Avoiding plugged ducts & weaning off the bottle

[SAMarshall]

I'm wondering if anyone has any advice about how to prevent plugged ducts/mastitis while exclusively pumping. I'm really paranoid about this! With my first, we had a delayed start due to him being in the NICU, then he was just not a great eater in general and I ended up with a few cases of plugged ducts, which was miserable. 

Right now, I am looking at exclusively pumping for my 3rd child, who was just born on Tuesday, December 27th at 28 weeks gestation. It could be anywhere from 3 weeks to 3 months with him in the NICU, and I am definitely wanting to give him all breast milk. I'm just really worried that I am not getting all the milk out as I pump and I will end up with plugged ducts, which will really mess up my supply and I won't have enough milk for him in the NICU. 

What are some tips for avoiding plugged ducts?

I am really hoping to start a breastfeeding relationship with my son while he is in the NICU, but I can only visit him once a day (if that) for a short time. I know he will be primarily bottle-fed until he goes home and I can really work with him on breastfeeding. 

Along those lines, does anyone have any experience with weaning a young infant completely off of bottles and onto the breast? My goal is to get rid of the bottles completely once he is home. 

It hasn't even been one week yet, and I can tell this is going to be quite a challenge! Any help would be great. Thank you!

[Mama2ChicknLil]

First, congrats on you rbaby, and I'm so sorry that you are seperated from him right now ;(

Do you have a hospital grade pump? If not get one!! How many ounces are you pumping (combined) at a session? Also, though I know this is not what most people are told (believe me, I've been one of the super freaked out: OMG you have a plugged duct! types), most plugged ducts will resolve themselves qithin 48 hours. Stay hydtrated, Ibuprofen for the pain, and get as much rest as you can, which I know is hard because you are worried about your babe.

Once baby is ok'ed as a "feeder and a grower", demand skin to skin. Talk to the head of the NICU if you have to, once baby is stabilized (some would argue that the skin to skin WOULD help stabilize baby) there is no medical reason not to allow it.

I have had 2 clients whose babies started in the NICU who went on to EBF through 6 months, and both were still BF at the end of the program (around 9 months). It is possible mama! And you are amazing for wanting it to work.

Secondly, look into lecithin supplements:

http://www.kellymom.com/nutrition/vitamins/lecithin.html

Just make sure you are pumping as much as you would be feeding baby. This may actually lead to you having some oversupply, at least to begin with, but one thing at a time right? Is there and IBCLC you can speak with at the hospital? Work out a gameplan for getting baby on the boob?

Breast compressions while pumping will help you get out as much milk as possible...Dr Jack Newman has great information on how to do that.

Good luck!!

[Megan73]

Good advice from the PP.
A couple of things...
I'd post your question in the NICU and preemie parenting forum for advice from BTDT mamas.
I'd also make sure that the flanges that you use with the hospital grade pump are the correct size - many women need larger ones.
Here's a video on increasing pumping output while pumping: http://newborns.stanford.edu/Breastfeeding/MaxProduction.html
I would start looking NOW for a really good LC you click with to work on the transition from breast to bottle.
Congratulations on your new babe. I hope he's home soon.

[SAMarshall]

Thanks for the advice! It's pretty exhausting doing all this pumping while taking care of two toddlers and trying to visit the hospital every day! I'm working on establishing a routine with everything and we're getting there. 

There are some LC's available to talk to in the NICU, so I will definitely use them if I have more questions. I have a Medela pump-in-style from about 3 1/2 years ago and it seems to be doing the job. I can also use the pumps at the hospital if I need to. I'm not usually there long enough to need them, though. 

I really hope this works out for the best and I can provide enough milk for my son. They started giving him milk yesterday and he seems to be doing well with it. And hopefully I can try to breastfeed him in a couple of weeks when he gets his sucking reflex. I am trying to take things one day at a time and hope for the best!

[RedSamhain]

Hey, congratulations on your new little one!  I've been exclusively pumping for my daughter since she was born in November, I find that the plugged ducts are really not difficult to deal with.  I put a hot water bottle on the plugged area for about 10 minutes at a time and massage inward from the area furthest from the nipple towards the nipple while pumping and that usually takes care of it in one or two pumping sessions,

I wish you all the best, please keep your chin up you're doing a great job for your little one and you should be proud of what a good mother you are.

[SAMarshall]

Thanks for the tips!

It's been 4 weeks now and so far I have not had any major issues.

I just remember with my first, I got plugged up so frequently that I am very paranoid about it now. I used to have to stand in a hot shower with one of those thick hair combs and run it down toward the nipple with a lot of force! It looked liked I had been attacked by a wild animal after I was done! (The redness would go away soon after.) I always read, "try feeding your baby more often to relieve the plugged ducts." Well, my son was not one of those comfort nursers. If he was not hungry, he would not eat at all! I'm very glad that I had a pump, but it didn't always work very well.

Anyway, things are going well. I've had a few small instances, but massaging and heat has been helpful. Hopefully I can put this all behind me soon!