Pumping for a Preemie in the NICU - Mothering Forums

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Old 07-01-2006, 12:15 AM - Thread Starter
 
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Does anyone have any good resources for me? My daughter was born 15 weeks early & I've been pumping & I am just starting to get some colustrum... I know it's going to be a long haul so I'm looking for any advice & info!
Thanks!

Jayme-
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Old 07-01-2006, 01:05 AM
 
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Sorry, I don't have much time to write much right now...



My DS was born at 30 weeks 2lbs. 13.8 oz. , I pumped for him until he was able to nurse and eventually switched to nursing completely. He is 18 months and still going strong.
When was she born?
If you haven't seen a Lactation Cons. yet, do so, ASAP! Pump as often as you can. If you pump like crazy now you can get a good stash going before your daughter needs it. (I'm assuming she's on TPN, or soon to be)
Hang in there! Eat heartily, get help from as many people as you can with childcare, meals, chores ect.

Ask me anything! I may not be able to help but I'll try. And remember she is YOUR daughter. You have the right to ask questions and make decisions in the NICU!

ETAne more thing Dr. Sears has a good preemie book
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Old 07-01-2006, 04:31 AM - Thread Starter
 
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She was born this past Tuesday, she's not ready to eat yet...
I've talked to a lactation consultant, and they've hooked me up with a great pump- right now I am pumping every 3 hours or so. I've nursed my others, so hopefully my body will work for me!

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Old 07-01-2006, 10:27 AM
 
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My DD was born 12 wks early and so I pumped like crazy for what seemed like forever!!
I second the LC!
Also LLL has a book "Breastfeeding Your Premature Baby" that was helpful (once the stress level dropped enough where I could read). Also a good general Preemie book is good for a reference when all those medical terms start to get thrown around.

Pretty much I pumped every 3 hours around the clock. I was so stressed about getting enough BM for DD and being able to nurse her eventually that there were times I was pretty wiggy about pumping (DH finally got me to go to his Aunt& Uncles house for an afternoon - only to have electricity go out right when I REALLY needed to pump - had a total melt down until we were able to leave to get back to RMcD house!). DD didn't have any BM until she was 10 days old and then it was only 1cc - so it is OK that a lot of those first pumping sessions only get a few oz - freeze it in small doses. We had TONS of frozen by the time we got out of the NICU...which was great for us.

Try to get baby on breast as soon as she is able. This will probably be a little while for a 15 wk early baby. I think it was around 32-33 wks for DD and then it was a dry breast (pumped first) and the nurse fed her through the NG tube while I had her there - to start getting her the idea that this is where her food will come from.

She will probably be given a pacifier to help develop her sucking muscles - it is ok (although I would suggest breaking the habit prior to 18m as now DD can't possibly LIVE w/o hers). I was terrified about nipple confusion so DD didn't get a bottle until 3 day prior to leaving the NICU (when they had to take out the NG tube and make sure she was still gaining). She is our first so I was able to be at NICU all the time and once we started to BF it was great and I (with LC & Dr approval) kept increasing the # of feedings that we did once they made sure she was gaining weight. By the end I was BFing all the time except the midnight & 3am feedings - DH gave DD her first bottle of EBM at the midnight feedings.

Some helpful things - some which you probably know - Drink lots of water. Try to pump next to baby's isolet - They had screens they could put up in our NICU.
Kangaroo Care once Dr OKs it is awsome for both baby's development and for you and your supply!! Not bad for Dad either!

With other kids it is hard and probably more stressful having a little one in the NICU - but try and get as much help as possible and get some rest when you can. Know that while it is good for you to be with your preemie as much as possible when you can't be there the Nurses are awsome! and our NICU (I would think a lot of them) have volunteers that come and spend time with all the babies.
As crissei said - you are your babies parent - the NICU environment is very intimidating but you are your babies advocate!! If something doesn't look right or you do not understand something ASK - even if it is for the second or third time. Keep a little notebook with you to write things down in! This is great for questions that come up when you don't have anyone around to ask and it is also great to look back on when you get out of NICU! The nurses are great and no one ever gave me a hard time when I asked the same question for days in a row. (stress will do that to you!).

GL and Congratulations on your new DD!! If you have any questions don't hesitate to ask!!!
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Old 07-01-2006, 10:41 AM
 
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I've been pumping exclusively for 11 months and no formula! it can be done. the schedule that works to keep up most people's supply is;

-8x per day for the first 3 months. you can sleep a stretch of 5-6 hrs at night if you want to, just make up for it with an extra pump. it doesn't have to be every 3 hrs, it can be every 2 or 2.5 or whatever is working for you.
-20 minutes per session of double pumping with a rented hospital grade pump. though some people have luck with the medela pump in style or other high quality store pumps.
-after three months you can go down to 6 times a day, eventually you can shave more off, I'm at 4x now, it does get easier and it helps to know that but just go one day at a time. I feel it is going to be extremely difficult for you to keep up with this schedule with so many other children, you are a wonderful mother to even try.

