Power Pumping vs Cluster Pumping - Which is Better for Increasing Milk Supply?

As a retired IBCLC with 30+ years experience in breastfeeding support, I am not sure that power pumping is the best method for increasing milk supply for every mom.  The method has limited scientific research and can cause moms quite a bit of frustration with such ridged and lengthy pumping sessions. Not to mention friction when dry pumping. While nipple stimulation does sustain hormone signals, research supports that regular extraction is the source of increasing milk supply.  Apart from moms who are relactating or inducing lactation, cluster pumping is a better method than power pumping because there is more milk to extract every 2 hours than there is when pumping again in 10 minutes. For clarity, I have outlined the power pumping method and cluster pumping methods below for moms with babies under six months below. While we are listing these times as pumping, nursing sessions can and should be used in place of these when possible.

Power Pumping 

60 minutes session once per day as below; pump an additional 7 x daily for 20 min. 

• Pump 20 minutes

• Rest 10 minutes

• Pump 10 minutes

• Rest 10 minutes

• Pump 10 minutes

Cluster Pumping 

Pump every 2 hours with one 4 hour stretch. The schedule below includes cluster pumping during the midnight to 5am window that prolactin milk producing hormone is the highest.

• Pump @ 12am

• Pump @ 2am

• Pump @ 4am

• Pump @ 8am

• Pump @10am

• Pump @ 12pm

• Pump @ 2pm

• Pump @ 4pm

• Pump @ 6pm

• Pump @ 8pm

• Pump @10pm

Power pumping is normally used for one week daily and a second week every other day.  Cluster pumping is meant to closely imitate an infant's growth spurt and results should be evident after 7 days of the outlined schedule.

No matter how many years go by, research has never found the principle of supply and demand to be refuted.  Better extraction through waiting long enough for milk to build and simulating a natural way baby's cluster nurse is my recommendation.  And remember, better extraction with a breast pump means a double electric breast pump with properly sized flanges and optimally not a wearable breast pump. If you own a wearable, it is for convenience.  Your electric breast pump should always be your main breast pump. But having said that, the best breast pump is the one you will actually use.

Here's to demand for supply!

Tanya

Hospital Grade Breast Pump Comparison for Corporate Lactation & Clinical Lactation

Hospital grade breast pumps also know as multi-user breast pumps are often used for corporate lactation and clinical settings. There are three we most often recommend.  

	Ameda Pearl	Ameda Platinum	Spectra S3 Pro
Pump Type	Hospital-grade, multi-user	Hospital-grade, multi-user	Hospital-grade, multi-user
Power Source	AC + rechargeable battery	AC only (plug-in)	AC + rechargeable battery
Suction Range	Up to ~250 mmHg	Up to ~250 mmHg	Up to ~270 mmHg
Cycle Speed	Stimulation: ~80–120 CPM Expression: ~30–48 CPM	Adjustable speed, ~30–80 CPM	Adjustable, up to ~70 CPM
Modes/ Adjustability	Stimulation & expression; customizable settings	Fully adjustable vacuum & speed	Adjustable suction & cycles
Closed System	Yes	Yes	Yes
Portability	Portable due to internal battery	Least portable; plug in	Portable due to internal battery
Noise Level	Moderate	Moderate	Relatively quiet
Durability/Use Intensity	For frequent clinical and rental use	Heavy-duty clinical workhorse	For hospital and high-use settings
Typical Use Settings	Hospital, clinic, rental, home use	Hospital, NICU, rental	Hospital, clinic, rental, transitional home use
Available Flange Sizes	25mm, 28.5mm, 30.5mm Inserts: 11mm–21mm	25mm, 28.5mm, 30.5mm Inserts: 11mm–21mm	16mm, 20mm, 24mm, 28mm, 32mm

---

An important detail to consider is the availability of flange sizes for these pumps.  Ameda has very few flange sizes, but does offer flange inserts to help reduce the flange size as needed.  Spectra offers flange sizes 16mm-32mm without having to use an insert. Warranty is another consideration. The Ameda Pearl and Ameda Platinum carry a 3 year warranty on pump mechanism while the Spectra S3 Pro offers a 2 year warranty.

