Pumping Instructions to Accompany the Protocols for Induced Lactation

We suggest a “baby honeymoon” for the first 48 hours of pumping. Pump every 2 hours by day and every 3 hours by night. Then over the next two weeks, start pumping as follows as often as you can.

8 - 12 times per day:

• Pump for 5-7 minutes on the low or medium setting
• Breast massage, light tickle, jiggle
• Pump for 5-7 minutes

It is suggested that the mother pump every three hours.

Note: Stopping the birth control pill while maintaining the domperidone and then pumping should cause a rapid decrease in the mother’s serum progesterone level while causing an increase in the mother’s serum prolactin level. This process attempts to mimic what happens after a normal pregnancy and birth. This should cause the mother’s milk supply to come in.

Assisting the Milk Ejection Reflex (Let-Down)

1. Breast Massage
   Do as you would for a breast cancer examination. Rotate the flats of your fingertips with gentle but firm pressure in concentric circles starting from the largest portion of the breast and working all around the breast towards the nipple. This will help to empty the alveoli (grapes) into the ducts (branches) and help to drain the breast.
2. Light Tickle
   Using the nail side of the fingertips, very gently rake your fingertips from the top of the breast towards the nipple. This helps to move the breastmilk towards the collecting ducts located just behind the nipple and under the areola (colored tissue surrounding the nipple).
3. Jiggle
   Lean over and give your breasts a light jiggle. This uses gravity to help move the breastmilk throughout the breast towards the collecting ducts and the nipple.

The entire procedure should take approximately 15 minutes.

• Pump each breast 5-7 minutes. (Use a double pump to save time and get a better result)
• Breast Massage, Light Tickle, Jiggle
• Pump each breast 3-5 minutes.

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Newman-Goldfarb Protocols. © Lenore Goldfarb, B.Comm, B.Sc, IBCLC
and Jack Newman, MD FRCPC, November 2002