Becky,
This is a very common phenomenon. That is, pumping for weeks or months w/
little or no direct bf can lead to low supply. I see it w/ premie babies and
I see it w/ moms who choose to pump and ebm feed instead of directly bf at
the breast. The way I look at it is pumping is very arbitrary. That is it
pumps for x min x times per day, but cannot adjust the supply/demand as a
healthy baby would. I also believe that the pump uses negative pressure
(suction) where the baby uses positive pressure too, actually "milking" the
milk out in a different fashion. I think this makes a big difference. So,
when you think about it, guidelines for normal newborn feedings are 10-14x
per 24 hrs. Therefore, mom could increase her pumping sessions, if possible.
And maybe add hand expression to really drain the breasts as much as
possible.

More importantly, IMO, is direct bf or at the very least kangaroo care. Can
the mom be there as much as possible? Being separated much of the time has
got to have a big impact, do we really know what the effects are? Maybe the
baby could feed some feeds with a nursing supplementer. The suggestion for
mom having a "cheerleader" was excellent too. Maybe another mom of a premie
who perservered and was successful. Good luck to them and glad you are in
their corner.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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