Once the milk comes in and until the baby can breastfeed effectively, mothers only need one effective expression method. Pumping with a double electric pump is generally more effective than manual expression when the baby is premature.
1) Express regularly and often
Mothers should continue to express every 3 hours and aim for at least 7 sessions in 24 hours. Some mothers feel better if they sleep longer at night. We recommend they have only one 5-hour sleep at night and move the day pumping sessions closer together so they are still pumping 7 times in 24 hours.
Once the baby is learning to breastfeed, mothers should express after the baby has been at the breast. They should still ensure they are expressing at least seven times a day.
2) Empty the breast at each expression
A mother should aim to express as much milk as she can even if the baby is not yet taking in all the milk the mother is making. Emptying the breast at each session ensures there will be enough milk as the baby grows and prevents the milk supply from decreasing.
Extra milk is frozen and stored. It is never wasted! If appropriate, it can also be donated to a milk bank.
Hands-on pumping, which combines breast compression with machine pumping, can also help increase and then maintain the milk supply.
3) Other ways to help maintain the milk supply
Mother should keep their babies in skin-to-skin care as much as possible (Hake-Brooks 2008).
Having the baby in regular contact with the mother’s breast and nipple can help maintain the milk supply. Depending on their maturity and health, babies may:
- Use non-nutritive sucking.
4) Monitor the expressed amounts of milk
Mothers should keep track of how often they pump and how much milk they get at each session. Choices for this include paper, a spreadsheet, or an app. There are several free apps available online.
Mothers should express the expected amounts of milk and the amounts should not decrease.
The amount of milk produced after two weeks can indicate how much milk a mother is likely to continue to produce. Mothers who produce about 500 millilitres (17 U.S. fluid ounces) each day by two weeks are likely to be able to feed their babies exclusively with breast milk (Hoban 2018). This amount should continue to increase to about 800 ml (27 oz) within one month.