The answer is F, All of the above.
To maintain a full milk supply the breast needs to be stimulated and drained often. The pituitary gland in
the brain releases the hormones prolactin and oxytocin. Prolactin tells the breast to make milk. Oxytocin
triggers the alveoli in the breast to contract, releasing the breastmilk and causing a milk “let down.”
Sometimes when women pump, they can feel milk in their breast, but have difficulty getting the body to
release the milk when pumping. Stressors can inhibit the body from releasing milk. Oftentimes, women
who need to pump have many stressors that can make it difficult to get the milk flowing. When I worked
in the NICU, it was not unusual to have a mother routinely come in to pump for their baby. When a
mother who has a full milk supply and ordinarily pumps large volumes would come in and express only
drops, there was an excellent chance her baby was having a procedure. As soon as mothers would
discover their baby was okay, the flood gates would open, and they were back to expressing high
volumes. Many mothers pump when they are at work. Anxiety and stress can inhibit milk let down,
making it difficult to pump good volumes when women have a short period of time to express in the
middle of a busy and stressful work environment. However, to maintain good volume it is very
important to drain the breast adequately. Below are a few tips to get you started.
Massaging the breast before pumping helps trigger the milk let down, resulting in a faster and/or
stronger let down than if they rely on the pump alone. I recommend clenching both hands and
massaging each breast, one at a time, as if you are kneading dough. Make sure to massage around the
entire breast, top, bottom, and sides. Do this for about 30 seconds to 1 min. If at any point milk naturally
starts to drip on its own, you are done and can move to the next breast. THEN begin pumping.
Compressing the breast while pumping can increase milk production greatly. Hands-on pumping can
increase output by nearly 50%. Having a pumping bra can make it easier to compress the breast while
pumping. Focus on firm areas of the breast. There are moments when you are pumping and very little, if
any, milk is coming out. However, when you compress your breast the milk begins the spray. When
babies feed, they use both compression and suction. Pumps only use suction, so even good quality
pumps tend to leave milk in the breast that you can access by hands-on pumping and hand expression.
Studies have shown that reflexology can also trigger a milk let down, allowing mothers to express more
milk when expressing by stimulating reflexes on the mother’s feet. This stimulates the pituitary gland.
Reflexology also helps balance the body and get mothers relaxed, triggering oxytocin which is a great
recipe for milk production! Massaging can also causes relaxation, which produces oxytocin, triggering a
Other things that can help your body release milk and increase your pumping output are relaxation,
visualization techniques, nipple stimulation, and warm compresses (particularly moist warm
compresses.) Every mom is different; therefore, you should try everything until you find the right fit for
you. Happy breastfeeding! Pump strong!