I was inspired to write this post due to some recent helping situations. I decided to compile all this information in one place. I may add to it later.
In order to have an excellent milk supply, it is important to remove milk from the breasts at least 8-10 times a day. (http://feedthebabyllc.comcare-plan-for-milk-supply/) When parent and baby are together, it is beneficial to keep baby skin-to-skin and allow free access to the breast. A baby is usually better at maintaining a milk supply than a pump and the extra nursing stimulates breasts to make more milk.
When a breastfeeding parent is separated from baby, it is important to express milk as frequently as possible, at least every 3 hours from the beginning of one expression to the beginning of the next. A double electric pump with properly fitting flanges works the best. Be sure to check the membranes frequently and change them at least every 3 months. A pump that is older than 1 year may not be as efficient. See (http://newborns.stanford.edu/Breastfeeding/MaxProduction.html) for learning a technique that increases the amount of milk that can be expressed by 48%!
Breastfed babies need approximately 25 ounces of breastmilk a day and usually feed 8-10 times in 24 hours. Two to four ounces per feed is typical. If the baby is given more milk in bottles than is typically received at the breast, it will be more difficult for the parent to keep up with milk expression during separation. Small, frequent feeds are also more physiologically appropriate than larger, less frequent feeds. It can take up to 20 minutes for a baby to recognize they are full and bottle-fed babies are frequently overfed.
It is easiest to maintain a milk supply, if as much milk as possible, comes from direct breastfeeding. If a baby sees the bottle as providing just barely enough and breasts as the place where milk is plentiful, the baby will be more likely to continue to breastfeed and it will be easier to maintain a robust supply. Bottle-feeding the breastfed baby involves using techniques that support breastfeeding. Towards this end, it is ideal to use a slow flow bottle nipple, paced feeds, and to only offer 1-1.25 ounces for every hour of separation. If the baby can be fed at drop-off and pick-up, even less milk will be needed to be fed by bottle. The following link describes paced bottle-feeding and has hand-outs for care providers. (http://kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/)
Night feeding also helps to keep a milk supply plentiful. If a baby is sleeping thorough the night, the breastfeeding parent misses out on some very important milk supply stimulation. If a parent bed-shares, nursing at night can be as simple as rolling over, offering the breast, and going back to sleep. Many parents are concerned about the safety of sleeping with their baby, but research shows it can be made to be just as safe as any other sleep location. (http://www.uppitysciencechick.com/sleep.html) If a parent does not want to bed-share, it is still possible to feed baby a few times at night and just put the baby back in their own sleep space. Avoid falling asleep while feeding in a chair or couch.
Many breastfeeding parents, who are separated from their babies during the week, find that their supply is lower by the end of the week. They often make up for their lowered supply by feeding more frequently on the weekends. If you find your supply is lowering, try a “nursing holiday” during which you spend all weekend in bed or lying around just nursing. Keep baby skin-to-skin and nurse all day and all night long. This will work quickly to increase supply.
©2013 Laura Spitzfaden, LLLL, IBCLC
