Getting mirco preemies to nurse - Mothering Forums

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#1 of 21 Old 07-06-2008, 07:25 PM - Thread Starter
 
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I know this is quite a bit down the road for me but I'm looking for advice now. My son was born at 32 weeks and I pumped for him while he was in the nicu and until he was 3 months old but we never quite figured out nursing. I'll admit, I was young, uneducated, had a complete lack of support, and was in an abusive relationship.
I successfully nursed my daughter, who was born at term, until she self weaned at 2 years old.
My boys are tiny right now and I am using the Medela Symphony and pumping every 2-3 hours, and waking once during the night to pump. I'm currently getting about 4oz. total every time I pump and about 7oz. during my night time pumping session.
I know the time will come when I will be able to try to nurse my babies and to be honest, I'm terrified. I still have so much guilt about how I handled things with my son and I'm afraid that because these guys are so early, they just won't get it. Add in the fact that there's 2 of them.
So, what are the chances of getting a micro preemie to nurse when the time comes?
I have Mother's Milk tea that I plan to start drinking but my midwife warned me that there were mixed studies on the safety of taking fenugreek and feeding preemies. I plan to talk to the nicu doctor about the safety of fenugreek and see what they suggest.
I guess that brings me to another question, what things can I do to help keep up my supply until they're ready to nurse? I'm already using the hospital grade pump, I don't know that I could pump more often than I already am since I'm home with 2 other children who need me. I'm trying to eat proper meals, lots of oatmeal for breakfast, making sure I'm hydrated.
My hubby has been more than supportive of me pumping and when he's home, he takes almost complete control of the house and kids so that I can rest and pump. Should I try to pump extra at night and on the weekends?
Thanks in advance. I wanted to try to search for all of this info but I'm not sure if the search function will be working anytime soon and I want to try to prepare myself as much as possible.

Lindsey- SAHM to Skylar (7-12-01), Leah (10-29-04), id twin boys Addison and Riley (6-17-08, born at 25w4d), and Terran (5-29-11, born at 28 weeks)

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#2 of 21 Old 07-06-2008, 07:36 PM
 
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Firstly, it's FANTASTIC that you pumped for three months under those circumstances!

I was told the same thing about Fenugreek. I can't remember what the reason was, but our LC said that while DD was still little I shouldn't take it, but once she was older/bigger it was fine. As far as milk production goes, 4oz sounds excellent to me! I only got half of that at a session. Are you getting kangroo cuddles? If you are, try to schedule those for before you're due to express, baby cuddles can do wonders for your supply.

I didn't successfully breastfeed DD because I just needed to get home before I went totally insane. A lot of other micro mama's I know DID. In fact, our hospital had a very success rate of mothers who wanted to breastfeed and went home with a fully breastfed baby. Of the micros in our 'group' (things seemed to work in cycles, lost of micros born, then lots of bigger babes, then lots of sick full term babies) Erin was the only who went home bottle fed. The rest were breast fed - there were five of us. Most of the mama's did need to use a nipple shield as their babies mouths were too small to latch well, but that seems like a small price to pay.
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#3 of 21 Old 07-06-2008, 08:18 PM - Thread Starter
 
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I haven't been able to hold either of them yet as their not stable enough. We almost got to a point with Riley where there were talks of him being held but they think he's now starting an infection.
I will bring up holding Addison when I go in tomorrow since he's not on any IV's at all, tolerating full feedings, but is still on the ventilator. The last time I asked about holding them, they were concerned that he wouldn't be able to sustain his temperature. For the record, the last time they were weighed, Addison was 1lb. 6oz. and Riley was 1lb. 4oz. (both up one ounce over their birth weight)

Lindsey- SAHM to Skylar (7-12-01), Leah (10-29-04), id twin boys Addison and Riley (6-17-08, born at 25w4d), and Terran (5-29-11, born at 28 weeks)

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#4 of 21 Old 07-06-2008, 08:31 PM
 
