Re: pumping patterns -- show me the RESEARCH for using power p...

[Guest guest]

*Technically* you don't run out of milk because you can always get another drop if you are patient and wait long enough. But let's face it, a lot of babies aren't patient and when they have to work really hard for that next drop, they quit feeding. If they got enough, they come off the breast happy. But if they didn't get enough, they can be crabby or sleepy (if not enough calories going in). So, if the mother's body has been trained by baby or pumping to produce x amount of milk every x amount of time, then to suddenly ask it to make that amount in half the time doesn't usually work very well. I have worked with two mothers who could pump any amount of milk any time they wanted. They just put pump to breast (I watched them!), and they had another letdown every few minutes. The first time it happened, I kept saying

to the mom, "You don't pump 8 oz of milk just because you want it. If your baby is breastfeeding, it will take several pumping sessions to accumulate a full bottle." She kept insisting that yes, she could get whatever she wanted whenever she wanted and asked if I wanted her to prove it. She had already nursed the baby. I said yes. To my amazement, I watched those letdowns just keep happening as she pumped. In about 10-12 minutes, she had 8 oz from one breast and asked me if she should continue. I thanked her for showing me, said I had never seen such a thing before, told her she was very lucky she could do that, and said, yes, please stop! And yet, her body only responded with stimulation. The flow stopped when her baby quit nursing, and she wasn't constantly leaking. But we know that most moms aren't going to just have flowing (not slowly dripping) milk whenever the breast is

stimulated.

Dee Kassing

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right?

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA==We do not

seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such

information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your

baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/

To: Sent: Tuesday, February 14, 2012 8:05 AMSubject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most

mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

just my experience... if baby wants to eat an hour after pumping--mom usually has to give that milk she just pumped. seems counterproductive to me. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- From: Dana Schmidt

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 12:15 PM

I'm not sure that is true because 1) we don't know when that baby will feed and 2) don't we tell woman that they will never run out of milk as long as their is stimulation? Not trying to be snarky, just curious Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the

minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA== We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be

displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit

www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/ To: Sent: Tuesday, February 14, 2012 12:46 PM Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

Dana, I, personally, would never have a mom pump an hour after breastfeeding. that's taking milk away from baby's next feeding. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re:

Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA== We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship

between you and any medical professional or other individual on this Website. Persons contacting us

or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information

that you transmit to us via

the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/ To: Sent: Tuesday, February 14, 2012 8:05 AM Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

I'd be game, but I have to find a willing mama. And to be fair, we have to be willing to share with the mother the possible repercussions: Baby may still be hungry after the feeding and may need to be supplemented because you removed milk from the breast an hour before the feeding (or two--depends if baby is a 2-hr feeder or a 3-hr feeder), and are you okay with offering the milk you pumped earlier as supplement by bottle or tube feeder or cup?

Dee

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right?

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA==We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written

agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse.

We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/

To: Sent: Tuesday, February 14, 2012 8:05 AMSubject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most

mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

Of course. It isn't quite so easy as I made it out to be, but on the other hand, how are we ever going to know if we don't DO something? It is then always "I think," or "My hunch is" or "It makes sense to me that...." All valid, but NOT EBP.

Jan

I'd be game, but I have to find a willing mama. And to be fair, we have to be willing to share with the mother the possible repercussions: Baby may still be hungry after the feeding and may need to be supplemented because you removed milk from the breast an hour before the feeding (or two--depends if baby is a 2-hr feeder or a 3-hr feeder), and are you okay with offering the milk you pumped earlier as supplement by bottle or tube feeder or cup?

Dee

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right?

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA==We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/

To: Sent: Tuesday, February 14, 2012 8:05 AMSubject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

not sure what you mean by this Jan...and I'm not going to respond until I do. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power

p...To: Date: Tuesday, February 14, 2012, 1:34 PM

Dee, you are a perfect person to do it, as is because you don't BELIEVE that the breast will regenerate any milk in the allotted period of time, and because you BELIEVE that the baby will be hungry and there won't be enough milk there.

Jan

I'd be game, but I have to find a willing mama. And to be fair, we have to be willing to share with the mother the possible repercussions: Baby may still be hungry after the feeding and may need to be supplemented because you removed milk from the breast an hour before the feeding (or two--depends if baby is a 2-hr feeder or a 3-hr feeder), and are you okay with offering the milk you pumped earlier as supplement by bottle or tube feeder or cup?

Dee

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right?

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA== We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/

To: Sent: Tuesday, February 14, 2012 8:05 AMSubject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

I love Mohrbacher's " magic number " concept and frequently refer Moms to

her site.

Re: a baby emptying the breast. Not sure if this tidbit will add anything to

this conversation, but wanted to mention that my husband once had a conversation

with Hartmann - the breastfeeding researcher from Australia, and was told

that the majority of babies take 2/3 of the available milk from the breast. My

husband is a mathematician who models biological systems and Dr. Hartmann was

suggesting this as a possible system to explore mathematically - the question

being how babies determine this stopping point.

