“Early and often,” is a phrase that is frequently used to describe the optimal practice of breastfeeding.  This accounts for the manner in which breasts make milk.  The more milk that is removed from the breast, the more the breast will make.  This is a supply and demand system that seems to be especially sensitive in the early days of lactation.  A very recent study that suggests that if colostrum, the first milk, is removed frequently, in the first three days, the breast is more likely to produce and maintain a generous supply of mature milk.  Morton, Hall, Wong, Thairu, Benitz and Rhine (2009)

This study was designed to determine if hand expression of colostrum (the early milk) in the first few days, combined with pumping mature milk using hands-on-pumping techniques (massage and breast compression while pumping) could prevent low milk supply, which is common in pump dependant mothers of pre-term infants.  While these infants benefit greatly from receiving breastmilk, their mothers frequently have difficulty maintaining an adequate milk supply.

Mothers who participated in this study, were taught hand expression techniques and were encouraged to hand express their colostrum, as many times as possible, for the first three days.  Additionally, they were instructed to use a double pump to express their milk, 8 times every 24 hours, beginning within the first 6 hours postpartum.  After their milk came in, mothers were instructed to pump 8 or more times per day and were taught to use a hands-on-pumping (HOP) technique.  This technique combines electric double pumping with massage and breast compression.

It was determined that moms who hand expressed colostrum more than 5 times per day, in the first three days, not only increased available colostrum but were able to produce a larger supply of mature milk than mothers who expressed colostrum fewer times in the first 3 days.  Additionally, after HOP training, mothers increased their own daily volumes of breast-milk by 48%. Morton et al. (2009)

While this study involved pump dependant mothers of premature infants, its findings may also apply to full-term mothers and infants.  This information underscores the importance of feeding, “early and often,” and how this practice can have a significant impact on the ease of sustaining a plentiful supply of milk.  If a newborn is not successfully removing milk from the breast in the first three days, frequent hand expression of colostrum may be an appropriate intervention to help ensure future milk production.

The results of this study may also apply to employed moms of full term infants, who are dependent on pumps to maintain their milk supplies during separations.  If these moms are encouraged to use HOP techniques, they may find it easier to maintain a plentiful supply for their infants, in spite of routine separation due to mother’s employment.

© Laura Spitzfaden 2010