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I wasn't able to hold Erin until she was 6 weeks old and nearly a 2 lbs because she was so unstable so I understand how hard it is. She was ventilated when I held her though so that shouldn't stop you (provided he is otherwise okay). I hope you get a cuddle, I'll keep my fingers crossed for you.
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#5 of 21 Old 07-06-2008, 08:44 PM
 
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skylarsmama-I have nursed both of my kids for 2.5-3 years. If I were you I would pump every chance I have. Nursing will help your babies fight off infection and help develop their systems. My daughter is 3 years old and has never been to the doctors for anything but immunizations. My 9 year old has been sick only a few times. Both of my kids are thin, healthy, and intelligent. This is your chance to really give them a boost. If you do not pump often then your supply will decrease and your babies will not be able to nurse. Its ironic but when I was pregnant with my first child my friends were betting I would never even nurse. However, I outnursed them all. I thought I would try for 6 weeks at most. Then six weeks became 6 months and 6 months became 2.5 and 3 years. Try to pump every free minute you have. Put the milk in the freezer and store it. I wish you luck with the babies. Keep us posted.
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#6 of 21 Old 07-06-2008, 11:36 PM
 
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I had a really hard time keeping up with my daughter's supply and she never was able to nurse efficiently enough to cut out tube feedings. I had to start doing A LOT of pumping around 3mos. I'd pump every 3hrs and then in the evenings when I'd come home from the NICU I'd pump about 15min, through two let downs, every 30min and continue that cycle for about 4-6hrs until I went to bed. It seemed to help a lot at increasing my supply. I did start taking Domperidone shortly after my daughter's birth because my supply was dwindling so badly. The neos recommended I not take any herbs but said that the Domperidone would be fine and it did wonders for my supply. I was able to pump for 17mos thanks to that medication.
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#7 of 21 Old 07-08-2008, 01:46 AM
 
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First I know how hard it is not being able to hold your little ones. It sounds to me like you are doing a great job pumping and getting plenty of milk. I don't think you need to worry about losing your supply though of course you are pumping for twins so the more you can get the better.I personally got better results when I slept through a couple of nights to avoid utter exhaustion.

As far as what to expect when you get to begin nursing your babies at the breast (which probably won't be before they reach about 32 weeks gestational age) is just to take it one day at a time and know that each time you get them to the breast even if just for a few moments it is progress. Their suck and latch is going to be weak in the beginning and you will just need patience and confidence. Follow your instincts, you nursed your little girl for 2 years so just do what comes naturally. The NICU is very into measuring what goes in, let them weigh before and after you nurse to get them to the breast as opposed to putting the pumped milk in a bottle so they can measure it. It helps to be at the NICU as much as humanly possible once they begin to nurse at the breast since they will usually keep them on an insane 3 hr feeding schedule. You need to get in as much practice as possible to get them fully nursing when you come home. You will have to work with them more to keep them awake and interested but it will be worth it! As far as nipple shields I would not go there unless it was a last resort because they are a hard habit to break and I personally could never get used to them (they felt so unnatural).

Hang in there momma you can do it!
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#8 of 21 Old 07-08-2008, 02:12 AM
 
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I know a baby who was born at 26 weeks and spent over 80 days in the hospital. He has issues with a week suck and his jaw was a little out of whack, so with those challenges he was not breastfeeding when he left the hospital (hold on, it gets better). The parents wanted him home more than anything (who can blame them!), so they allowed other feeding methods using mamas milk, just to get some weight on him. But with lots of support, she kept trying at home and was able to successfully breastfeed! A year later, he was still breastfeeding. So although I don't have any advice, I just wanted to share a success story that might be encouraging.

