Hi Mammalicious,
You have raised a number of issues. I will try to answer them.
First pumping is not the same as breastfeeding. The amount of milk you get from pumping is not the amount you have – it is only the amount you managed to get out by pumping. Your baby will get a lot more milk when breastfeeding directly from you than you can pump out.
When a mother returns to work and pumps her milk at work her body is ready and expecting to give the milk to the baby (although some mothers still find this hard work). But when you are breastfeeding your baby AND asking your body to express more it is very hard work indeed.
Being able to express 1.5 oz is already very good. If you need more simply express on more occasions and add the milk together. In this respect expressing is like breastfeeding - the more you do it with more milk you will get. Thus if you express six times for 10 minutes you’ll get more milk than it you express once for an hour.
When you breastfeed directly three things are working together to help the milk leave your body and enter the baby’s body.
• Your hormone levels are raised, especially oxytocin. Oxytocin helps the milk ejection reflex – this is the reflex that squeezes the milk out of the aveoli, the milk producing cells, and pushes it into the ducts which take the milk to your nipple. When you pump or hand express the levels of oxytocin are much lower.
• The baby uses suction to help the milk come out – the pump tries to duplicate this but hand expression doesn’t.
• The baby’s mouth milks the breast with its tongue and jaw movements. Hand expression tries to duplicate this but the pump doesn’t.
On top of this many mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump.
Many things that don’t matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.
You can also encourage the let-down reflex artificially, by looking at your baby, or by having a piece of his clothing next to you.
• Apply a warm wet cloth to your breasts.
• Massage the breasts in small circular motions around the perimeter of the breast.
• Gently stroke your breasts with your fingernails in a downward motion toward the nipple
• Lean forward and gently shake the breasts.
• Gently roll the nipple between your finger and thumb.
It may help to try a hand expression technique called the Marmet Technique,
http://www.lactationinstitute.org/MANUALEX.html
This is useful because it helps the let-down and so you get more milk.
(Please note that the diagram of the breast anatomy is out of date. Recent research has discovered that the milk reservoirs under the areola (the dark coloured part of the breast near the nipple) do not exist. The method, however, still works.)
Some mothers have found that the pumps are not good at getting the let-down to happen and so they use hand expression until the let-down and then swap to pumping. You can also use the times at the end of the Marmet Technique, including the massage, stroke and shake but instead of doing the hand expression use the pump.
Different pumps work differently for different mothers. There is an article called, How Do I Choose a Breast Pump?
http://www.lalecheleague.org/FAQ/pump.html which explains the differences.
A one month old full breastfed baby will drink about 750 ml a day. A six month old full breastfed baby will also drink about 750 ml a day. This is one of the big differences between a breastfed baby and an artificially fed baby. The amount of milk the baby drinks each day remains the same.
This is because breast milk changes. It changes from the beginning of the feed to the end of the feed. It changes from the beginning of the day to the end of the day. And it changes as the baby grows older.
In fact I’ve just been sent this link,
http://www.nzherald.co.nz/section/st...ectID=10345723, which is an article in a New Zealand newspaper which tells that breast milk of older babies is higher in fat content than breast milk of younger babies.
Artificial milk does not do this. This milk is always the same no matter whether you make it in the morning or in the evening or whether you make it when the baby is one month old or six months old. Because of this the calorie content is always the same. This means that the only way to get more calories into the baby is to give more milk. Thus an artificially fed six month old baby drinks a lot more milk than an artificially fed one month old baby.
Your question, however, was how to tell how much a baby will want at a particular feed? This is a “how long is a piece of string” question. It is too difficult to answer because each baby is different and each feed is different.
Generally the advice is to store the milk in small qualities. That way you can give the baby an ounce at a time until the baby doesn’t want any more. It is easy to add more milk if the baby is still hungry. But if you heat 6oz of milk for the baby and he only drinks 1 oz then you have just wasted 5 oz.
It you are dealing with fresh milk only using a bit at a time is easy. (And remember that breast milk can keep in the fridge for a long time – up to 7 days.). One mother in our group who was freezing her milk for longer storage used an ice cube tray to freeze it in. Once frozen she kept them in a plastic bag – this way she could easily get exactly the amount she wanted.
The article What are LLLI's guidelines for storing my pumped milk?,
http://www.lalecheleague.org/FAQ/milkstorage.html, gives the LLLI guidelines for storing human milk.
Best wishes,
SARAH
La Leche League Leader
LLLHK@hotmail.com
2548-7636
