Shirley I don't think anyone knows the answer to this. Very good research question(s). I think most of us would agree that early, regular milk expression from the start will help to ensure a good supply. I think this is a standard of care at this point. Start sooner, not later. But I don't know if we know WHEN to go to cluster pumping/expression with the longer sleep interval, if at all. For clients pumping long term for babies in nicu and when there is plenty of milk stored, I have counseled moms re lengthening the pumping interval (say from q2 to q3.5 hrs) if the moms are indicating that they are getting very weary. Advice is to closely watch supply and increase again if need be or when baby begins taking in more and/or breastfeeding at breast. It is difficult to balance the need to express the milk regularly and their need for sleep and meeting other family/personal needs. Many families travel back and forth to hosp and home. I think some of the decreased supply issues would not even be there if nicu practices were more favorable re getting baby to breast/kangaroo care etc. Lots of these moms really could be bf alot sooner, IMHO. And some of them could be rooming-in with their feeders/growers as we used to call them when I was an nicu nurse. Laurie Wheeler, RN, MN, IBCLC Louisiana Breastfeeding MediaWatch Campaign Violet Louisiana, USA mailto:[log in to unmask] ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com