 QUESTION: I gave birth on Sunday Feb. 27 to a baby
girl, Isobel. She was 23 weeks and weighed 1 lb. 3 oz. (5550g). She is
in a stable condition, being ventilated etc. in the SCBU at the
University of Wales, Cardiff.
I am expressing milk, but I need some advice on how to increase my
milk production. How often should I express and for how long on each
breast?
I have previously had a daughter, Elizabeth, at 27 weeks. She is
9 months old and fit and well, but I failed to breastfeed her although
I tried and tried. I really need to help Isabel by providing milk and
then breastfeeding.
Please give me advice.
Congratulations on the birth of your daughter, Isobel (I've always
loved that name!) I'm sure you know that providing your pumped
breastmilk is the greatest gift you can give her.
Is there a Lactation Consultant at the hospital? If not, then you may
be able to find one in private practice, or else a La Leche League
Leader nearby. These people can help you both now while you are
pumping and also when you make the transition to the breast.
The first couple of weeks after birth are extremely critical in terms
of milk supply. It is quite easy for most new mothers to build up
their milk supply. As time goes by, this becomes more difficult. This
is especially so for women who are pumping.
I hope you have a good quality hospital-grade pump. You should also be
double pumping - both breasts at the same time. Frequency is the most
important factor in building and maintaining a good milk supply.
Ideally you should be pumping every 2-3 hours during the time you are
awake. At night, you should be pumping at least once. Remember that
the average newborn is feeding 8-14 times per day. Therefore, pumping
sessions should be similar.
If you are able, while you are trying to build up supply, I would
recommend pumping every 2 hours during the day. If you wake up at 7:00
am and go to sleep at 10:00 - 11:00 pm, you would be able to get in
8-9 pumpings. Then you should also pump once or twice during the
night. With a pattern like this, you should find your supply going up.
When you increase your pumping frequency, it normally takes about 2-3
days to start seeing the increase in milk supply. It can't happen in
just a day. Once your supply has increased, you may find that you can
cut back a little on frequency - every 3 hours or so.
Probably the worst mistake women make is sleeping through the night.
Going long periods of time without pumping causes your hormone levels
to fall. Hormones control lactation. If you find your supply dropping,
then you would want to return to the every 2 hour pattern.
There are probably going to be days when you just can't get in as many
pumpings as you'd like. Try not to drop below 5 pumpings per day.
Also, it would be better to pump for just a few minutes than to
entirely skip a pumping.
In terms of time, with a good breastpump you should be able to empty
the breast in about 10-15 minutes. When trying to increase supply, go
for 15 (even if nothing is coming out during the last minutes). Once
your supply has increased, you should be able to drop back to about 10
minutes.
I hope this is helpful. There is a great deal of good information
available at Breastfeeding.com's website. I would also recommend La
Leche League's website: http://www.lalecheleague.org
Please let me know if I can be of further help.
Cher Sealy, RN, BSN, IBCLC
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