12 ounces every 2.5 hours.

The pain she is having is either due to her extreme over-supply (she is
making milk for quadruplets), or vasospasm.  You do not have to see any
vasospasm to have it.  And exclusive pumping for weeks on end is hard on
nipples.

I would have her try a heating pad on "low" on nipples (over clothes)
immediately after pumping for 10 minutes, and as needed if the pain occurs.
If this makes it go away while the heat is applied, it is vasospasm.  Then
you need to watch her pump and be sure the flanges fit well.  For
exclusively pumping moms I really like the gradually sloping "pumpin pals"
flanges. She should also use the lowest amount of suction that is effective
for her.  Then she really should calm down her supply, or she may have
mastitis soon.


Kathy Leeper, MD, IBCLC
Medical Director, MilkWorks
Lincoln, NE

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