This is the third post in my “what worked for me” series including increasing fluids, increasing calories, and increasing pump times.
The standard advice in the lactation world is to pump for 15-20 minutes every 2-3 hours. This is the advice I was given in the NICU (both times) by IBCLCs and that every mom I’ve spoken with has been given. I don’t know where this number came from- if there have been studies or if it’s just a guess. What I do know, is that for some of us, this is not nearly enough to establish and maintain an adequate milk supply.
My babies on tap were FAST… none of them nursed for more than 15 minutes per session. They were all fed on demand so sometimes they were constantly back on the breast, and we were okay with that. Taking this into consideration, one would think that equal pump time should be sufficient. The reality is, no pump is as effective as a human infant at extracting milk. Having an infant at breast also increases all kinds of feel good hormones that help the milk flow. The baby licking and stimulating the nipple is another wonderful stimulant. Back in my days of nursing, just being around my sweet little ones could cause a let down. This hasn’t happened to me with exclusively pumping. You can read my road to milk here.
With this baby, I’ve had to dramatically increase the time I spend attached to the pump in order to establish and maintain a decent milk supply. Sadly, I’m not a major over supplier with milk to go around- at my absolute highest, I maxed at 36-40 opd. Currently I sit around 32 opd with a drop just before my monthly arrives (but that’s another post). This is enough milk to meet a fully breastfed infants needs (24-30 oz is what a breastfed infant requires).
I have maintained that if I followed the well known advice of only pumping for 15-20 minutes per session, I would have lost my milk supply. I did a little study one day, you know, for scientific purposes. I switched bottles out every 20 minutes during my pump sessions to measure and record how much I had at each juncture and how much I ended up with at the end of the session. These sessions are representative of my average sessions- first morning (after 7-8 hours of sleep because I am much further into the pumping game) is 90-100 min with a total output of 12-16oz and later sessions are 60 min with 5-8oz output (depending on how long I go between sessions). For the first 12 weeks, I didn’t go longer than 4.5-5 hours at night EVER. This is important for establishing supply.
First morning pump- after 8 hours of sleep. 20 minutes of pumping yield is 5 oz.
At 40 minutes, I’m up to 9.5 oz.
60 minutes in, I now have 11.75 oz.
At 100 minutes, I stopped pumping at just shy of 15 oz.
This is my LARGEST pump of the day- accounting for 1/3 or more of my daily total. If I stopped at 20 minutes, I would have 5oz or only 1/6-1/7th of needed supply. Now, let’s looks at my second pump of the day- FOUR hours after my first morning pump session.
20 minutes in, I have 3.5 oz of milk.
At 40 minutes, I have 5.5 oz of milk.
At 60 minutes, I have just about 7 oz of milk.
This is my second largest pump session of the day. I pump 5-6 x daily at this stage of our journey. The next pump, I expect 6 oz at 60 minutes and then I will drop to 4.5-5 oz for the last two sessions of the day. This is assuming an optimal supply day. Some days, my total number is closer to 32 oz, which means each of my pumping sessions yields 1-2 oz less. If I pumped for 20 minutes, after my two largest pumping sessions, I would have collected a total of 8.5 oz. This would be incredibly discouraging. It also would mean that my breasts are not completely empty which is likely to lead to a multitude of issues including:
- clogs
- mastitis
- lower fat content of milk
- low milk supply or losing supply from inadequate pumping
- having to supplement with donor milk or formula
- discontinuation of pumping because of loss of supply or feelings of inadequacy.
I haven’t taken the time to repeat this same experiment with an entire day of pumping, but I know what my body does and what it takes to get milk out. I have found a couple of things that now allow me to speed up my pumping time now that my milk supply is established. One is using the Symphony, Sonata, or Spectra (I have some caveats to this as it didn’t fully empty me) breast pumps. I get similar results with the Symphony and Sonata pumps. When my supply is normal and well regulated- I can usually stop pumping at 60-70 minutes in the morning now and 45 or so minutes during the day sessions. When my supply is dipping due to my menstrual cycle, I increase my pump times to encourage greater production.
There is considerable time in between let downs when I pump for this length of time, I often push the letdown button again to stimulate more flow. By pumping for extended periods of time, I have been able to maximize my output, pull all the fat out (I get nice, fatty milk- up to 30% at times!), avoid clogs and mastitis and feel confident in my ability to feed my baby 100% mamas milk. It takes serious dedication. For the first 13 weeks, I spent EIGHT hours every day dedicated to milk collection. That’s more than a full time job, since it’s a seven day per week task. Now I spend between 5-6 hours per day collecting and storing milk (still a full time job when you multiply by 7 days per week). This is not easy. It is not simple. It is time consuming, it is emotional, it is hard, household tasks don’t get done on time, I have tears sometimes, my preschooler may watch too much Amazon Prime some day (I’m anti TV, so this is a hard pill for me to swallow), I’ve gained weight… BUT it is WORTH IT.
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