Thank you Susan! That is great information. I think that will be very helpful to our patients. Just came back from ILCA conference and it was awesome! Heard two IBCLC's from Egypt speak about their study in which they saw the same thing. The mother's made more milk, and they found that it was higher in fat and calories, too! They found that the least volume and fat content was achieved from pumping only, then more from hand expression and the most from hand on pumping. So important for the mom of a nicu baby to know! I bet that having periodic breast massage during hands on pumping would also improve volume and maybe fat content too. Thanks again.Tricia Shamblin, RN, IBCLC
Date:    Sat, 23 Jul 2016 12:19:02 GMT
From:    "[log in to unmask]" <[log in to unmask]>
Subject: Hands on pumping

I have had great success with the following: Massage each breast for about 30 seconds. Lots of skin of mother's palm and fingers on the breasts.  massage top and bottom, left and right, repeat.  Repeat on other breast.  Pump for 4-6 min. When the stream of milk stops or slows,  remove flanges. Massage again.  Finish pumping for another 5-8 minutes.  Total pumping time is 10-15 min. Mothers are usually amazed when seeing more let downs of milk during the 2nd half of pumping!  Can hand express each breast for 3-5 min after pumping if mother is willing.  I teach this with the first pumping during the hospital stay if I am there. 
  




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