Encouraging mom to "power pump" for a few days will usually bring a 
supply back up.  Power pumping means pumping every 45-60 minutes while 
the mom is awake, (she is allowed to nap when she needs to, and is not 
asked to get up to pump, and is asked to pump at night when the baby 
wakes her, or at least once if baby is hospitalized.)  She sets up the 
pump in a convenient place, and uses it for 10 min or so whenever she 
passes it, in effect "clustering" pumpings about 45 min apart.  This 
takes advantage of the normal length of a prolactin spurt (40-43 mins), 
the mom will be constantly pushing up her prolactin, and this increases 
milk supply.  As long as the baby is no longer vulnerable to infection, 
she can wash the collection kit every few hours, and protect it from 
dust by placing a clean receiving blanket or towel over it after use.  
If the baby is in NICU, then it's best to clean the kit each time it is 
used.  Some moms prefer to place the entire kit in the refrigerator, and 
take it out to use it again a few times before cleaning.  I feel we are 
on solid ground recommending this, because we know that human milk is 
safely left at room temp for 6-8 hours (for a healthy, full term 
infant).  Anticipatory guidance is important, so that mom does not 
expect large volumes of milk at these frequent pumpings, but that she 
understands that she will probably see an increase by the 3rd or 4th day 
of doing this.  Obviously, mom needs support to be able to do this - 
enough privacy to feel comfortable pumping, and someone to take care of 
her physical needs so she can put this much energy into pumping for a 
few days to a week.
Unless mom has hormonal or developmental issues that prevent her from 
making milk, this seems to work very well.
Catherine Watson Genna, IBCLC  NYC

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