Pumping for my new Premie

[Amys1st]

We just had an unexpected arrival of our dd2 Margaret Patricia "Maggie" this week at 25 weeks. She is in the NICU and I started pumping about 2 hours after my emergency c section.

I have now pumped for 4 plus days and I am building my supply.

I want to talk to any mamas who have been there with their premie and what obstacles did you face etc. My 1st was the nurses looking at me strange when I pumped nothing after my surgery and said- thats to get the process going and then I showed them what I pumped when I left 2 days later-all 7 jars of colstrom. If they could see what I brought to the NICU yesterday and what is piling up in my freezer!!

Thankfully I know enough about nursing since I nursed dd1 until she clwd at 30 months.

So like I said before plus- how did the intial nursing session go, etc??

[lacysmommy]

I don't have any advice for you, but I wanted to give you my support. I'm so glad you're an informed mama and can make sure your baby is getting the milk she so desperately needs!

My sister was a dedicated pumper when her DS3 was in the NICU when he was teeny (for RSV when he was 4-8 weeks old, full term baby). She ended up filling half the fridge with her milk, and all the other pumping mamas had the other side of the fridge. She had to throw away a ton of milk afterward. Wishing you the same huge supply "problem" my sister had!

Love, Carolyn

[bri276]

I didn't have a preemie but have to pump exclusively because of my dd's cleft palate. It's SO important for your baby that you are doing this!! You're an awesome mama!

One thing I definitely reccomend is putting a sign in your baby's bassinett that reads "No formula please, BREASTFED baby". This will avoid any mistakes because unfortunately, most babies in the NICU are formula fed and often times nurses assume yours is too. Several times my dd was given Enfamil when there was plenty of clearly labelled perfectly good colostrum in the fridge.

I know especially with all the going back and forth and having another child to care for at the same time that you must be very busy but this group has offered me so much support and answered all my questions;
http://groups.yahoo.com/group/EPers/

here is a site with a whole list of other groups;
http://www.exclusivelypumping.com/web_resources.htm

a few things- the nicu guidelines are often much more strict than need be, they would throw away all milk after 24 hrs - if they do that to you, just take it home and freeze it instead, it's good for 8 days in the fridge and 4-6 months in the freezer (depending on how cold it is). general "rules" of EP'ing are 8-10 times per day for the first 12 wks, 20 minutes per session, hospital grade pump is best though plenty of ppl have had luck with a Medela Pump in Style. good luck! I sincerely hope you won't need this info for long and that Maggie will be a champion bf'er!

[sweetpeasmom]

Hello.
Welcome to the world Maggie
My dd Megan was also born at 25 weeks. I also quickly got a huge milk stash within the week and was told to stop bringing it since I had so much. I agree with pp about stated NO FORMULA and make it very clear to all the nurses. I had put on the card that if they noticed my bm was running low to call me before hand and not to give formula. They were instructed to call me at anytime and I would come down and give them more. Of course did they? most of the time no and I swear my milk dissappeared at times. I would keep track of your milk and read in the logs how much was given to your baby. Not so much in the beginning but afterwords.
But anyways, our first nursing session went well. But it went downhill from there and she gradually flat out refused my breast. Sadly I could only be there for 1 or 2 feedings a day, so she was primarily bottle feed. I kept trying and kept trying at home also. I did end up succeeding 6 mths after I brought her home and she is a nursing pro now still.
Good luck to you, be persistant, strong get all the support you can if they have a lc there. Feel free to pm me anytime

[gentlebirthmothr]

Originally Posted by bri276

One thing I definitely reccomend is putting a sign in your baby's bassinett that reads "No formula please, BREASTFED baby". This will avoid any mistakes because unfortunately, most babies in the NICU are formula fed and often times nurses assume yours is too. Several times my dd was given Enfamil when there was plenty of clearly labelled perfectly good colostrum in the fridge.

a few things- the nicu guidelines are often much more strict than need be, they would throw away all milk after 24 hrs - if they do that to you, just take it home and freeze it instead, it's good for 8 days in the fridge and 4-6 months in the freezer (depending on how cold it is). general "rules" of EP'ing are 8-10 times per day for the first 12 wks, 20 minutes per session, hospital grade pump is best though plenty of ppl have had luck with a Medela Pump in Style. good luck! I sincerely hope you won't need this info for long and that Maggie will be a champion bf'er!

Lily,

WOW didn't know about this in NICUs and I should of known all long.

Amy,

Congratz on the birth of Maggie, but to sorry that she is a premmie, but you are definetly her a better start life then most NICU moms as I know of would do. Hope will stop when she wants to wean.

Thank you.

[Attached Mama]

Congratulations on your new precious one!! Sorry for the difficulties tho. Well, I know nothing about preemies, but I just felt so proud of you that I had tears in my eyes when I read that you were pumping for her. I had to pump for a few wks for my DD just because she was small and didn't latch on well. It warms my heart to hear about loving mommies. I pray she will be out of the hsptl in no time and nurisng and growing like a champ.