I hope you get to hold your babies very soon
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#9 of 21 Old 07-08-2008, 11:30 AM
 
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and congrats to the birth of your twins. My twins were born at 30 weeks and I pumped every 2 hours around the clock. I was never able to get much, maybe 3 oz a time. I tried the fenugreek, mother's tea and nothing seemed to help. I even tried pumping every 15 mins to no avail. When my babies were old enough to be put at the breast, they would only suckle if I had a nipple shield on. They never quite grasped the concept of nursing so this made it very difficult as well. I ended up pumping for them for 4 months (they both came home after 52 days in the NICU) until my milk started to dry. They were colicky and I was literally up all hours, I was barely getting 2 hours of broken sleep in a 24 hours day. I was only getting an ounce, and I was still pumping around the clock.

My point in all of this rambling is, you can only do what you can do. I felt horrible when I started to dry but you can't fight your own body. Just take it one day at a time and if you are only able to give your babies breast milk while they are in the hospital, that is GREAT! and no reason to feel guilty about it. Babies are hard, twins even harder. It's great that you are doing your part in giving them your milk. This does make a world of difference for you LO's.

single mommy to identical twin girls (3/06) Non-traditional mama just : through life.
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#10 of 21 Old 07-21-2008, 04:31 PM
 
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Id say that concidering how little they are, you're getting a decent amount! I know my friend (who's babes were 30 weekers) only got an ounce at a session and never had her supply increase. So even if you are only getting what you are now, thats still awsome, and just remember that every little bit helps!

If you do want to try to increase your supply, you might want to try pumping more than once at night, even if that means less pumping during the day. Night time nursing causes your body to release the most hormones for milk production; same with pumping. I know when I pumped for my ds, I would have my supply dip, start pumping beyond my breasts being empty for a few minutes and start waking up 3 times a night to pump instead of just once. My supply would go back up within a day or two.

Is there any chance you could try a Lactina instead of the Symphony? It might not make ANY difference, but for some reason, I cannot get a lot out with the Symphony, yet have no issues with the Lactina. I dont know for sure but I think the Lactina had more suction for me (might have just been those particular pumps though).

You might also see an increase in your supply just from kangaroo care when that happens. I agree that that contact can do amazing things for your supply!

In any case, you're doing an AWSOME job! Hugs!!!

Cari-mama to Eriq, Lile, Paikea, Kaidyn, and Mieke is here!! 2/9/10
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#11 of 21 Old 07-21-2008, 09:04 PM - Thread Starter
 
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Id say that concidering how little they are, you're getting a decent amount! I know my friend (who's babes were 30 weekers) only got an ounce at a session and never had her supply increase. So even if you are only getting what you are now, thats still awsome, and just remember that every little bit helps!

If you do want to try to increase your supply, you might want to try pumping more than once at night, even if that means less pumping during the day. Night time nursing causes your body to release the most hormones for milk production; same with pumping. I know when I pumped for my ds, I would have my supply dip, start pumping beyond my breasts being empty for a few minutes and start waking up 3 times a night to pump instead of just once. My supply would go back up within a day or two.

Is there any chance you could try a Lactina instead of the Symphony? It might not make ANY difference, but for some reason, I cannot get a lot out with the Symphony, yet have no issues with the Lactina. I dont know for sure but I think the Lactina had more suction for me (might have just been those particular pumps though).

You might also see an increase in your supply just from kangaroo care when that happens. I agree that that contact can do amazing things for your supply!

In any case, you're doing an AWSOME job! Hugs!!!
Honestly, there is no way I can pump more at night. I stay up until about 11pm to pump and then I usually wake up around 3am to pump. My daughter usually wakes between 5:30 and 6am. I'm already running on very little sleep and it's hard for me to function most days.
I love the Symphony and after buying larger flanges, it's a lot more comfortable. My insurance approved this pump and I seem to be getting a decent amount with this.
I held the boys for the first time this weekend. I didn't kangaroo them because they're still on the ventilators but the nurses have started to suggest they'll be ready for it soon.
I've been bringing my pump parts with me so I can pump in the nursing room in the nicu. I get a lot while I'm there.
I've been keeping track of how much milk I'm getting and I'm getting 28-35oz. per day (lately it's been much closer to 35oz.)
I'm feeling much better about how much I'm pumping. My biggest worry, looking ahead, is getting them to latch.

