Breastfeeding in the NICU - Mothering Forums

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Old 06-17-2010, 03:49 PM - Thread Starter
 
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A friend of mine had a baby on Monday but he has been in the NICU (recieving only IV fluids) since then. She has been pumping every few hours and labeling/numbering the containters. She knows she has to give the colostrum first but does it matter what order the milk goes into baby after that? Is there special stuff in the milk beyond the colostrum stages? He'll be getting around 5ml at a time starting today. Also, what is the best way to warm the milk w/out ruining everything in it (esp. the colostrum). I've had 18 years experience in breastfeeding but little to no experience in pumping so I'm no help to her!! Thanks in advance!!

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Old 06-17-2010, 03:56 PM
 
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I would just go by dates and time. Give the oldest milk first.

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Old 06-17-2010, 04:07 PM
 
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She might find that the doctors will want to give any freshly pumped milk first (after the colustrum). My NICU did. They told me that there was a loss of nutrients in the freezing and warming process. I never checked this out myself; I just put everything in a deep freeze knowing I would eventually use it all anyway (and I did pull oldest frozen first when necessary).
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Old 06-17-2010, 04:12 PM
 
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When ds was in the NICU, they'd give him oldest first, and warm it up by putting the bottle of frozen milk into a cup of warm water. It doesn't really take long to thaw out that way.

With the colostrum, since there was so little of it, they would take it out of the jar I pumped into with a syringe and feed him from that.

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Old 06-17-2010, 04:15 PM
 
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Are they giving the milk in the tube or a bottle?

If he is still in the NICU they will likely just let the milk defrost at room temperature.

They probably won't warm it if they are not giving it in a bottle. If they do want to give a bottle I would skip it and go directly to breastfeeding.

My son was in the NICU and had the tube as well and that is what we did.

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Old 06-17-2010, 04:48 PM
 
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Are they giving the milk in the tube or a bottle?

If he is still in the NICU they will likely just let the milk defrost at room temperature.

They probably won't warm it if they are not giving it in a bottle. If they do want to give a bottle I would skip it and go directly to breastfeeding.

My son was in the NICU and had the tube as well and that is what we did.
DD1 was in the NICU and couldn't breastfeed from the breast until day 12 because she had IV lines in her belly button and they wouldn't let me hold her 'belly to belly' to nurse her. So we fed her by tube and then bottle and then breast.

(maybe now, 4 years older and wiser, I might be inclined to question the IV reasoning, but I didn't then... and despite not nursing until day 12 she's still nursing now at 4!)

I pumped into small containers and then we warmed them up in a bowl of lukewarm water. Since it was such a small amount it didn't take long at all to warm the milk.

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Old 06-17-2010, 05:00 PM
 
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DD1 was in the NICU and couldn't breastfeed from the breast until day 12 because she had IV lines in her belly button and they wouldn't let me hold her 'belly to belly' to nurse her. So we fed her by tube and then bottle and then breast.

(maybe now, 4 years older and wiser, I might be inclined to question the IV reasoning, but I didn't then... and despite not nursing until day 12 she's still nursing now at 4!)

I pumped into small containers and then we warmed them up in a bowl of lukewarm water. Since it was such a small amount it didn't take long at all to warm the milk.
My son just had the tube that went from his nose to his tummy and an IV in his head. They were going to feed him through the tube but they decided to let me BF him instead.

I had already BF him before he was transferred to the NICU from the hospital he was born at so that might have affected the decision.

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Old 06-17-2010, 05:07 PM
 
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My son just had the tube that went from his nose to his tummy and an IV in his head. They were going to feed him through the tube but they decided to let me BF him instead.

I had already BF him before he was transferred to the NICU from the hospital he was born at so that might have affected the decision.
Yeah, I figured our experiences were a bit different, but not knowing the OP's friend's situation I thought I'd toss our story into the ring.

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Old 06-17-2010, 05:11 PM
 
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Yeah, I figured our experiences were a bit different, but not knowing the OP's friend's situation I thought I'd toss our story into the ring.
He failed his apgar test and was immediately put into cooling and she has not gotten to hold him or an opportunity to nurse, if that makes any difference. I know the OP's friend's situation. She had placental abruption.