Summary

Ameda Platinum

• The most traditional hospital/NICU workhorse

• Plug-in only (no battery)

• Excellent for continuous, high-volume clinical use

• Often chosen for NICUs and long-term rentals

• 3 year limited warranty

Ameda Pearl

• Hospital-grade performance with added portability

• Internal rechargeable battery

• Good balance between clinical strength and flexibility

• Suitable for clinics or parents needing occasional portability

• 3 year limited warranty

Spectra S3 Pro

• Strong hospital-grade suction with Spectra’s comfort-focused design

• Internal rechargeable battery

• Closed system with intuitive controls

• Often preferred for comfort-oriented users transitioning between hospital and home

• More flange sizes available without using inserts

• 2 year limited warranty

Depending on your needs, any of these three pumps are exceptional choices for your corporate lactation or clinical needs.   Available at Lactation Connection.

Here's to productive purchasing,

Tanya

Relactation Protocols for Bringing Back Milk Supply

If you are considering relactation, your foundation for success is frequent, effective milk removal.  And the good news is that your breasts have made milk previously and mammary tissue and prolactin (milk producing hormone) receptors are established. It can take time to re-establish milk supply so be ready to put the effort in for the length of time that it has been since you last nursed.  For example if it has been two weeks, you may be able to relactate in as little as two weeks.  If it has been two months, it may take that long.  However, the protocols below may help expedite this process.

Protocols

• Frequent pumping or nursing (8–12x/day, including overnight when prolactin levels are highest)

• Latch your baby on if possible.  Feeding tubes allow you to supplement your baby at breast until milk comes in.

• Get skin to skin with your baby often as it increases oxytocin (milk ejection hormone)

Lactation Aids

• A high quality electric breast pump such as a Spectra S1 or S2; wearable are not as effective

• Lactation Aid Feeding Tubes can help keep baby to the breast for assistance with keeping the baby at breast to boost oxytocin for better let-down

• Supplements can be used to help, but will not work without adequate stimulation and extraction

Medications & Supplements

• Motherlove More Milk Plus - Tried and true herbal supplement containing goat's rue and fenugreek. Fenugreek is not recommended if you have diabetes, hypoglycemia, or PCOS subtypes sensitive to glucose shifts.

• Legendairy Milk Liquid Gold - Combination herbal supplement with goat's rue, milk thistle, shatavari, fennel, alfalfa and anise. Not recommended for mothers with SLE disease, plant allergies associated with ingredients listed.  May lower blood sugar.

• Metoclopramide (Reglan):
  Prescription only. Used occasionally, short-term, and cautiously. Evidence for meaningful volume increase is mixed, and side-effect risk limits routine use.

Manage Expectations

Frequent, effective removal of milk by baby or high quality double electric breast pump is essential.  Pack your tenacity as you will need to keep this up 8-12 times per day and include night feeding or pumping until milk supply is well established. Be prepared that volume increases gradually over weeks and manage your expectations. While a comprehensive study* shows that 79% of moms were successful at being able to resume breastfeeding, full milk supply may not always be reached. Some moms were only able to produce 25-50% milk supply, but every ounce counts for the health of your baby.

Hang in there mama!

Tanya

References:

*Matern Child Nutr. 2022 Oct 12;19(1):e13440. doi: 10.1111/mcn.13440

J Trop Pediatr. 1997 Aug;43(4):213-6. doi: 10.1093/tropej/43.4.21

Breastfeeding with PCOS

If you have Polycystic Ovary Syndrome (PCOS), maintaining milk supply requires intensive milk extraction due to risks of delayed milk "coming in" and potential hormonal interference from insulin resistance and/or high androgens. To endeavor to get milk to come in and keep your milk supply, below are some protocols that may help.