Lindsey- SAHM to Skylar (7-12-01), Leah (10-29-04), id twin boys Addison and Riley (6-17-08, born at 25w4d), and Terran (5-29-11, born at 28 weeks)

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#12 of 21 Old 07-22-2008, 09:50 AM
 
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Honestly, there is no way I can pump more at night. I stay up until about 11pm to pump and then I usually wake up around 3am to pump. My daughter usually wakes between 5:30 and 6am. I'm already running on very little sleep and it's hard for me to function most days.
I love the Symphony and after buying larger flanges, it's a lot more comfortable. My insurance approved this pump and I seem to be getting a decent amount with this.
I held the boys for the first time this weekend. I didn't kangaroo them because they're still on the ventilators but the nurses have started to suggest they'll be ready for it soon.
I've been bringing my pump parts with me so I can pump in the nursing room in the nicu. I get a lot while I'm there.
I've been keeping track of how much milk I'm getting and I'm getting 28-35oz. per day (lately it's been much closer to 35oz.)
I'm feeling much better about how much I'm pumping. My biggest worry, looking ahead, is getting them to latch.
I know it's hard but try and get as much rest as possible. I had horrible supply problems and I was pumping all the time, but was exhausted. When I started to get more rest my supply went up.

My dd came home on a bottle, but after months of hard work she did eventually learn to nurse and did so until she was two.

Never jump into a pile of leaves with a wet sucker. - Linus
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#13 of 21 Old 07-24-2008, 01:35 AM
 
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Hang in there Lindsey. It sounds like you are doing a great job. I hope you will be able to hold your babies soon!

I had a 35 week premie who did very well with breastfeeding right away. Even then, I had to fight with some of the NICU nurses who were worried he was not getting enough milk. I'd second the advice to ask the nurses to weigh the babies before and after nursing. Also, as you get closer to 34-36 weeks when the babies would be able to coordinate sucking and swallowing, if it is possible for you to spend more time at the NICU to promote breastfeeding, that's an important time.

Be patient with yourself and your babies. Even if they are never able to breastfeed, you are giving them an amazing, wonderful gift in your breast milk. I know it's a lot of work, but it's worth it mama!!
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#14 of 21 Old 08-06-2008, 03:36 PM
 
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Wow, I posted that like a week before I had my kiddo, wierd! Now we're working on breastfeeding too, lol.

I am again getting more milk with the lactina, which I have at home, than the symphony, which I use at the NICU. Its really wierd-especially since I SHOULD be getting more when I'm around him. However, I did find I got a lot more when I pumped while I was holding him. I know your guys are still pretty fragile, but if theres anyway you could kangaroo care and pump at the same time, you might get the same result.

I understand about being exhausted too! I talked to a LC last night and she asked how much I was pumping-I'm going every 3 hours round the clock. She said you know, you dont HAVE to pump at night, but I really do, I wake up anyway so I might as well right? lol If I could just sleep all night I so would, at least for a day or two, ugh.

Again, you are doing an awsome job! Hopefully both your dudes (and mine, hehe) will learn to nurse and be little champions

Cari-mama to Eriq, Lile, Paikea, Kaidyn, and Mieke is here!! 2/9/10
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#15 of 21 Old 08-06-2008, 05:22 PM - Thread Starter
 
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Wow, I posted that like a week before I had my kiddo, wierd! Now we're working on breastfeeding too, lol.

I am again getting more milk with the lactina, which I have at home, than the symphony, which I use at the NICU. Its really wierd-especially since I SHOULD be getting more when I'm around him. However, I did find I got a lot more when I pumped while I was holding him. I know your guys are still pretty fragile, but if theres anyway you could kangaroo care and pump at the same time, you might get the same result.

I understand about being exhausted too! I talked to a LC last night and she asked how much I was pumping-I'm going every 3 hours round the clock. She said you know, you dont HAVE to pump at night, but I really do, I wake up anyway so I might as well right? lol If I could just sleep all night I so would, at least for a day or two, ugh.

