Maximize Your Milk Supply: Science-Backed Pumping Tips

It's common to feel stress and uncertainty about milk production, but understanding the foundational rules of how your body makes milk will give you control.

The Critical Window for Initiation Timing is absolutely critical when establishing a robust supply.

• Start Early: For mothers of very low birth weight (VLBW) infants, research showed that mothers who started pumping within the very first hour after birth produced dramatically more milk, not just on day one, but weeks later, compared to those who waited even just a few hours. Initiation of milk expression within 1 hour following delivery increased the milk volume in mothers of VLBW infants.

• Focus on Hand Expression in the Early Days: If your healthy term infant is feeding poorly (12–36 hours postpartum), studies suggest hand expression might improve eventual breastfeeding rates at two months compared with breast pumping. This is partly because mothers found they were more comfortable expressing by hand with others present than using a pump. Furthermore, the small volume of colostrum expressed during this period (median volume 0.5 ml for hand expression and 1 ml for pumping in one study) may appear insufficient when collected into the large system of a pump, potentially undermining maternal confidence.

Optimize Your Pumping Schedule: Timing and Frequency

•Frequent Milk Removal is Key: To make milk, you need frequent stimulation. The mechanism controlling milk production is related to the degree of fullness of the breast. Removing milk helps messenger hormones and proteins to send the signal to make more milk.

• Prioritize Frequency Over Volume: While it is tempting to wait longer between sessions because you see a larger volume in the bottle, this is a false impression. Your total milk production over a full 24 hours might actually be lower because you pumped less frequently.

Optimizing Pump Settings and Duration

• Vacuum Level: Adjust the pump vacuum to the mother’s own maximum comfortable level (often between -98 mmHg and -270 mmHg).

• Milk Letdown Timing: To enhance letdown, start the pump with a stimulation vacuum pattern (about 120 cycles/minute, similar to an infant's initial sucking). As soon as milk ejection is detected (by sensation or increased flow), change the pump to an expression pattern with a lower cycle frequency, which is more efficient at removing milk.

• Pumping Duration: Long expression sessions are generally not required for mothers who are not pump dependent. However, mothers who have many or late milk letdowns may need to pump for 15 minutes or longer to drain the breast thoroughly. Aim to express until milk no longer enters the collection set.

By utilizing frequent and effective pumping methods like these, you send the loudest, clearest signal to your body for increased milk production.

References:

1. Flaherman VJ, Gay B, Scott C, et al. Randomised trial comparing hand expression with breast pumping for mothers of term newborns feeding poorly. Arch Dis Child Fetal Neonatal Ed. 2012;97(1):F18-F23.

2. Jones E, Dimmock PW, Spencer SA. A randomised controlled trial to compare methods of milk expression after preterm delivery. Arch Dis Child Fetal Neonatal Ed. 2001;85:F91-F95.

3. Kent JC, Prime DK, Garbin CP. Principles for maintaining or increasing breast milk production. J Obstet Gynecol Neonatal Nurs. 2012;41(1):114-121.

4. Lai CT, Rea A, Mitoulas LR, et al. Short-term rate of milk synthesis and expression interval of preterm mothers. Arch Dis Child Fetal Neonatal Ed. 2020;105:F266-F269.

5. Morton J, Hall JY, Wong RJ, et al. Combining hand techniques with electric pumping increases milk production in mothers of preterm infants. J Perinatol. 2009;29(11):757-764.

6. Parker LA, Sullivan S, Krueger C, et al. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study. J Perinatol. 2012;32(3):H205-H209.

7. Parker LA, Sullivan S, Krueger C, Mueller M. Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med. 2015;10(2):84-90.

8. Prime DK, Kent JC, Hepworth AR, et al. Dynamics of milk removal during simultaneous breast expression in women. Breastfeed Med. 2012;7(6):442-447. (Note: This publication was first published electronically in 2011).