You will have to remove milk from your breasts on a regular basis 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 milk is produced. Initially, hormones play an important role in the production of milk. After the first 1 to 2 weeks after the baby is born, milk removal, through either breastfeeding or milk expression, 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 had been producing hormones that maintained the pregnancy. The sudden drop in these hormones, once the placenta is gone, signals prolactin to start working. Prolactin "tells" the breasts it is time to start producing large amounts of milk. A mother feels the result of prolactin when her milk "comes in" about 3 to 5 days after birth. Increased milk production usually occurs at this time even if a baby has not been breastfeeding well or often. However, frequent breastfeeding or milk expression sometimes speeds up the process of establishing increased milk production. Occasionally, a mother has 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 to keep your breasts drained.
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, a baby must latch deeply onto the breast and use the structures in their mouth to create intermittent suction and squeeze milk into their 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.
So if your baby is premature or sick and unable to remove milk effectively enough to stimulate and maintain your milk production, you will need to express milk until they are stronger.
Milk transfer also can be done 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. "Hands-on pumping" is a technique combining breast massage and pumping, which helps maximize milk supply in mothers of premature infants.