Chris's supply discussion was great...I have great wonder at what is really in
control, and I am aware of a variety of pumping regimes that work sometimes
with NICU moms. (When we pumped the African elephant at the zoo, we started, I
think, when she was beginning to loose her supply, after several days of
engorgement. We never got a lot of milk, and only were able to pump  at best 3
times a day and a few times none but we got milk for 4 months!)
 Fairly frequent pumpings seems to be important with most mothers over time,
but not necessarily with every mother.
Initial engorgement or fullness should yield pumped milk in increased volume.
Pump should function well.
What I have noticed is that some mothers are big producers. Others are not.

A control factor is over time and thru the stresses seems to be with the baby
and the mother. Skin-to-skin care, frequent updates and contacts in whatever
manner baby can handle at that point in the care, and a good start help milk
supply establishment.

It may not happen that she starts pumping within even 24 hours. It is better
to start early, but she may not be able to start pumping. In the context of
the issues of the baby's birth and condition, she may not be able to pump. She
needs connection with her baby. I will forego pumping in order to see that a
mother can visit her baby in those early hours since a premature birth.

In other words, never underestimate the power of a mother connecting with her
baby as another major factor in milk supply!

Fritzi Drosten
Pidemont, Ca