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Old 06-17-2010, 05:28 PM
 
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When DD was taking those tiny 5 ml feeds it was always by tube. They would draw up the amount into a syringe and just put it in the incubator with her for a while to heat up.

Once she started taking larger amount we'd measure it into a bottle and put the bottle in a dish of warm water to heat up. then she was either cup or tube fed.

II seem to remember microwaving bottles of breast milk is not recommended as it does something to the milk but I don't see how you could microwave such a small amount anyway.

I hope you friend gets to hold and feed her little one soon. It's so hard not to be able to do such basic things.
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Old 06-17-2010, 06:04 PM
 
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Originally Posted by ekblad9 View Post
A friend of mine had a baby on Monday but he has been in the NICU (recieving only IV fluids) since then. She has been pumping every few hours and labeling/numbering the containters. She knows she has to give the colostrum first but does it matter what order the milk goes into baby after that? Is there special stuff in the milk beyond the colostrum stages? He'll be getting around 5ml at a time starting today. Also, what is the best way to warm the milk w/out ruining everything in it (esp. the colostrum). I've had 18 years experience in breastfeeding but little to no experience in pumping so I'm no help to her!! Thanks in advance!!
someone from my ddc 4 years back alerted me to this, so here I am!!!

I had a nicu baby in 2/06 and was in the 6/06 ddc. So an early baby, I too started pumping right away after she was born. I didnt get anything the first or second time I pumped, but 48 hours after, I had 7 little bottles of colustrum.

Can I suggest freezing the milk in 1/4 cup amounts for a while and then in 4 oz amounts. The baby when getting milk will only get 1-20 cc's of milk at first and they will take it slowly.

If she is pumping around the clock like I did, GET A HOSPITAL GRADE PUMP. the pump n style is fine for a few pumpings a day, but it will cut your production in half within 2-4 weeks.

Pump around the clock every four hours and for 15 minutes only. You can rest at night for 6 hours but pump right after.

if need be, pm me and I can go from there...
Label each and every pumping by date and time of day you pumped it. Your early in the morning pumping has less calories and they will want to use it over time not all at once.

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Old 06-17-2010, 06:08 PM
 
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She knows she has to give the colostrum first but does it matter what order the milk goes into baby after that?

Earliest first and go that way.



Is there special stuff in the milk beyond the colostrum stages?
The milk is designed esp for that baby. The mother's body knows if it was early, if the baby was sick etc. It will have stuff in it that is healing for the baby. Make sure he gets it!!



He'll be getting around 5ml at a time starting today. Also, what is the best way to warm the milk w/out ruining everything in it (esp. the colostrum).

The hospital will warm it in a closed bottle, jar etc and merge it in a warm water bath to defrost. dont shake it up!!

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Old 06-17-2010, 06:24 PM
 
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the order of the milk thing was kind of confusing but i had 2 preemies and stays in 3 different nicus- they all did it the same.

freshest first. so if you pump right before a feed- that's what they'll want to use. second choice is any milk that's been refrigerated. once it's been frozen, they will use the oldest first.
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Old 06-17-2010, 08:16 PM
 
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THANK YOU AMY!

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Old 06-17-2010, 08:33 PM
 
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freshest first. so if you pump right before a feed- that's what they'll want to use. second choice is any milk that's been refrigerated. once it's been frozen, they will use the oldest first.
This is how our NICU did it, too.

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Old 06-17-2010, 10:20 PM
 
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my hospital used oldest first, but until she'd been there quite a few days, i was barely keeping up anyway, so the milk had often only been in the fridge for a few hours or maybe overnight. i don't think it'd make a huge difference what order she gives it in... not over a few days anyway...
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Old 06-19-2010, 02:26 PM
 
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Thank you all so much for taking the time to post. The information is very much appreciated. She got to breastfeed her little one yesterday afternoon for the first time and was up all night nursing him. I don't even know if they did the colostrum at all actually. I think she just put him to the breast first. Have to check on that, but most importantly, we are successfully nursing!

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Old 06-19-2010, 02:44 PM
 
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Thank you all so much for taking the time to post. The information is very much appreciated. She got to breastfeed her little one yesterday afternoon for the first time and was up all night nursing him. I don't even know if they did the colostrum at all actually. I think she just put him to the breast first. Have to check on that, but most importantly, we are successfully nursing!
Yay!

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