. Even had I heard of such a test, I would never use that in isolation to estimate milk production for a mother who is doing any amount of feeding from the breast.
>
> Why? The pump does not work the same way as a baby does. In most cases, but not all, I find good industrial grade pumps can usually remove more milk than the baby does because the baby gets full or, in the case of an inefficiently feeding baby, the baby gets too tired to remove more milk. In some cases, the baby does a stellar job and the mother doesn't release well to the pump. I find this often occurs with women with smaller ducts and large milk storage capacity -- and sadly sometimes with moms with small ducts and small milk storage capacity. In some cases, I have met mothers who will release much more milk if the baby has done even a minimal amount of sucking and swallowing on the breast first. They need contact with the baby first to trigger their milk ejection reflex. And then of course there is the issue of massage and hand expression. I just saw yet another mom who could hand express more than she could remove with her decent double electric pump.
>
> So my conclusion -- milk production is highly dependent upon many variables and pumping in isolation is not an appropriate gauge of what a mother is producing unless she is a dedicated exclusive pumper. Even then, it could be that she is not pushing for "what she could produce" and may be adopting the far more rational strategy of collecting "enough milk to satisfy her baby" without driving herself nuts with extra and unnecessary pumping.
>
> In which case, why make her wait four hours which could slow down milk production if she is on the smaller end of milk storage capacity instead of just having her record the output for 24 hour period? That would be more accurate than a single data point from one pump.
>
> For any mother that is putting her baby to the breast -- a lot of observations should be made about how the baby is sucking and swallowing, how much the baby can drink (if needed with a test-weigh), how that observed feed relates to other feeds that you did not observe and if the mother is pumping, what type of pump, how she massages while pumping, how the mother responds to relaxation techniques, pain levels while pumping.................... sigh -- I could go on and on.
>
> My question is, how long ago was the four-hour pump rule made up? Is it still relevant given what we now know about milk storage capacity and the variability in response of both mothers and babies throughout the day?
>
> Best, Susan Burger
>
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