Milk supply and the NICU

I'm looking for some advice regarding The NICU and breastfeeding/milk supply. My boys were born at 30 weeks and are now 6 weeks old. I've struggled with pumping and my supply. I've seen a number of lactation consultants and have tried everything-even Reglan. The boys are starting to learn to breastfeed and will be coming home soon but my supply is dropping even more. I guess I'm curious as to what others experienced with their milk supply once getting home. Is it crazy for me to think that it would go up if I could sit on the couch and feed them constantly? At this point I want to at least be able to breastfeed them every other feeding.

Re: Milk supply and the NICU

  • You are not crazy for thinking that as it will help supply if you are breastfeeding them constantly. Does it help if you pump near them or have a picture of them while you pump? Both helped me a lot while my son was in the NICU. I noticed a huge difference when I pumped right after holding him skin to skin or helping with his care times pumping in the same room vs at home without him. Once home though he was always nursing and my supply went up. Check out Yogi brand nursing support tea. Also lactation smoothie: 1/4 cup oats, 1 tbsp cacao powder, frozen banana, 1-2 tbsp flaxseed meal (more = more milk supply), 3/4 cup milk, 1 tbsp peanut butter. Good luck!
  • I'd do some power pumping before they come home.  Do you have a hospital grade NICU pump right now? My LO never took to nursing because he couldn't in the NICU for a few weeks And became used to not having to work (suck hard) for his food.  He would get mad at my breast and decided with the LC that it was best to continue pumping.  I was only able to stay 1 pump ahead as I pumped exclusively for 8 months.  It was stressful, but as long as I was 1 pump ahead of a feeding all was okay. Keep your fluids up, that was the only way I was able to pump as long as I did.  I've heard that supply can go up once they are actually nursing - but I have no first hand experience on that.
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  • Milk supply is based on supply and demand... the more you pump/ breastfeed the more milk you should make. 
    My LO was born at 27weeks 4days and stayed in the NICU for 64 days. During that time I pumped like crazy.... every two hours during the day and every 3 hours overnight.  When trying to establish your milk supply you need to pump every two hours for atleast a 24 hour period. Pumping every two hours will tell your body you need to make more milk. Pumping every three hours is for maintenance and longer than that you will probably have a decrease in milk supply. 
    Make sure you are getting enough rest, napping is so important. I know you're probably too stressed to nap or you probably want to spend all your free time with your babies but if you don't you are going to burn yourself out before your babies come home. 
    If you haven't you should rent a medical grade pump, most hospitals rent them out. The motor is stronger than a personal pump. Stay hydrated and make sure you're eating a well balanced diet. Stress effects milk supply and lack of sleep adds to stress. So nap and find something you enjoy to allieviate stress. 
    Also it helps not to fixate on the volume when you're starting out but focus on frequency. There are supplements out there to increase your milk supply.... BE CAREFUL. I had a bad allergic reaction to fenugreek, sever facial swelling. I had taken it before in a supplement and didn't have a problem but due to the change in my hormones I am now severly allergic. 
    As new moms who are determined to breastfeed we stress ourselves out making enough milk. You CAN make MORE than enough.
    When my baby came home I was producing over 30 ounces a day! Needless to say I had a very large milk reserve. She's 5 months now (2 months adjusted) I'm still pumping ..... only twice a day now , producing ATLEAST 12 ounces a day. 
    You can do this! Just pump til you capump anymore. You could even pump every hour if possible to help establish your milk supply. 
    Remember. ,.you'll produce based on supply and demand... so pump pump pump! 
    Don't forget to rent a medical grade pump, even if just for a few weeks. 
    Sorry I wrote you a novel. Lol A little pump time reading!
     I hope this helps! 
    I'd love to know how it goes. Keep us posted!
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  • I'm trying!! I'm getting a pretty good amount too! Just had my baby last Monday at 25w3d via emergency c section. And although it's exhausting it's so rewarding!!!
  • I'm pumping now. Just had my baby 5 days ago. My milk is just now starting to come in so we've been supplementing in NICU. She gets so tired out when she tries to breastfeed. She doesn't get anything out or she will get very little. The most I've been able to pump at a time is 17 ml and she gets 46 ml every 3 hours. She can take her whole 46ml bottle by herself when we don't attempt to breastfeed but is too tired to even get half down after a breast feeding attempt. 

    Any my advice on if I should keep attempting to breastfeed or just go with bottle feedings for now?!? When we do skin to skin I get more milk so could easily do that just prior to pumping in the hopes of getting more milk. I just would like some thoughts or suggestions or experiences shared. Thanks! 
    Mommy to an angel baby and a sweet little girl Earth side.
  • @LifeofLauren2 - I used to pump right after kangaroo.  We'd move DS to my husband's chest when I went to pump.  I always had better output after kangaroo.  What do her docs say about nursing?  My doctors said no for a few weeks in the NICU until they felt he was strong enough then we were allowed to 'try' to nurse until he'd get tired then do the remainder of the feed with a bottle.  

    How often are you pumping?  Are you drinking 100+ oz of water and eating enough?  Those had huge impacts on my supply.  I know how hard it is to take care of yourself well when your baby is in the NICU but it's essential if you want to continue to nurse/pump.  Good luck!  
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  • Thanks @DiFazette! We were told she gets too tired after nursing attempts to feed her through a bottle so if we try nursing then she gets her feeding in her tube. Once we stopped trying to nurse she picked up on her bottle feeding so for now it looks like we are going to exclusively pump and supplement the rest with formula. So I can pump all day and contribute enough milk for 2 of her 8 feedings. :( 

    I do pump every 2 hours during the day and every 3 hours at night. It's so hard for me to wake up at night. I'm assuming (and hoping) it will get easier when she gets home (which may be as early as tomorrow!). 100+ oz of water is a lot! I didn't know it's that much! Dang. I need to step it up! 

    Thanks for the advice!
    Mommy to an angel baby and a sweet little girl Earth side.
  • @LifeofLauren2 - good luck!  I'm not sure that 100 is science based, but when I dipped below that my BM output took a hit.  You need enough water for your body and all of your BM.  
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  • This board seems very much asleep/dead, but I just want to say thanks for the advice! 
  • There's also research out there that supports BFing preemies, even ones in the NICU
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