[DaryLLL]

I don't have a premie but I have counseled moms with them.

Are they letting you do kangaroo care yet? Skin to skin once she is strong enough is a good thing for her growth and to get her used to your smell and feel, thereby readier for bfing.

The suckling reflex does not kick in til 35 wks gestation. But it might start earlier since she is out and learning more about the world.

Are you in touch with LLL and/or a IBCLC?

links about bfing a premie

http://www.kellymom.com/bf/preemie/preemie-links.html

[abbieandlady]

I have pumped and breastfed a preemie. I am also an on call support partner for our local nicu.

When my ds was in the nicu one of the nurses gave me some great advice. "BF is just like all other developmental milestones. Don't expect it to happen until the adjusted age would indicate that they should." IN other words don't expect to nurse until your baby reaches their due date.

Some Nicus will encourage nuzzling very early. This can actually lead to a lot more stress for you and baby.

I encourage mom's to refuse the docs in then nicu. Wait until you get home. Whenever you give a bottle do so topless and allow your little one to nuzzle at will. This is ecspecially effective if you pump some first so that the smell is strongest and the taste is there, but they don't have to work as hard for the let down.

Hang in there and don't stress about the artificial nipples. Preemies are more resilient than most babies and do very well.

[Ruthla]

Congrats on your new baby and I'm sorry she's so early. I hope she's able to come home soon.

[twins10705]

I had 29 weeker twins! If you need any advice or support you can PM or e-mail me anytime and I will be happy to tell you about my experience. I suffered from a low milk supply(and still do) I think part of this was that they didn't allow me to put the babies to breast even one time while they were in the hospital...looking back I wish I would have asserted myself!! They made me feel weird for wanting to try(and these are my first babies) and kept saying things about how they were too small etc...don't believe them! This is *your* baby and you do have a say(though they won't let you know that if they can help it). Find out if they do spoon or cup feeding(my NICU did not) -- if not, bring in your own slow flow bottle nipples...the nipples they use in the NICU are super fast flow..funny they are made by the formula companies and given FREE to the hospitals (I personally believe they are specifically designed to discourage breastfeeding)...your baby is not going to want to suckle for milk at your breast when she is used to having the milk literally poured down her throat with barely a suck. Around 30+ weeks GA they should begin to allow "non nutritive sucking" at your breast while being gavage fed -- push this issue....you should pump first..then have the baby experience your nipple if she wants to while eating...helps associate the full feeling with your breast. Around week 32 GA you should be able to actually breastfeed...if you can -- avoid all bottle feedings as long as possible and just have them gavage when you aren't there...of course one of the NICU criteria for the baby leaving is to "nipple" all feeds and gain weight...nipple can be either your breast or bottle.
Another thing - -they will want to "add calories" to your milk...they didn't even consult me and I didn't know I had a choice at the time....but if I could do it again, I would not add calories unless the baby was just not growing, kwim? The calories are just formula added to your milk -- they won't tell you that this greatly increases your baby's odds of developing NEC -- a devastating condition for preemies that often ends in loss of life....I would research it well beforehand if I were you...25 weekers can be so delicate, I think it should be criminal to feed them formula. They have this idea that formula is just fine for these tiny babies...they are ignoring the real stats.
If they are like my NICU -- they will want to give the hepB vax and RSV shot *before* leaving! That is a huge dose of toxic matter to inject into a baby that technically should not even be born yet -- research research research! is my best advice to you...the preemie SIDs death rate is 4X higher for a preemie.
E-mail if you have any questions about anything and I pray your little one is in good hands! Congrats on the new baby!

--Amanda

[abbieandlady]

Amanda,
Wow what a scary trip through the nicu it sounds like you had. Just to reassure not all nicus are like this. There are even some out there that house their own bm banks and won't allow the preemies to receive formual of any kind.

-Holly

[DaryLLL]

Originally Posted by abbieandlady

I have pumped and breastfed a preemie. I am also an on call support partner for our local nicu.

When my ds was in the nicu one of the nurses gave me some great advice. "BF is just like all other developmental milestones. Don't expect it to happen until the adjusted age would indicate that they should." IN other words don't expect to nurse until your baby reaches their due date.

This is incorrect. The suckling reflex begins at 35 weeks gestation. My own 37 weeker bfed just fine from birth.

Some Nicus will encourage nuzzling very early. This can actually lead to a lot more stress for you and baby.

I am not sure what you mean by stress. Why would you not want to be skin to skin with your own baby, no matter the age? You can do bottlefeeds skin to skin to let the baby get used to your smell and skin texture, as a prep for later bfing.

I encourage mom's to refuse the docs in then nicu. Wait until you get home.

This is contradicted by twins10705 experience. I agree that early skin to skin can increase your bfing hormones and milk supply.

[sweetpeasmom]

Some Nicus will encourage nuzzling very early. This can actually lead to a lot more stress for you and baby.