Again, you are doing an awsome job! Hopefully both your dudes (and mine, hehe) will learn to nurse and be little champions
I'm not brave enough to try to hold them AND pump but I do take my pump attachments with me and pump as soon as I finish holding them.
I've been getting about 35-38oz. per day for the past few weeks. I'm actually calling around to different stores to find a chest freezer that will fit in the small space we have but not have to be ordered.
We're hpoing to try to introduce them to the breast in the next week or two so we shall see how it goes.
Good luck with your little one. I hope he figures it out quickly and is able to come home soon.

Lindsey- SAHM to Skylar (7-12-01), Leah (10-29-04), id twin boys Addison and Riley (6-17-08, born at 25w4d), and Terran (5-29-11, born at 28 weeks)

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#16 of 21 Old 08-07-2008, 02:43 AM
 
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I'm the mom of a former 25 weeker, who was in the NICU 133 days. It is REALLY difficult for most moms of micro preemies to get their babies the breast feed. My daughter showed interest, but she simply didn't have a strong enough suck. We had to use a bottle with a preemie nipple (which basically just allows the milk to very slowly drip out, so no real suck is needed). I pumped for 9 months.

I don't want to discourage you from trying. Even if your babies never actually breast feed, they (and you!) will benefit from the close contact. Try not to stress about it. That will only make breast feeding more difficult and your milk supply go lower. You can try supplemental breast feeding (where they stick a tiny feeding tube on your nipple and hook it up to a bag of your pumped breast milk), but I personally found it awkward and stressful. (And my daughter never got the hang of it anyway.)

I took fenugreek for most of the 9 months I pumped, until I realized it was upsetting my daughter's stomach really badly. (I think that's rare, though.) I tried other supplements--mostly herbs but also Reglan...they didn't help much if at all. (In fact, the Reglan really made me nuts, even though I couldn't see it at the time.)

I did pump regularly at night, but by the end of 9 months, I was utterly exhausted, which reduces milk supply. You have to find a balance of what works for your body.

Massaging my breasts before pumping seemed to help, but most of the other advice you'll read about pumping didn't help. Do stick with the hospital pump for as long as possible. They do work better than even the high end consumer models.

Finally, don't be afraid to call it quits. One of the best decisions I ever made was to quit pumping. It was such a relief for me, and improved everything about my life. It had become such a very great struggle to get much milk, and as I said before, I was so exhausted I could hardly function.

ANY amount of breast milk your babies get is FANTASTIC. Don't beat yourself up if you're unable to breast feed them or give them pumped milk for months.

Hugs,

Kristina
www.MiracleBabyAnastasia.com
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#17 of 21 Old 08-15-2008, 07:48 PM
 
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I pumped and pumped with my preemie until he finally learned how to nurse. If I ever see that pump again it will be too soon (I remember imagining turning it into a homemade bomb and blowing the thing up.) It seemed like an eternity and I had every kind of infection and blister and problem while I pumped and pumped and pumped. DS was simply not interested for months. The lactation specialists had me on a rigid pumping schedule. I was pumping and dumping enough milk to feed ten babies. I finally toned it down and just pumped when I felt I needed to and stopped stressing about it. I had plenty of milk when my son was ready without additional supplements.

And although the road to functional breastfeeding was sooooo long and hard, I'm so glad I stuck with it. I still consider exclusively breastfeeding a preemie one of the hardest things I've ever done. But the sense of accomplishment I now have and the bond with my son was worth every tear. Hang in there! :
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#18 of 21 Old 10-14-2008, 12:47 AM
 
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My DS was born at 29 weeks and was tiny, less than 2 pounds. I started pumping 10 times a day with a hospital grade pump. He spent 8 weeks in the NICU, during which I did as much KC as I could get away with. I started putting him to the breast (after pumping) at 2 weeks. It was a battle with some nurses, but most were supportive. He went home weighing 4.5 pounds, and only getting about a third of an ounce from a half hour of nursing.

