In a message dated 97-02-25 09:49:45 EST, you write:

<< From:    [log in to unmask]
 Subject: PNS and milk supply

 This is in regards to the post about the PNS and a decreasing milk supply in
 working moms.  We don't think the PNS is to blame.  We think it's probably
 the schedule of pumping.  When a mom is at work, she pumps only 2-3 times a
 day for 10-15 min., 5 days a week.  We all know that a pump will never be as
 effective as a baby in stimulating the breast to make milk.  If the mother
 was at home and nursing "on request", she would probably be nursing more
 often and for longer amounts of time.  Women who return to work and continue
 breastfeeding are doing the best they can.  Maybe our expectations are not
 realistic for some of them to maintain a full milk supply under those
 circumstances.   >>

Dittoes .. I also try to give anticipatory guidance to my mom's who are
planning to return to work.   I recommend
1.  Practice nursing and pumping simultaneously in the early weeks before the
return to work ( builds supply in freezer, gets her used to "double", and
gets baby used to the pump on the other side).
2.  Return to work on a Thursday or have a dry run with the babysitter before
the actual day of official return.
3.  Continue to pump with the baby in the mornings and on days off (weekends)
to keep milk supply up.  ( This is the best tip from one of my mamas)
4.  Give yourself permission to REST at home.  (Lie down to nurse, have quick
meals, enlist help, eat and drink well)
5.   If something happens and the store of milk runs low or mom's milk
diminishes I suggest a baby honeymoon...bedrest with baby, fluids, and look
at what her diet has been.  I find that one thing that often precipitates a
decrease in milk is mom with a reduced intake (particularly protein-no bkfst,
pitiful lunch, no snacks....)

I have found when mom's milk supply decreases, she calls for help because she
wants to continue nursing and rebuild her supply, I think it's her
expectation, too.  When this happens and she wants to wean, she's not likely
to call.  In either case, I ask what her goals were/are and progress from
there.  I agree its not always the pump but how often shes pumping.

Liz Flight, RN, IBCLC from sunny Jacksonville FL