Jessica,
We have moms pump postcibum (pc or after breastfeeding)to protect or
rebuild the milk supply if baby is not sucking well.  There are many
possible reasons for low milk supply.  The most common, in my
experience, are baby related.  If baby is not latched well, does not
suck well, has a tongue-tie or other anatomical anomaly, he is not going
to be efficient at removing milk and stimulating further supply.  In
that case, pumping after feeding will help to remove milk the baby was
unable to, helping to maintain the supply and provide milk to complement
the baby with while we work on helping him improve his technique.
(Remember supplement is something you give instead when skipping a
breastfeeding, complement is something added to a breastfeeding).

Some low supply situations are mom's issue.  There are several
developmental and hormonal problems that lead moms to have lower
capacity to make milk.  There is some evidence that stimulating a lot of
prolactin can at least partially overcome some of these problems.  This
seems to be why pumping an "empty" breast seems to work, and why
domperidone or reglan/metoclopramide work, and why really frequent
feeding may work if the baby is a competent suck-er.  Lisa Marasco
addresses this in her presentation on PCOS and Low Milk Supply, I
strongly recommend catching her talk at ILCA.

In reality, there is often more than one problem.  I suspect many women
can solve/compensate for one breastfeeding difficulty, it's when 2 or 3
things conspire that breastfeeding fails.  Case in point- a recent
client who is a cancer survivor, had radiation to her chest which
destroyed her thyroid and might have affected her breasts, has type 2
breasts (just slightly less than fully rounded), and has a micrognathic
baby with a short tongue.  Try teasing apart the relative contribution
of all those factors!  But that's our job, and I find it a wonderful
challenge.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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