Principle #4. Avoid increasing milk production beyond baby's needs
When a lactating woman removes her milk mechanically, that is, by pumping, it is important she pumps milk that corresponds with her infant's needs.
A cohort study of 346 breastfeeding women by Cullinane et al in 2015 showed that breastfeeding women who pumped a few times a day were at increased risk of mastitis. (Reasons for pumping were not investigated.)1
From the mechanobiological perspective, milk production which exceeds the infant’s needs increases the risk of excessively high intraluminal pressures and breast inflammation.
However, frequent flexible milk removal, directly from the breast by the infant, offering the affected breast first, will not result in a production mismatch. This is because we can trust infants to self-regulate at the breast, and refuse the breast when they don't want it. You can read more about this here.
Frequent flexible milk removal by hand expression or a pump is a necessary response to breast inflammation if the woman has been predominantly mechanically expressing her milk. Any mismatch in supply needs to be dealt with once the breast inflammation has resolved.
You can read more about this here.
References
- Cullinane M, Amir LH, Donath SM, Garland SM, Tabrizi SN, Payne MS, et al. Determinants of mastitis in women in the CASTLE study: a cohort study. BMC Family Practice. 2015;16:181.