I encourage you enormously to try and keep going as long as possible. I'm sure you have been told about the power of breastmilk in helping to prevent necrotizing enterocolotis (sp?) and the other important benefits especially for preemies. Please join us in this group, there are lots of mothers who had preemies:

http://groups.yahoo.com/group/EPers/


DD1 7/13/05 DD2 9/20/10
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Old 07-01-2006, 12:04 PM
 
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nak
What I loved about pumping for DS while he was in NICU was that it was something I could do for him to help him get better faster. Even when I wasn't with him, I still took care of him by doing this. I found it very hepful to have pictures of him at home to look at while pumping. Also, I called to check on him for each feeding I missed, and aligned my pumping schedule with his feeding schedule. I had more production when i pumped at his bedside and after kangaroo care. Oh, and I had many visits with the LC - use them as much as possible. If you don't have a deep freeze, you should consider getting one. You may be able to get a car adapter for your pump which can help you feel not so tied down.

My baby went home completely on breast - no bottles, but he wasn't as young as yours. They just kept telling me over and over that he wouldn't but he's a real boob baby Good Luck to you.
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Old 07-01-2006, 02:31 PM - Thread Starter
 
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Quote:
Originally Posted by Kathi13
My DD was born 12 wks early and so I pumped like crazy for what seemed like forever!!
I second the LC!
Also LLL has a book "Breastfeeding Your Premature Baby" that was helpful (once the stress level dropped enough where I could read). Also a good general Preemie book is good for a reference when all those medical terms start to get thrown around.

Pretty much I pumped every 3 hours around the clock. I was so stressed about getting enough BM for DD and being able to nurse her eventually that there were times I was pretty wiggy about pumping (DH finally got me to go to his Aunt& Uncles house for an afternoon - only to have electricity go out right when I REALLY needed to pump - had a total melt down until we were able to leave to get back to RMcD house!). DD didn't have any BM until she was 10 days old and then it was only 1cc - so it is OK that a lot of those first pumping sessions only get a few oz - freeze it in small doses. We had TONS of frozen by the time we got out of the NICU...which was great for us.

Try to get baby on breast as soon as she is able. This will probably be a little while for a 15 wk early baby. I think it was around 32-33 wks for DD and then it was a dry breast (pumped first) and the nurse fed her through the NG tube while I had her there - to start getting her the idea that this is where her food will come from.

She will probably be given a pacifier to help develop her sucking muscles - it is ok (although I would suggest breaking the habit prior to 18m as now DD can't possibly LIVE w/o hers). I was terrified about nipple confusion so DD didn't get a bottle until 3 day prior to leaving the NICU (when they had to take out the NG tube and make sure she was still gaining). She is our first so I was able to be at NICU all the time and once we started to BF it was great and I (with LC & Dr approval) kept increasing the # of feedings that we did once they made sure she was gaining weight. By the end I was BFing all the time except the midnight & 3am feedings - DH gave DD her first bottle of EBM at the midnight feedings.

Some helpful things - some which you probably know - Drink lots of water. Try to pump next to baby's isolet - They had screens they could put up in our NICU.
Kangaroo Care once Dr OKs it is awsome for both baby's development and for you and your supply!! Not bad for Dad either!

With other kids it is hard and probably more stressful having a little one in the NICU - but try and get as much help as possible and get some rest when you can. Know that while it is good for you to be with your preemie as much as possible when you can't be there the Nurses are awsome! and our NICU (I would think a lot of them) have volunteers that come and spend time with all the babies.
As crissei said - you are your babies parent - the NICU environment is very intimidating but you are your babies advocate!! If something doesn't look right or you do not understand something ASK - even if it is for the second or third time. Keep a little notebook with you to write things down in! This is great for questions that come up when you don't have anyone around to ask and it is also great to look back on when you get out of NICU! The nurses are great and no one ever gave me a hard time when I asked the same question for days in a row. (stress will do that to you!).

