Lea asks about how a mother could increase her output to a pump. The
mother in question has been trying to pump for four days, but we are
not told how old her baby is.

From Lea's post: "Has been pumping about 3xs a day for 4 days.  She
has tried pumping after breastfeeding, instead of breastfeeding and
while breastfeeding.  She gets an initial let down and then it stops.
She is massaging during the session.  She's fiddled with the intensity
and suction but can not get her output to increase.  She has ample
milk supply and is exclusively feeding beautifully.  Flange size is
good."

I am guessing the reason for the pumping is to store breastmilk for
future use, since there seems to be no other obvious reason for her to
be trying to increase her supply.  How much milk is she expressing now
on what is referred to in the post as 'an initial letdown'?  How long
is it between the 'letdown' and when 'it' stops  - and what is 'it',
the 'letdown' or the milk flow? 'Letdown' is supposed to stop - and
milk flow wanes when the milk ejected in the MER has been removed from
the breast.

If her baby is brand new and she's been pumping right along while she
gets started breastfeeding, I would think the bulk of her milk is
going into her baby, as it should do. Maybe she just doesn't have the
same love for the pump as for the baby so her oxytocin spike is less
emphatic when she pumps.

If the baby is older and she started pumping four days ago in
anticipation of going back to an outside job again, four days can be
too short a time to expect to see an increase in the amount she gets
out per pumping session.  Also, if her baby is on a schedule,
especially if the baby is going for a long stretch at night without
feeding, she will need to pump at evenly spaced intervals around the
clock to mimic the feeding pattern babies show **when supply is low**.
 If her baby is older and her supply is indeed ample, then whatever
feeding pattern she uses has not yet put the baby or the breastfeeding
at risk.  If we are talking about a baby in the first week of life,
it's too early to judge whether her ongoing milk supply is ample, good
enough, or inadequate. And her love for the pump, or her lack thereof,
will also influence how readily she gives down milk to it.

I don't have enough information to assess whether this is a problem,
and certainly not enough information to be able to give any specific
suggestions. I'd need to know baby's age so we know how far postpartum
mother is initiating pumping, baby's feeding pattern, and I'd need to
know how much she is expressing because it could just be a need for
reality check.

Rachel Myr
Kristiansand, Norway

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