I'll have to totally disagree, sorry. But when we did try to bf in the beginning and it was when she was around 32 wks gestation, her stats actually were 100%, she needed no added oxygen like she did when she feed by bottle. She actually needed supplemental oxygen with her feeds by bottle all the way up to 38 wks gestation. So bf was totally less stressful for them. In Jack Newmans' Ultimate Breastfeeding Book, he actually has a little part on bf preemies and even says that research shows that bf is less stressful to a preemie than bottlefeeding and that sure seemed true the times we tried. She always had apnea and brady's while bottle feeding but yet never when we were bf.
I'd definitely do the skin to skin as much as possible, even while bottlefeeding! In the beginning she'll be feed through a tube, when she's stable to come out and you can hold her, do it skin to skin, while feeding through the tube. I wish I had known to do this while I was in the NICU but sadly I didn't.

I'll have to agree with not adding the added hmf's. She wasn't given any in the beginning but she did reach a stage where she was stuck at 2 lbs and was losing weight. They did add the hmf at that point and she did start to gain but they kept it up till discharge. Of course when i was there, i never added it and they even told me to do so after discharge, which i never did and she grew just fine.

[LaughingHyena]

I wish you all the best with your little one, pumping full time is hard but it is so worth it in the end. It was so hard to have this little baby that I really couldn't do much for except make sure she had my milk.

The first time she latched on and sucked was a magical moment for me, that was the first time I really felt like she was my baby. Until then I'd alway been worried that I wouldn't recognise her when I came in.

One thing that we fouund was that we really had to keep up with reading her notes and keeping track of her feeding times. It was all done on a schedule and the nursers were not good at remembering to call mums up from the ward to feed but would just EBM or formula at the set time. We tried hard to make sure that we always were around at the same times each day and that when we left we told the nurses when we would be back. I still think it sucks that we had to make all the extra effort but I do think it made a difference.

[Happypants]

just wanted to say thanks for the info and links that others have provided. some of the pumping links at kellymom are especially good. i just had a 26 weeker on saturday and came on here to post this very question.

[Lizzardbits]

:

Good luck to you mommas and your sweet babies

[twins10705]

Originally Posted by abbieandlady

Amanda,
Wow what a scary trip through the nicu it sounds like you had. Just to reassure not all nicus are like this. There are even some out there that house their own bm banks and won't allow the preemies to receive formual of any kind.

-Holly

I have also heard of NICUs who only use cloth diapers! It makes sense to me...I mean just how good can a perfumed pampers trapped inside an isolette with a respiratory distress baby really be?? I didn't know there were NICUs that had bm banks...it really is reassuring to know not everyone with a preemie will have to go through what I did....but I have a feeling the bm banking, cloth diapering NICUs are still in the minority....

--Amanda

[Sarah]

Best wishes to you Amy and Maggie! I hope that you are recovering from your surgery and that you are getting lots of support from the NICU staff... and if not from them- from MDC! I hope Maggie continues to thrive on your love and breastmilk. Sorry I can't offer any personal experience in the pumping advice stuff... my first baby was born early with an emergency c at 35 weeks, hardly technicly a preemie and nursed right off the bat (conveying that we didn't have to wait till the due date)

At the time of his birth I was on a mailing list with a woman whose daughter came very early 23/24 weeks I think) and she had a LOT of support from her neonatologists to pump for her baby... she became such a believer in the miracle the milk did for her daughter's thriving she went on to be one of the co-founders of the Austin Milk Bank!! Anyway- I think that the Austin Milk band does have a lot of information on their website about preemies and pumping- check it out! I think the correct name may be Mother's Milk Bank of Austin.

Love Sarah

[Amys1st]

Originally Posted by Happypants

just wanted to say thanks for the info and links that others have provided. some of the pumping links at kellymom are especially good. i just had a 26 weeker on saturday and came on here to post this very question.

Congrats on your new baby as well! I hope this info helps you as well. Please please keep in touch with me thru pm or whatever to watch our babies grow.


Also- I appreciate all the advice and I am sorry to any pps who had bad experiences in the NICU. We are very blessed to be near one of the finest NICUs in the Chicago area if not the country. The good thing- there are stats and studies etc posted everywhere about breastfeeding all over and given to the parents when they have their baby enter the nicu. Ten minutes after I delivered, when they showed up to transfer her there I stated our stand on attachment parenting and breastfeeding exclusively. The hardest thing for us was not being able to hold our baby but at 25 weeks, the cuddling actually is way too much stimulation. 25 and 26 weekers are a whole new ballgame compared to the ones in the 30 weeks. But my milk supply is plentiful and one thing a nurse told me was to store it in a small supply each so it dosent get tossed. So I have like a 1/2 inch in little jar. Also I am a very pro bfder as it is never mind for my new little babe. Its even more important that she gets the milk since this milk I am pumping is filled with even more nurtrients etc that my body could not supply in utero for the last trimester.

[sweetpeasmom]

The hardest thing for us was not being able to hold our baby but at 25 weeks, the cuddling actually is way too much stimulation

That was the hardest thing for me also. It was 3 weeks before we got to hold her and even that it was only for a few minutes.