Rob,

There are a number of reasons why the mom in question could have a drop in
her milk supply. Much of this is related to how things got started. The first
14 days are crucial to calibrating the breasts to make lots of milk over the
long haul, especially when pumping. That is why Paula Meier suggests at least
a 50% oversupply by day 14 to act as a buffer for drops later on.

How frequently is the mother pumping and how many times in 24 hours. She
should be pumping at least 10 times if she wants to build up the supply. We
know from Peter Hartmann's work that the degree of drainage of the breasts at
each feeding or pumping sets the stage for the amount to be made. I would
suggest that the mother use an electric pump with a double set up that is the
big industrial version (not the plastic rental version). Have her massage and
compress each breast as she pumps to drain them as thoroughly as possible.
Have her cluster pump, just like a baby cluster feeds. The fat content of the
milk will be higher the closer together the pumpings are.

I have had a fairly good amount of success in these situations by having the
mother receive acupuncture for increasing the milk supply. You might suggest
this to her.

Marsha Walker, RN, IBCLC
Weston, MA

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