GL and Congratulations on your new DD!! If you have any questions don't hesitate to ask!!!
Thanks for all the info!
I am feeling fortunate that I was able to nurse my other children, so I don't have as many doubts about my body knowing what it's doing...
I know it's going to be a long time before I can even think about nursing her, and I know she needs my milk & it's the one thing I can do for her

Jayme-
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Old 07-01-2006, 02:32 PM - Thread Starter
 
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Quote:
Originally Posted by bri276
I've been pumping exclusively for 11 months and no formula! it can be done. the schedule that works to keep up most people's supply is;

-8x per day for the first 3 months. you can sleep a stretch of 5-6 hrs at night if you want to, just make up for it with an extra pump. it doesn't have to be every 3 hrs, it can be every 2 or 2.5 or whatever is working for you.
-20 minutes per session of double pumping with a rented hospital grade pump. though some people have luck with the medela pump in style or other high quality store pumps.
-after three months you can go down to 6 times a day, eventually you can shave more off, I'm at 4x now, it does get easier and it helps to know that but just go one day at a time. I feel it is going to be extremely difficult for you to keep up with this schedule with so many other children, you are a wonderful mother to even try.

I encourage you enormously to try and keep going as long as possible. I'm sure you have been told about the power of breastmilk in helping to prevent necrotizing enterocolotis (sp?) and the other important benefits especially for preemies. Please join us in this group, there are lots of mothers who had preemies:

http://groups.yahoo.com/group/EPers/

Thanks so much for the link!

Jayme-
Boy13, Boy12, Boy10, Girl7, Girl5, Twin Boys 6/14/09
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Old 07-01-2006, 02:33 PM - Thread Starter
 
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Quote:
Originally Posted by PMolly
nak
What I loved about pumping for DS while he was in NICU was that it was something I could do for him to help him get better faster. Even when I wasn't with him, I still took care of him by doing this. I found it very hepful to have pictures of him at home to look at while pumping. Also, I called to check on him for each feeding I missed, and aligned my pumping schedule with his feeding schedule. I had more production when i pumped at his bedside and after kangaroo care. Oh, and I had many visits with the LC - use them as much as possible. If you don't have a deep freeze, you should consider getting one. You may be able to get a car adapter for your pump which can help you feel not so tied down.

My baby went home completely on breast - no bottles, but he wasn't as young as yours. They just kept telling me over and over that he wouldn't but he's a real boob baby Good Luck to you.
That is exactly how I feel! There's not much I can do for her, but pumping so she gets my milk makes me feel like I can contribute to her care

Jayme-
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Old 07-01-2006, 02:50 PM
 
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nak

32w twins here...

pump often! every 2 hours if you can, sleep 2, 4-hour stretches at night

start kangaroo care, and let them lick/smell/be close to the breast. babies CAN do it on vent/cpap... although you will have to find the nurses willing to deal with all the cords

find the bf-ing friendly nurses and request that they sign up for primary care of your baby

you dont have to give bottles, ever. our twins were fed with their ng tube until two days prior to going home. i was at 2-3 breastfeeding sessions per day and we roomed in with them 48-hours before discharge solely bf-ing to make sure they did well. babies do not learn to bottle feed better or faster than they learn to bf.

some babies can latch prior to when they are "supposed to" latchon according to milestones in books. try as early as you can. i had one twin latched on for 3-5 min. at a time at 32.5 weeks.

domperidone is okay in the u.s. now... request it before you see supply issues so you will have it at the ready. our ibclc was cool w/ fenugreek too and that worked well for me and no issues with the girls.

hang in there! take care of you and dont stress too much trying to spend every minute in the nicu. pumping is honestly one of the best things you can do for a preemie, (k-care too, when you are present at the nicu), in my book.
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Old 07-02-2006, 04:43 AM - Thread Starter
 
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Quote:
Originally Posted by balawre
nak

32w twins here...

pump often! every 2 hours if you can, sleep 2, 4-hour stretches at night

start kangaroo care, and let them lick/smell/be close to the breast. babies CAN do it on vent/cpap... although you will have to find the nurses willing to deal with all the cords

find the bf-ing friendly nurses and request that they sign up for primary care of your baby

you dont have to give bottles, ever. our twins were fed with their ng tube until two days prior to going home. i was at 2-3 breastfeeding sessions per day and we roomed in with them 48-hours before discharge solely bf-ing to make sure they did well. babies do not learn to bottle feed better or faster than they learn to bf.

some babies can latch prior to when they are "supposed to" latchon according to milestones in books. try as early as you can. i had one twin latched on for 3-5 min. at a time at 32.5 weeks.

domperidone is okay in the u.s. now... request it before you see supply issues so you will have it at the ready. our ibclc was cool w/ fenugreek too and that worked well for me and no issues with the girls.

hang in there! take care of you and dont stress too much trying to spend every minute in the nicu. pumping is honestly one of the best things you can do for a preemie, (k-care too, when you are present at the nicu), in my book.
Thanks for the tips & advice
I think I know you from the CD community on LJ- I'm blognotfound over there

Jayme-
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Old 07-02-2006, 11:17 AM
 
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34 week preemie here so he was the big guy in the nicu and we made it to breast (via nipple shield) quickly.

