Establishing your milk supply is driven by hormones during the early weeks after birth. Regular and frequent milk removal sends the signal to keep making more milk. The feedback you give to your body during this time helps establish your milk supply, and after the first few weeks, your supply becomes regulated and will be driven mainly by demand.

Prolactin is the hormone responsible for making milk. In addition to being released when milk is removed, it has its own circadian rhythm and is highest during the middle of the night and early morning hours. So, removing milk during that time significantly impacts the overall milk supply. The more times milk is removed when prolactin levels are high, the more milk that is made.

Babies breastfeed an average of 8 - 14 times a day (or more). Initially, your baby will want to nurse every 1.5 - 3 hours. As they grow and become efficient feeders, it may be closer to every 2-3 hours and up to 4 hours overnight. When you follow your baby’s cues for nursing, you will discover there is no exact or set schedule. They may nurse several times, getting a “full” meal, while other times, they are just up for a snack. Offering to nurse is always okay, and it is excellent to offer before your baby is very hungry. Think about when you wait a little too long to eat; you can be a little more irritable and have a hard time thinking clearly, grabbing cookies instead of nutritious whole foods. As long as feeding is going well overall, if your baby is hungry, they will nurse. If they aren’t, they won’t. 

Whether you are pumping to replace one feeding for your baby or exclusively pumping, you want to send the message loud and clear to make a full milk supply to support your baby's needs. Pumping to remove milk every 2-3 hours around the clock with a 4-hour stretch at night hits the mark for most parents. Each of us is different, and once your milk supply is established, you can play around with the times a little more to see what works best for you. Some people have a larger storage capacity for milk and can go a little longer between pump sessions without it decreasing their supply, while other folks can’t wait so long and need to stick closer to every 3 hours. Remember, each breast may produce different amounts of milk. This is fine as long as the combined total from both sides is enough to feed your baby.

• Middle-of-the-night pumping is still a must. If you have eliminated your middle-of-the-night pump time or stretched the time between sessions in the middle of the night, you may need to add it back in or decrease the time between milk removals.
• Stress is a big supply buster. When you are stressed, cortisol levels rise, the hormone responsible for telling us it is time to run for the hills and not time to sit back, relax, and feed the baby. When we are relaxed, oxytocin, the love hormone, is released. Oxytocin tells the milk to flow. Oxytocin is responsible for the let-down reflex. It may be helpful to listen to soothing music or a meditation, gaze at photos of your cute little one, put on a comedy, or do anything else that helps you de-stress and relax while you pump.
• Apply heat to your breasts before you pump. Heat helps get the milk flowing more easily. 

• Hands-on pumping is a gentle massage method that can help kick-start milk flow, and remember that the more milk we remove, the more room there is for milk to refill. After you finish pumping, hand express to get more milk out. This can help fattier milk move down through your milk ducts. The fat molecules are stickier and larger and move slower than the water molecules. 
• Power pumping or cycle pumping involves pumping for a short time, taking a break, and then repeating. It can be divided into amounts of time that make the most sense for you. The break is important, so once you begin pumping again, you trigger another let down. Try pumping for 10 minutes, taking a break for 10 minutes, and repeat that cycle. Some people pump for 10 minutes, break for 5, pump for 5, break for 5, and pump once more for 5 minutes. You can experiment to see what works best for you.
• Replace pump parts to ensure they are working their best. Duckbill valves, which many parents find remove more milk during pumping than traditional valves, need to be replaced monthly. Backflow protectors should be replaced every 3 months. Connecters and tubing may need to be replaced every 6 months or so if buildup reduces your pump's effectiveness.
• Flanges or breast shields that are too big or too small can cause nipple damage and reduce the amount of milk you can remove while pumping. Your flange size may change during your pumping journey or for your next baby. It is a good idea to check your flange size occasionally to ensure the best fit possible.
• Make dietary changes and drink plenty of water. Our gut health plays a key role in milk production. Many of our hormones are affected by our diet, which influences our supply. Choose as many whole foods as possible and limit processed and sugary foods. 

So many factors influence our milk production and the amount of milk we are able to remove with a breast pump. Keeping the above basics of milk production in mind and trying some of the tips and tricks for increasing supply is a good start to maintaining or increasing your milk supply. If you still need to increase your milk supply, contact your local IBCLC (International Board Certified Lactation Consultant) to co-create a care plan to meet your pumping goals.

Feeding your baby is a journey, and there is no one right way to do it. Whether you choose to breastfeed, pump at work, or exclusively pump, what matters most is finding a feeding method that works for you and your family. If you're pumping and notice a dip in your milk supply, you can choose from several effective strategies to help increase it and continue to meet your breastfeeding goals.

1. https://pubmed.ncbi.nlm.nih.gov/22424466/

1. https://pubmed.ncbi.nlm.nih.gov/16510619/
2. https://exclusivepumping.com/how-much-milk-do-breastfed-babies-eat/
3. https://kellymom.com/mother2mother/exclusive-pumping/
4. https://livingwithlowmilksupply.com/how-to-stimulate-let-down-reflex