You will have to remove milk from your breasts on a regular basis if you are to provide enough of your milk for your high-risk baby. Many mothers find they can appreciate their babies' breastfeeding patterns when they understand how breast milk is produced. Initially, hormones play a greater role. After the first one or two weeks postpartum (after the baby is born), milk removal has a greater effect on the amount of milk produced.
With the expulsion of the placenta after a baby's birth, a drop in the hormones that maintained the pregnancy soon occurs and allows the hormone prolactin to begin to work. The placenta is expelled, which signals a drop in the hormones that maintained the pregnancy. The sudden drop in these hormones allows the hormone prolactin to begin working. Prolactin "tells" the breasts it is time to begin producing large amounts of milk. A mother feels the result of prolactin when her milk "comes in" at around three to five days postpartum. Increased milk production usually occurs at this time even if a baby has not been breastfeeding well or often. However, frequent breastfeeding sometimes speeds up the process of establishing increased milk production. Occasionally, a mother experiences a delay in the production of large amounts of milk.
Ongoing, long-term milk production depends mostly on milk removal by nursing or pumping. The more often milk is removed, and the more completely it is removed, the more milk the breasts make. The opposite is also true. When milk is removed less often, or an insufficient amount is removed, the breasts get the signal to slow milk production and make less. Milk removal occurs when a baby effectively breastfeeds or you are pumping frequently.
Effective breastfeeding requires effective sucking by the baby so that enough milk is transferred from the breast into the baby's mouth where it is swallowed. To suck effectively, a baby must latch deeply onto the breast and use the structures in his or her mouth to create intermittent (periodic) suction and squeeze milk into his or her mouth. Proper sucking signals the mother's body to release the hormone oxytocin. With the release of oxytocin, your milk will "let down." This is the term used to describe the flow of milk from the breasts.
Milk transfer also can be accomplished through milk expression techniques. This can be done with your hand or with a breast pump. Hand expression is done by compressing the breast tissue with your hand. Your milk can then be collected onto a spoon or into a container. There are breast pumps that can remove the milk as well. Some breast pumps are manually operated, while others are either battery-powered or electric.