Immediate Postpartum Protocols

Early Initiation: Start nursing or hand expression within the first hour of birth.

Frequent Removal: Breastfeed on demand or use a hospital-grade pump at least 8–12 times every 24 hours (roughly every 2–3 hours).

Night Feedings:  Pitocin levels are the highest between 12pm-5am, so don't take advantage of nursing or pumping twice during those hours..

Antenatal Expression: Begin expressing colostrum at 38 weeks (with medical approval as it may cause contractions) to "wake up" breast tissue and build a supply before birth.

Avoid Early Supplementation: Unless medically necessary, avoid formula in the first few days to maximize biological stimulation of the breast. 

Skin to Skin Contact: Even if pumping, use skin to skin contact with baby to boost oxytocin which aids with let-down. 

 Advanced Extraction Techniques

Breast Pump & Flange Selection: Make sure to use a good double electric breast pump, not a wearable and measure for correct flange size to use.  A wearable breast pump should only be used on occasion.

Triple Feeding: If the baby cannot latch effectively, nursing is followed by 10–15 minutes of pumping on each breast to ensure thorough drainage.

Hands-On Pumping: Use a hands-free bra and perform breast massage while pumping to increase milk output by as much as 48%.

Power Pumping: Simulate cluster feeding once a day for several days by pumping for 20 minutes, resting for 10, pumping for 10, resting for 10, and pumping for 10.

Night Pumping: Prolactin levels are highest between midnight and 5 a.m.; ensure at least one extraction session occurs during this window. 

Metabolic & Hormonal Management

Insulin Sensitivity: High insulin can block milk synthesis. Manage this through a low-glycemic index diet and, if prescribed, continuing Metformin, which is considered safe during lactation.

Galactagogues: Certain herbs like Goat’s Rue (which supports insulin sensitivity) and Moringa may be more effective for PCOS-related supply issues than traditional herbs like Fenugreek.

Stress Management: High cortisol from stress can trigger androgen spikes that inhibit milk flow. Use skin-to-skin contact (Kangaroo care) to boost oxytocin and lower cortisol. 

Non-insulin Resistant PCOS

Following the immediate post-partum protocols and advanced extraction techniques is essential.  Poor prolactin response could be the culprit of low milk supply additional pumping especially between 12pm-1am and switch nursing (moving baby back and forth between breasts every 5 minutes) may be helpful.

Lifestyle, diet and weight management can help regulate hormones.  

Some find Myo-inositol and Vitamin D supplements helpful. Vitamin D dosage in prenatal vitamins is often 400-600IU/day which is insufficient.  Recommended dosage is 1000-2000IU/day to begin with upper level dosage at 4000IU/day.

Recommended Support

Prenatal Consultation: Meet with an IBCLC (International Board Certified Lactation Consultant) before birth to assess breast development (checking for Insufficient Glandular Tissue) and create a custom plan.

Weight Monitoring: Frequent weight checks for the infant in the first two weeks are critical to ensure they are transferring enough milk despite potential PCOS-related delays. 

Having PCOS does not mean you are unable to breastfeed, but it does pose challenges and milk supply may wain even with your best efforts.  The initial colostrum is your baby's first immunization and any breastmilk is liquid gold for you baby's health. Don't be discouraged if your milk supply is not like the next moms.  Your tenacity and effort to give your baby the best is what counts.

Every ounce counts,

Tanya

Are Lansinoh Glass Bottles Lead-Free?

Lansinoh glass bottles are a great option when needing a larger than 5-6 oz wide mouth bottle in glass for your infant.  There was some question about three years ago as to whether the paint on the logo was lead-free.  This type of information stays on the internet forever, so we wanted to clear things up.  

Lansinoh changed their logo in 2023 and sources from Lansinoh recently stated to Lactation Connection in writing that the bottles contain no lead so you can be assured that they are now lead-free aka Pb-free if you are purchasing the Lansinoh 8oz Glass Bottles with the new logo.

