question about NICU babies being fed breastmilk

phanatic

hi ladies. i really wasn't sure were else to post this, so i thought this might be the best place.

DS #2 was born on wednesday at 38 weeks gestation, but he was sent to the NICU pretty quickly after we went to recovery because he was having a hard time breathing. they were originally going to keep him for 48 hours [should have gotten him back to me around 2 this morning], but he's still dealing with immature lungs and they just put him on a ventilator this morning.

i really, really want to breastfeed him and i've been pumping roughly twenty minutes every two hours in order to stimulate my milk into coming in. i was able to get about a quarter of an ounce of colostrum last night, but i haven't gotten anything since then at all. he's getting all of his nutrition through an IV right now, but i was wondering if anyone could help me out by telling me what you did aside from pumping for your babies. i know i'm going to have to work hard at it [and i don't mind that at all] until he's able to nurse, but at this point i don't know when that's going to be. they won't let him take a feed without him being able to breath on his own.

thank you, in advance, for any help you may be able to give me. 

Leigh71

I want to answer your question...but need to clarify..  do you want to know what I did to get my milk supply up?  Or about their BM (breastmilk) feedings in the NICU?

Sweets2005

If you can't put your baby to breast, then the only other thing I know of to most help stimulate your milk coming in would be kangaroo care (holding your baby with skin to skin contact). That would really help a ton. Also, do you pump in the NICU at his bedside? I always got more milk when I pumped next to my LOs isolette. They say having pictures next to your pump at home helps also. Do you have a really good, hospital grade, double pump? Even if he can't feed, will they let you hold him doing kangaroo care? Or do a non-nutritive feed where you could pump beforehand to empty  your breasts and then attempt to nipple him. That will help both with your milk and him learning to breastfeed. Definitely talk to your LOs doctors and tell them how important this is to you and hopefully they will help you as much as they can. Good luck and congrats on your brand new baby boy!!! Hope his stay is a short one!

phanatic

Leigh71:

I want to answer your question...but need to clarify..  do you want to know what I did to get my milk supply up?  Or about their BM (breastmilk) feedings in the NICU?

anything you did to help boost your supply would be fantastic. 

Leigh71

Feeding a little one now... promise I will come back and post some things I did while my girls were in the NICU.  It may be about 30 minutes. 

phanatic

Sweets2005:

If you can't put your baby to breast, then the only other thing I know of to most help stimulate your milk coming in would be kangaroo care (holding your baby with skin to skin contact). That would really help a ton. Also, do you pump in the NICU at his bedside? I always got more milk when I pumped next to my LOs isolette. They say having pictures next to your pump at home helps also. Do you have a really good, hospital grade, double pump? Even if he can't feed, will they let you hold him doing kangaroo care? Or do a non-nutritive feed where you could pump beforehand to empty  your breasts and then attempt to nipple him. That will help both with your milk and him learning to breastfeed. Definitely talk to your LOs doctors and tell them how important this is to you and hopefully they will help you as much as they can. Good luck and congrats on your brand new baby boy!!! Hope his stay is a short one!

i wish i could do kangaroo care, but i'm not allowed to hold him at all because he's got a line in the artery of his cord to monitor his blood pressure and reduce the number of heel sticks he's getting in general. i will defiitely keep this in mind as soon as i am allowed to hold him, though.

right now i'm still in the hospital, so i'm pumping with their pump. i should be released tomorrow and the first place i'm going is to buy a pump. 

all of the doctors have been super supportive thus far. and thank you so, so much for your suggestions. i'll put as many to use as possible. i'd heard of someone recording their baby's cry on their phone in order to trigger their let down. ever heard of that?

phanatic

thank you.

Leigh71

Ok... I'm back. 

1.  I recommend renting the hospital pump.  It is worth it!  I used a Medela Symphony... rented one and had it at home, and the NICU had one I could use when I was there for visits. 

2.  Have you been in touch with the LC there?  Lactation Consultant.  They are very helpful in giving you tips.  My LC gave me a breastmilk/pumping diary.  I recorded all of my pumps...amt. I rec'd, etc.  It was a nice log to have.

3.  I was trying to pump every 2 hours.  I became exhausted...and stressed out when I didn't get much milk.  I found if I sometimes waited 3 hours....that extra hour helped me relax/get more milk.  I made a sign...it was an 8x10 clear plastic frame.  I made 2.  I kept one at home in the nursery, and kept 1 at the hospital in their room.  It has their pictures in it...and I would look at it as I pumped.  I also took in hats, onesies (once the central lines are out of the tummy)...and each day I would take home the old outfit, so I would have something to smell as I pumped. 

4.  If I was away from the NICU...I always called to check on the girls before I pumped.  I found if I talked to the nurse about how they were doing, etc.  I felt more of a connection and had a better pump.

5.  I was very, very stressed out when the girls were in the NICU.  To help me relax, I played Enya on my iPod...and listened to it when I pumped.  Or I read a book... or kept my eyes on the TV... anything to not stare at that empty milk bottle attached to the pump.

6.  Before each pump I would massage each breast...and that helped my milk 'let down'.  I even bought a microwaveable warm/heat pack from the drug store (CVS)put in my bra about 10 minutes before a pump... to help my milk flow better during pumping.