I rented a scale, and triplefed for the next two months. When he was about 4 months old, he finally started consistently getting about an ounce from nursing. At that point, I started cutting back on some bottles, and then cut out overnight bottles -- we only nursed at night. When he was 5 months, we were down to only two bottles a day, and when he was about 5.5 months, he refused a bottle one night. And that was it -- he didn't have another bottle for two months!

I hadn't expected it to take that long, but I couldn't stomach the thought of giving up. It seemed so hopeless many nights, and then he would make a leap forward unexpectedly. I didn't have any supply problems, and ended up donating about 1300 ounces of frozen milk that we would never use.

My son just needed to get big and strong enough, I think. It was a long, hard road, but I am SO glad I stuck it out! He is now 9 months and still EBF, and its wonderful!
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#19 of 21 Old 10-15-2008, 08:42 PM
 
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You are doing awesome at pumping and you have a great supply! It may seem daunting, but you are going to do great! Since you don't have a supply issue you may be able to scale back pumping (just make sure you pump between 1 and 5 am) especially if you are ever tempted to quit. The minute you notice a dip in your supply you can add back pumpings. If you notice a big dip at 6 weeks or so domperidone works wonders at restoring/surpassing previous levels. You are in great shape! Keep it up!
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#20 of 21 Old 10-16-2008, 08:39 PM - Thread Starter
 
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Have a good update but I have to make it quick because I'm tandem naking :
Addison came home Sept. 5th and Riley came home Sept. 11th. They were getting half bottle feeds and half nursing but we've transitioned to exclusive nursing and they're doing great. I still use the nipple shields. They'll both latch on without them but it's much easier with the shields. When I have extra time to work with them, I'll nurse without the shields but I figure we can work on getting rid of them when they're bigger.
My supply is more than enough and it blows my mind that I was able to keep up enough of a supply, for 87 days, to be able to EBF twins. I've only thawed 4 bags of milk from my freezer and that was because I really needed coffee and the boys don't tolerate the caffeine. I'm currently trying to find a local mom that needs donated milk
Thanks for all of your advice and support!

Lindsey- SAHM to Skylar (7-12-01), Leah (10-29-04), id twin boys Addison and Riley (6-17-08, born at 25w4d), and Terran (5-29-11, born at 28 weeks)

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#21 of 21 Old 10-17-2008, 01:11 AM
 
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Honestly, there is no way I can pump more at night. I stay up until about 11pm to pump and then I usually wake up around 3am to pump. My daughter usually wakes between 5:30 and 6am. I'm already running on very little sleep and it's hard for me to function most days.
I love the Symphony and after buying larger flanges, it's a lot more comfortable. My insurance approved this pump and I seem to be getting a decent amount with this.
I held the boys for the first time this weekend. I didn't kangaroo them because they're still on the ventilators but the nurses have started to suggest they'll be ready for it soon.
I've been bringing my pump parts with me so I can pump in the nursing room in the nicu. I get a lot while I'm there.
I've been keeping track of how much milk I'm getting and I'm getting 28-35oz. per day (lately it's been much closer to 35oz.)
I'm feeling much better about how much I'm pumping. My biggest worry, looking ahead, is getting them to latch.
I would hold my surviving twin and pump right there in the NICU. Got gobs of milk while doing so. I love that Symphony. It should be mandatory for all insurance companies to provide that pump to preemie mamas. I would do nutrititional milk boosting. I have a bunch of recipes if you PM me with your email I will send them. I strongly suggest fighting the bottle feeding. I demanded that baby got only naso-gastric or breast (sometimes with SNS, sometimes just breast). Took baby home on naso-gastric tube and breast (insisted they teach me to insert so we could get home). After just three days at home and able to settle to our own relaxed schedule I never had to use the tube or SNS again. I am convinced that if I had gone tube to bottle to breast she would never have been exclusively breast fed. Even being a 31 week 2 and 1/2 lb preemie, she never got a bottle in her life. She went from tube to breast to sippy cup.
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