A Super Stimulation Plan is a useful tool when there is a known for low milk supply. Such as, history of a breast reduction, history of low milk supply with a previous child, or if their baby is born with a limited ability to breastfeed effectively, as with a preterm or late preterm infant.
The Super Stimulation Plan is designed be short term, lasting no longer than the first two weeks. Why? Because it is exhausting, that is why. It is not a sustainable long term plan and should not be used as such.
The Super Stimulation Plan is almost always coupled with the Supplementation Plan. The lactating parent with risk factors for a low milk supply will also have a baby who is at risk for not getting enough to breastmilk to meet their growth needs . A well-fed baby is a better breastfeeder, so be sure to feed the baby while you super stimulate the milk supply.
Right after birth and for the first two to four hours of life
Enjoy skin-to-skin time as soon as you can after birth. This may be in the delivery room or in the recovery room once you have left the OR. They will probably encourage you to do this. If baby isn’t latching on, ASK FOR HELP.
It is important that he not only get skin-to-skin time, but also that he latches. There is a difference between a baby who is interested in latching and can’t latch on and a baby who is just happy to lie around and snuggle, but isn’t showing signs of hunger. If he is looking like a baby bird or a woodpecker, do what you can and ask for help to get him on. If baby doesn’t latch, hand express both breasts, dripping colostrum on the baby’s lips.
At four hours of life
- If baby has latched after birth, aim for a minimum of an additional five feedings in the first 24 hours of his life (for a total of at least six feeds in his first 24 hours of life).
- If he has not latched on, hand express colostrum into a spoon or directly into his mouth. Don’t be discouraged if you don’t see much, even a few drops is great. Experiment with different holds and positions when hand expressing. Everything is fair game as long as it doesn’t hurt—there is no one right way to do this!
- Make sure your pain is well-controlled, especially if you have had a Cesarean birth. The more you can get sitting up in bed or even in a chair, the easier this will be.
Birth to 72 hours of life
- If baby is latching, breastfeed, hand express, top off with expressed milk in a spoon.
- Before your milk is in, your goal is to make sure your baby nurses well and gets all the colostrum you are making. If baby is latching in the first three days, there is no need to pump. I do recommend you hand express after most feedings and top baby off with any drops he happened to leave behind.
- In the first three days, any supplementation with your own milk or formula can be done with a syringe or spoon since the volumes are so small.
- If baby is not successfully latching, hand express, top off, supplement if necessary and pump both breasts for 10-15 minutes. Since baby isn’t stimulating and protecting your milk supply, you will need to do it for him. The goal is at least eight good breast stimulations (nursing or pumping) in any given 24 hour period.
Day 3 to Day 14
- This is where the “Super Stimulation” comes in.
- If baby is latching, pump after four to six breastfeeding sessions per day. Pump within fifteen minutes of finishing breastfeeding so that your breasts have time to refill before the next nursing session. Pump for 10 to 20 minutes on the highest comfortable vacuum. For the sake of sanity, I recommend doing these extra pumps during the day and/or when you have help at home.
- If baby is not latching, feed the baby via bottle, then pump 10 to 12 times per day.
- Ugh! You will almost never catch me telling a mother to pump this many times a day. Remember that this plan is for Super Stimulation. The mother of a non-latching baby only needs to pump eight times per 24 hours. The Super Stimulator needs to pump more, but remember that it is just for the first two weeks.
- I do not recommend pumping every two hours around the clock to get in 10 to 12 stimulations sessions. Its okay to pump hourly at some times of the day and go as long as four to five hours between pumps at other times of the day (i.e. overnight). As long as you get 10 to 12 stimulations in somehow, you are good.
- Within the 14 day period, have an appointment with an IBCLC to do a formal transfer weigh. This will help to identify if your supply is in fact low. It will also help you clarify if supplementing baby is necessary and if so, how much is the right amount to supplement.
Remember, the Super Stimulation Plan is not designed to continue past 14 days without close guidance from a trusted IBCLC, as it can be emotionally and physically taxing to the whole breastfeeding family.