You mentioned you're getting some colostrum now. Maybe having nursed others you are getting more than I did as a first timer but I was only putting out drops at first. The nurses gave me a special syringe to collect them (sticky stuff that) and then gave him any few mLs I could collect. It wasn't much but it was something even then.

Otherwise, I tripple the K-care suggestion and would just add a vote for Dr Sears preemie book. Our nicu had a copy parents could borrow and read at the hospital. Good info there.

Edited to qualify that by quickly I mean we made it to fulltime breast by his due date. Maybe that's not really so quick.
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Old 07-02-2006, 01:15 PM - Thread Starter
 
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34 week preemie here so he was the big guy in the nicu and we made it to breast (via nipple shield) quickly.

You mentioned you're getting some colostrum now. Maybe having nursed others you are getting more than I did as a first timer but I was only putting out drops at first. The nurses gave me a special syringe to collect them (sticky stuff that) and then gave him any few mLs I could collect. It wasn't much but it was something even then.

Otherwise, I tripple the K-care suggestion and would just add a vote for Dr Sears preemie book. Our nicu had a copy parents could borrow and read at the hospital. Good info there.

Edited to qualify that by quickly I mean we made it to fulltime breast by his due date. Maybe that's not really so quick.
I am only getting drops too right now, and using syringes to suck them up & store them in the freezer

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Old 07-02-2006, 02:39 PM
 
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Quote:
Originally Posted by balawre
nak

32w twins here...

pump often! every 2 hours if you can, sleep 2, 4-hour stretches at night

start kangaroo care, and let them lick/smell/be close to the breast. babies CAN do it on vent/cpap... although you will have to find the nurses willing to deal with all the cords

find the bf-ing friendly nurses and request that they sign up for primary care of your baby

you dont have to give bottles, ever. our twins were fed with their ng tube until two days prior to going home. i was at 2-3 breastfeeding sessions per day and we roomed in with them 48-hours before discharge solely bf-ing to make sure they did well. babies do not learn to bottle feed better or faster than they learn to bf.

some babies can latch prior to when they are "supposed to" latchon according to milestones in books. try as early as you can. i had one twin latched on for 3-5 min. at a time at 32.5 weeks.

domperidone is okay in the u.s. now... request it before you see supply issues so you will have it at the ready. our ibclc was cool w/ fenugreek too and that worked well for me and no issues with the girls.

hang in there! take care of you and dont stress too much trying to spend every minute in the nicu. pumping is honestly one of the best things you can do for a preemie, (k-care too, when you are present at the nicu), in my book.
nak -- great advice! Bottles mess things up, it took 5 months of perseverance before one of my babies started actually bfing and now at 9 months my smaller baby will only actually breastfeed 2-3X per day at most. I was discouraged from putting them to breast AT ALL in my NICU -- but wish I could have gone back now and asserted myself(but first kids, recovering from c-section, scared etc oh well). I do recommend definately letting them have the micropreemie pacifiers...the poor things are like little pincushions in there and having something to suck is healthy for them since all they do is lie there all day.
Good luck -- it is a hard road as I'm sure you have been told, our prayers are with you and your little one!

--Amanda
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Old 07-03-2006, 12:06 AM
 
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My DD#1 was 7 weeks early, but had no suck swallow. The nurses and drs told me we'd never get out of the NICU EBF, but we did! I pumped like CRAZY the whole time. I pumped every three hours or so. We'd go in and see her, do kangaroo care, change her diaper and feed her, then I'd go and pump. I pumped for 20-30 mins each time. I made sure that I was drinking TONS of water and did massage (stood up while pumping so breasts were hanging down and massaged them towards the ground) while pumping. I also almost always had something of hers near me while pumping, a shirt, some booties or whatever. That kind of helped me feel like she was close, since I couldn't hold her and pump.

We did a ng tube (but convinced the drs to use one we could just leave in). I'd put her to the breast and let her nuzzle it/hold it in her mouth and then then the nurses would put milk in her ng tube. That way she got the feeling of fullness from breastmilk while she was at the breast. She really had a difficult time nursing until we got a nipple shield and then she caught on right away. I would definitely look into that as an option because their little mouths don't have much strength and the shield can really help them draw the milk easily.

I'm sending you tons of hugs and prayers. I hope your little one grows quickly!!

Olivia

SAHM to four beautiful babes :
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