Research shows us that hand expressing for 5 min after 5 feeds a day for the first 3-5 days or until milk transitions yields better milk production at 1 month. It also helps tide the weight loss that often occurs immediately postpartum.

https://globalhealthmedia.org/videos/how-to-express-your-first-milk/

Some moms can benefit from early colostrum collection if there is a medical indication like history of breast augmentation, female factor infertility and/or gestational diabetes.

Most OBs and midwives are okay with moms practicing hand expression once a day after 37 weeks gestation. You can collect any colostrum you see and freeze it in a little syringe.

https://abm.me.uk/breastfeeding-information/antenatal-expression-colostrum/

Skin to skin is baby's closest place to home in the first three months of life. It helps babies burn fewer calories by helping them regulate their temperature, heart rate, breasting and blood sugar. It gets all the good bonding and milk making hormones flowing and gives everyone a do-over on hard days.

https://www.rachelobrienibclc.com/blog/the-1-piece-of-advice-i-give-to-all-parents/

Babies often breastfeed really well their first time right after delivery while adrenaline is rushing and their feeding reflexes are firing. They ten do into a “birthday nap” for 12-18 hours where they are hard to rouse for feeding. Be sure to wake by the 2-2.5 hour mark so we reach the target 10-12 feeds per 24 hours. By the second night, babies are often alert and ready to feed to help your milk transition from colostrum to mature milk. Night Two is VERY DIFFERENT from Night One typically and can catch parents off guard if they don’t know it’s coming. On Night Two, babies start clusterfeeding, asking for the breast very frequently or staying attached from most of the night. Have all of your snacks nearby and Netflix quequed because it is going to be an all nighter feeding the baby.

https://www.thelactationplace.com/news/2018/9/18/breastfeeding-or-chestfeeding-in-the-early-days-what-you-really-need-to-know

Nipple damage and pain when breastfeeding is super common BUT IT IS NOT NORMAL. Pain and damage tell us that the baby is trying to hold the latch with the wrong muscles. Their brain is smart and will create a workaround to hold the latch if something isn’t firing the right way. But this compensation can cause pain/damage and tells us that the baby is not feeding efficiently. We want babies to be competent at the breast!

You can measure your nipples near your due date. We have a new study that shows most moms get more milk in less time with a smaller flange by measuring the TIP of the nipple (not the base) and choose the same size flange that you measure. For example, if you measure 15mm at the tip, order a 15mm flange. We are no longer sizing up and using a larger flange. In my experience, most moms measure between 12 and 16mm. If someone tells you that you are a size 20-24, they are likely not following the new guidance. You can download the new flange fit guide here:

https://babies-in-common.kit.com/ffguide

If you are using powdered formula, the water you mix if with must be over 158 degrees. Powdered formula is not sterile so we need the hot water kills any bacteria that might be lingering.

https://www.lactationuniversity.com/uploads/5/5/3/2/5532100/final_preparing-formula-lu.pdf

https://www.cdc.gov/cronobacter/prevention/index.html

Many mothers are offered hormonal birth control in the hospital or at their 6 week appointment. We see anecdotally that ANY form of hormonal birth control has the potential to reduce milk production. Consuming your placenta also has the potential to reduce production since it is full of progesterone. We typically recommend waiting at least 8 weeks before starting hormonal birth control to build milk production first. A reduction in wet and dirty diapers, losing growth percentiles, and/or less volume when pumping may indicate a dip in production.

https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/13-contraception-and-breastfeeding-protocol-english.pdf

The Spectra S1 and S2 are my favorite pumps on the market. They are workhorses and are designed to build milk production and support exclusive pumping if needed. The motors are identical. The S1 has a rechargable battery and the S2 must be plugged into an outlet.

Many moms are interested in wearable pumps. We typically find that wearable pumps do not pull as much milk as a high quality double electric pump. If you want to use a wearable pump, we usually recommend balancing it with good milk removal with your baby or a high quality pump. A wearable pump is not recommended as an only pump.

I love a hand pump. It can help express colostrum in the early days, acts as a great backup in your purse or car, if nursing or pumping is delayed, and functional in a power outage.