Expressing regularly using a breast pump is different to breastfeeding your baby. Expressing breast milk is a skill you learn. Babies are often able to drain the breast more effectively than a pump.
If your baby is not able to feed from the breast, you may need to be using a breast pump at least 8-10 times per day. The best pumps to achieve this are the hospital-grade electric pumps.
It may take two or more weeks before your milk supply is established after the birth of your baby and the amount expressed each day (daily milk volume) is consistent. Many mothers find that on one day milk volumes are reasonable, while the next day they have dropped back. Review this every couple of days, rather than worrying over each expression.
Milk production is a demand and supply process. As milk is removed from your breasts, your body is signalled to make more milk. The more frequently and thoroughly the breasts are emptied (though breasts are never truly “emptied”), the faster they try to refill. To keep milk volumes healthy, do not wait until the breasts are full in order to express breast milk. Full breasts release a hormone which tells the body to slow down milk production.
Therefore, you need to express breast milk very regularly, usually 8-10 times each 24 hours with a maximum break of five hours overnight.
How much milk should I be producing?
Milk production rates vary throughout the day with milk supply normally greatest in the morning and gradually decreasing as the day progresses.
Record on your Expressing Log Sheet when you are pumping and how much you express. Add this up each day. Initially when you are expressing milk after your baby’s birth, volumes will vary from day-to-day, but you should see a gradual increase. All mothers vary greatly in volumes expressed.
- A general average can be estimated:
- By day 5: Up to 200 to 300ml per 24 hours.
- By day 8: Up to 400 to 500ml per 24 hours.
- By day 14: Up to 750ml per 24 hours.
- Thereafter: 750 to 1000ml per day.
- In the first few days you will express colostrum. It is normal to only express a few drops. Milk usually “comes in” around day three, but may not until several days later.
- No matter how much milk you are producing, every drop is valuable. Every drop of breast milk your baby receives provides nutritional and immunological benefits. When it comes time to breastfeed your baby, your volume may significantly increase.
Why your milk supply may be low
- If you are ill or under a lot of stress.
- Hormonal disorders such as thyroid or pituitary imbalances.
- Retained placental fragments
- Returning to work
- Some medications can cause problems with establishing a supply.
- Many mothers find their supply goes down when they have a cold (avoid cold and flu preparations as they can decrease milk supply).
- Hormonal birth-control should NOT be started before your baby is six-to-eight weeks old.
Tips for increasing milk volume
Try to stay as relaxed as possible when you express.
- Cuddling your baby and playing relaxation music may help reduce stress.
- Expressing beside your baby and after cuddles often results in more milk being expressed.
- Rest and good nutrition are important. This means three healthy meals per day, with snacks. Drinking to thirst, which usually means greater than two litres of water per day. Also going to bed early, although you may need to set the alarm to get up once overnight to express.
- Try to reduce caffeine levels to less than three cups of instant coffee per day.
- Do not diet while expressing milk for your baby. This has been known to vary fat levels in milk.
- Avoid smoking or try to reduce the amount of cigarettes smoked each day. Do not express while smoking or just after smoking.
- As your baby is recovering from illness or surgery, we encourage you to enjoy kangaroo care (cuddles with your baby, skin-to-skin). Wear clothing that enables you to unbutton your shirt, remove your bra and cuddle your baby close to your chest. All babies benefit from this contact with their mothers, and your body responds positively to holding your baby close.
- When expressing, double pump for no less than 10 minutes each breast, wait ten minutes, then express again until milk flow ceases, plus a further two minutes. The length of each expressing session should be no longer than 30 minutes.
- Hand express after pumping to drain the breast further and stimulate more milk production. Express at least 8-10 times in 24 hours. Warm compresses and massaging the breasts will help your milk “let-down”.
- Cluster expressing for two-to-three days, where you can aim to express every one-to-two hours during the day, with a five-hour break overnight, is a real supply booster.
- Ensure you have a breast pump that is designed for mothers who are establishing or maintaining their milk supply by expressing milk for their babies.
- Double pumping – using two expressing kits to express both sides at the same time – with a hospital-grade electric pump is more efficient if you are expressing long-term.
- When building milk volumes, remember: plans you set in motion today may not show results for a few more days down the track.
If these measures are not helping, please speak to the lactation consultant or doctor at the hospital about medication that can assist in building up milk supply. Once taking medication, you will need to regularly check your progress with the doctor. Tablets may need to be continued until your baby has resumed or commenced regular breastfeeding. Suddenly stopping the tablets can cause your milk supply to drop, so weaning gradually is a good idea.
An educational video on ‘maximising milk production’ can be viewed online
Before purchasing or hiring a breast pump it is a good idea to speak to a lactation consultant, nurse or an Australian Breastfeeding Association Counsellor on 1800 686 268.
Lactation Service, Division of Medicine
Level 9, Queensland Children’s Hospital
501 Stanley Street, South Brisbane
t: 07 3068 1807
t: 07 3068 1111 (general enquiries)
In an emergency, always call 000.
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.