QUESTION: Hi. I was wondering if you had any tips on how I can express more milk I am going back to work and my supply to me seems low and I am determined to keep my son breastfeeding after I go back to work.

I have read that I should be able to pump 3-5ounces on each side when I Pump ( I have a double pump Medela) However when I do pump I usually get 1 - 1 1/2 ounces out of my left and about 2 ounces out of my right. This has been very discouraging for me. So any supply I do get will be wiped out fairly quick because it takes longer for me to pump (he is a hearty eater)

Any advice on this will be greatly appreciated.  Thank you for you time

Dear Amy,

It sounds to me like you are getting discouraged needlessly. I think you are doing just fine! You say you are getting about 1 1/2 oz. from the left and 2 oz. from the right (total of 3 1/2 oz). That sounds perfect. You say you are unsure how much your baby weighs. If we assume he gained back to birthweight by about 2 weeks and then gained the average pound per month, then he would probably be around 10-11 lbs now. Even if he were up to 11 pounds, an 11 pound baby needs about 29 oz of milk per day. If your baby were feeding every 3 hours on average (8 feedings per day), then you can see that he would be getting about 3 1/2 oz per feeding.

Quite often I get calls from women who think their pump isn't working. When I ask them what is wrong, they say, "Well, I'm not filling up the bottles."  What I explain in return is that, if they were, then they would be really uncomfortable, because that is way more milk than their babies require. Mother nature does a wonderful job of getting a mother's supply to match her baby's need.  By the way, the fact that you are getting more out of one side is very normal. For some women the difference may be as much as 4-5 times as much on one side. It is no reason for concern. Nor do you need to try to "build up" the supply on the side that makes less. There is a website and "club" for women who pump for their babies. Their whole purpose is to help each other make pumping easier and more efficient. You might want to become a "member." Go to www.enscript.com/pump/

Here are some general suggestions I would give to anyone wanting to build up supply:

The 2 most important factors in establishing and building up a good supply are (1) frequency of stimulation to the breast (every 2 hours during the day works well!) and (2) getting enough rest. This does not mean 8 straight hours of sleep. It means trying not to overdo it and getting a little extra rest each day while you work to build up supply.

* Always double pump because it has been shown to help increase prolactin (the hormone responsible for milk supply).

* If your baby is willing, putting your baby to the breast more often for 2-3 days will usually work wonders. If not, then you can pump after feedings for a couple days (about 5 minutes of double pumping). There is no better pump than a baby. That is why it is preferable to let the baby build up the supply. You say your baby is a "hearty eater." That is great! 

* Get some extra rest while you are working on building up the supply. If you don't normally take a nap, begin taking one. If you already do, then begin taking two!

Once you feel like your supply has built up a little, you can keep it up by pumping once or twice a day after feedings. Mornings are usually ideal because that is when your supply is usually at its highest. 5-10 minutes of double pumping should do just fine.

Hope this helps!

Cher Sealy, RN, BSN, IBCLC, LLLL

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