>>Lisa and Diane,
Can you please explain how/why you feel your plan worked? I am finding
it confusing to reconcile the downregulation that occured with pumping
off 10-12 oz and 6 hrs later to fully pump same breast.<<

Laurie, here's how the logic went: Rule #1 of autocrine theory is that
milk not removed causes build-up of FIL (and stretch of
mechanoreceptors) and eventual down-regulation. However, mom was not
able to tolerate a lot of fullness for very long and was on the verge of
quitting. She shared with me that when she had fully pumped her breasts
down previously, it took about 6-8 hours for them to become
uncomfortably full again (with breastfeeding on-going). It was Diane's
idea to fashion the strategy around how long it took mom to get
uncomfortable. The idea was switch breasts at about that time, and in
order to get the full 6 hours out of each breast, the "used" one was
pumped out at the switch. Now I know that sounds entirely backwards, but
in Diane's experience with several moms, it was only after she
lengthened the time per breast (she's done 12 hours!) that supply would
start to decrease. This was how we were able to stretch things out.
Maybe it gave FIL more time to sit (build up and exposure). For sure it
decreased the constancy of nipple stimulation, as baby was able to tank
up pretty quickly and didn't need to feed often.

The 10-12 oz was cumulative in 24 hours. We only pumped both breasts
down to bottom at the very beginning; from then on it was one breast
only every 6 hours. Remember, what she was pumping off thereafter was
what was LEFT in the used breast after 6 hours of duty, and not off the
top of a full breast.

Hopefully Diane can jump in here and add her thoughts.

Lisa Marasco

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