Ellen

Ellen Rubin, MA, IBCLC, LLLL

[Guest guest]

Jan, I'm not saying that in a normal healthy situation that the milk will not regenerate.. It's the moms who are having supply problems who pump. or who's babies can't get the milk easily... that's what confuses the issue. and yes. I'd love to do a study--but it should be blind and we need a lot more than 2 moms to participate and we'd need moms with similar issues, etc. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: Date: Tuesday, February 14, 2012, 3:20 PM

Ahhh, Dee, cuz I'm old and grumpy -- but basically because I don't have enough moms to be able to do this. Not to mention a baby weigh scale to loan/rent to them.

See, as thinker-upper of the "research" I get to figure out the parameters!! <GBG>

But you are right. What we probably need is one person who thinks it is a bad idea to pump an hour afterwards, and one person who thinks it would be fine to do that and see if we come up with the same information or different....

Jan

LOL! Now Jan, how do you know it's not **you** who are the perfect person to do this study? Maybe this study would prove the opposite of what *you* think!

Dee

Subject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...To: " " < >Date: Tuesday, February 14, 2012, 5:13 AM

From what I can see, there are two different scenarios here. One is a baby IS draining the breast and one is a baby NOT draining the breast. If a baby is draining the breast and pump is pumping for additional supply for supplementing (medical/non-medical) then I would pump an hour after WHEN POSSIBLE. If a baby is NOT draining the breast it is because their is a mechanical problem that will be benefited by artificial stimulation of pumping/hand expressing, right?

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyhttp://events.constantcontact.com/calendar/monthview?llr=l54fo5cab & eso=001ZABXYVzq37ea8EnRYjjrzA==We do not seek to establish any professional relationship with any person or entity as a result of any visit to this Website. Transmission of the information is not intended to create and receipt does not create, a doctor-patient or other professional relationship between you and any medical professional or other individual on this Website. Persons contacting us or any medical professional through this Website should not send personal health, confidential, or sensitive information, and should not ask specific medical questions. The Website is a public forum and any comments that you make or submit to us may be displayed publicly on that forum, so you should be cautious about making such comments. No information submitted electronically through the Website or email to us will be treated as privileged, confidential, sensitive or personal health information unless we have previously entered into a written agreement with you to protect such information. Any person submitting confidential or sensitive information to us without first entering a prior written agreement with us to protect such information waives all rights to confidential protection or doctor-patient privilege. We assume no responsibility for the loss or disclosure of any information that you transmit to us via the Internet. Please call or visit www.cradlehold.net for an evaluation. Please see the attached should you desire more in-depth lactation advice.Home Consultations Breastfeeding Home Visit Services:The best time to observe a mother and baby is when the baby is ready to nurse. We offer flexible scheduling in order to accommodate your baby's needs. A typical initial evaluation lasts approximately 1-1.5 hours. Appointments can be arranged during days, evenings and weekends. http://breastfeedinghomevisitservices.weebly.com/

To: Sent: Tuesday, February 14, 2012 8:05 AMSubject: Re: Re: pumping patterns -- show me the RESEARCH for using power p...

I may be way off here, but I thought there was general agreement in the group that if the baby was draining the breast, pumping immediately after feeding didn't increase the milk supply appreciably, and waiting awhile would be helpful. If the baby was not doing a good job of draining the breast, then pumping right after the feed IS much more helpful.

Most often, I have moms pump whenever it works for them. We talk about what is going on with her, and why the pumping is important. Sometimes it is a baby issue -- sometimes it is a mom issue as to why we are pumping. Sometimes it is because mom wants to build a bit of a stash in the freezer. Not all my moms are pumping for the same reason, and not all of them have the same issues. Hence different strokes for different folks.

Always always I have in the back of my mind that if I make the plan of care too difficult for her to keep, she is likely to throw in the towel. Or the pump, as the case may be. What may be a perfect plan in my mind, is not necessarily a perfect plan -- or even remotely doable -- in the mother's mind. So while I might want her to pump after every feed, but she can only pump two times a day, she is applauded -- anything is better than nothing. And I tell her that.

Jan

I am going to recommend everyone read Morbacher's Magic Number. She has done extensive reading of the literature on milk supplies and does marvelous talks on exclusive pumping. I have not seen any evidence yet to suggest that pumping an hour after feeding serves any benefit for the standard situations when babies are incapable of removing enough milk to satisfy their needs. http://www.clinicallactation.org/article.php?id=8 & journal_id=5I would love to see the evidence upon which the suggestion to pump an hour after feeding is being made and I will definitely read the methods section for the drop-out rates. Given what I see in my clinics, I would think the drop out rates would be high -- just as they are for the SNS when it is used indiscriminately. As I already mentioned, I do use it for atypical situations, but NOT for the vast majority of situations that can more easily be fixed with a plan that is more doable for most mothers.Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

As I recall from previous studies, 76%. However, I question whether or not a pump is as good as a baby if the baby is feeding effectively.

Jan

and was told that the majority of babies take 2/3 of the available milk from the breast.