We would not recommend buying older bottles with the older oval logo shown above out of an abundance of caution.  Above is an image of the older logos along with the dates of use by Lansinoh.  Below are images of the new glass bottles and where you can purchase to be assured you are receiving only the new style. 

Lactation Connection as a company prides itself on sending you what is pictured so as another example if you are buying Spectra bottles two-pack you will see pictured the new beige cap style which is what you are being sent or the Spectra pink logo bottle singles which are also always sent as pictured.  The pink logo bottles are being discontinued so the pink Spectra bottles will only be available while supplies last.

Here's to finding the feeding supplies you need,

Tanya

How to Express More Milk with your Spectra Breast Pump

At Lactation Connection, we are frequently asked which setting mom should use on the popular Spectra S1 and S2 breast pump to get the most milk.  While settings are important, flange size is equally important.

Your goal with your Spectra flange size is to engage the milk sinuses which are located an inch behind the nipple.  So it is really important that the flange allows the nipple to move freely without drawing in too much tissue.  You can use the guide below or a silicone nipple measuring tool.

What about the settings?  Cycle pumping is recommended by Spectra when using the S1 or S2. Below is the procedure to start using the Spectra pump effectively.

      Cycle 70 (Massage Mode) for 5 minutes 

      Cycle 54 (Expression Mode) for 5 minutes 

      Cycle 70 (Massage Mode) for 5 minutes 

      Cycle 38 (Expression Mode) for 5 minutes 

Some moms leave their pump on higher setting, but know that the Expression Mode (38 cycles per minute) is very effective at draining the breast and relieving clogged milk ducts.

In addition, relaxed pumping is best. You first need realistic expectations of how much you should be getting when you pump.  After the initial week postpartum, you should only expect what your baby needs.  To determine this amount, take your baby's weight and multiply by 2.5.  Then divide by 8 feedings.  This is the amount you are looking to pump in total from both breasts.  For example, a 10lb baby x 2/5 + 25oz ÷ 8 is 2.5 oz.  So you may get one once on one breast and perhaps an ounce and a half on the other.

Effective tools for relaxation to aid with let-down include the following:

1.  Once you position the breast shields, don't watch the bottles!

2.  Look at your baby or baby's picture.

3.  Wrap a swaddling blanket around your neck so you can smell the baby.  

4.  Relax your shoulders.  Hold the breast flanges in a c-hold at the flanges instead of by the bottles so you can drop your elbows and relax your shoulders.

5.  Make sure you are comfortable.  Use a short stool if needed to bring your lap up and keep you from leaning too far forward and straining your back.  Pumpin' Pal angled flanges are excellent for keeping you from leaning forward and are a real back-saver!

Best wishes for an abundant pumping session!

Tanya

Ninni Co Breast-like Pacifier Review

While I did not dissuade the use of pacifiers for breastfed babies in the past, I had never found one that I could fully endorse.  Now, after 32 years serving nursing mothers, I feel confident in giving the Ninni Co pacifier my full endorsement.  As a retired International Board Certified Lactation Consultant, I love the graduated shape, the breast-like soft feel, the breathable shield and the view into the baby’s mouth for suck assessment.  This pacifier is not only recommended by lactation consultants for nursing babies to transition between breast and bottle more easily, but it has also been recommended for use in suck training and oral motor development in pediatric feeding therapy. 

Why is the Ninni pacifier so highly recommended?

1. This breast-like super soft medical grade silicone pacifier mimics the tissue of the breast which encourages baby to create strong suction and a vacuum effect similar to breastfeeding.

2. For proper use, baby’s mouth needs to open wide and remain open while using their tongue to suck in a natural peristaltic wave unlike other pacier styles which encourage a pursed mouth and chomping.

3. This breast-like pacifier can be used as a training tool to help babies with oral dysfunction develop a more effective suck technique. It’s great for post-op rehab for tongue ties and cheek ties or a disorganized suck.

Here's to more natural suckling,

Tanya