7.  I was not allowed to hold Lauren for 11 days, nor was I allowed to touch her....  she was too unstable.    It was very hard.  I worked on her baby book quietly next to her bed and just watched her for those 11 days.  The RN gave me a small piece of fabric (it was fleece).  She asked me to wear it in my bra for a day or two...so it would smell like me.  The nurses would put it under her head while she was on the vent, so she could smell me.  I had 2 pieces of the fleece fabric and would trade them out if one became dirty/spit up/saliva on it.  It wasn't very big... the piece was maybe an 8x10 size... just large enough to fit under her head.

8.  Since she was not allowed to eat for almost 2 weeks... I froze my colostrum and milk for her.  I dated/timed each container of milk, so when she started feeds, I the nurses would give them in chronological order.  When in doubt, freeze your milk.  It takes a very short time to defrost...and if you freeze it it won't go bad.

9.  This one I made up....but it worked!!  To make my low milk supply "last"... I asked the doctor if we could supplement it.  They gave Lauren full strength colostrum.  When it became more like regular milk.... the nurses fed her a 1::1 ratio of half breastmilk and half formula.  I didn't want her to have formula....but feeding her half and half...my supply lasted longer, and I didn't feel the pressure to have large volume pumps.  ***my milk didn't come in for like 4 or 5 days.  I just kept "pumping" every 2 hrs. to get my breasts ready to produce milk.

10.  I ate good healthy meals.  I drank 3000cc of water a day.  I had a large water jug that held 1000cc and I drank 3 of those a day.  At breakfast I had 2 milks, lunch 2 milks, and dinner 2 milks.  I also had 2 or 3 small juice boxes in the day too.

Leigh71

I had a nap during the day in her room.  It was nice they had a pull out couch in their room.  I was so sleep deprived... and when I didn't take a nap, my milk supply was low.  I also only pumped 1 time in the night.  like at 2 or 3 a.m.  I felt it was more important to sleep and recover from delivery...and I think the sleep helped my milk supply.

The LC suggested I ask my OB for Reglan.  (because my milk supply was so low).  I took it 2 to 3 times a day....and my pumps went from 30cc a pumping....to about 90-100cc a pumping!  The LC told me Reglan doesn't work for everyone....but it really helped me.  (a side effect of Reglan is it increases oxytocin I believe).

GL to you!  hope some of that is helpful.  I''m off to sleep before the next feeding. 

I hope you have a very short stay in the NICU and your LO is home very soon.

witt0198

The only thing I want to add is about how you're actually pumping. The lactation consultants working with me had me cycle fast to induce a let down, and then slow to extract the milk, then fast to induce another let down....so on and so forth.

 I ditto the hospital grade pump. Your insurance should cover it as your baby is in NICU, the doctor may need to write a script for it.

Also ditto to the heat application, and massaging your breast. There have been actual studies showing how much more milk mom's who massage their breasts towards the nipples get than those who don't.

Sweets2005

I agree with the PP about trying to get multiple let downs. If your milk slows down, don't assume you are done. Take off the pump, massage (maybe even apply a little heat if you can- I kept a heating pad next to my pump), and start again. Also, have an LC fit you for the horns. I was surprised to find out I was using the wrong size horns.And the white membranes on the pump have to be replaced often, maybe once a month or whenever your suction starts to go down.

See if your hospital has pumps you can rent.

Eating oatmeal helped for me. Actually, I made lactation cookies and then I had a quick breakfast I could just grab in the morning on the way to the NICU. Ultimately, my supply was much too low for twins so I started taking domperidone with great success- but you can only buy it online.

Good luck!

 

lgmom2010

I pumped for 10 mins every hour until my milk came in real good...then 20 mins every 3 hours. I also made sure I was napping every day and did deep breathing during pumping, and I produced a lot!! Good Luck! And congrats on your LO!

ShannonSky

1. Make sure you are pumping around the clock until your supply is established. 

2. Use a hospital-grade pump.

3. Do skin-to-skin time if/when you can - second best is sitting right next to LO and third best is pumping with an article of LO's clothing or blankets (the smell helps).

4. Oatmeal is great for naturally increasing supply.

5. If you had a C-section, your milk coming in will likely be delayed by 24-48 hours.

6. When using the pump, turn it up until it is just slightly uncomfortable. Once the flow starts, back off on the pressure a bit. Once the flow slacks, turn it up again. Repeat.

7. Do not follow arbitrary time limits when you're pumping, pump until you are empty. And once you are empty, hand express until you are really empty. An empty breast tells your body to produce more milk.

8. When producing colostrum, I'd put one of the little rubber cups (the part at the top of the flange that gets sucked up and down) into the neck of the bottle I was pumping into, then use an oral syringe to suck up the colostrum. The colostrum is AMAZING - give every drop you can to the baby when he's ready.

9. Watch this video (it's a bit graphic, but shows you what you need to be doing): https://newborns.stanford.edu/Breastfeeding/HandExpression.html. 

smeyer

In addition to all of the great suggestions you've gotten so far...  Once your milk comes in (or even if it fluctuates later), try power pumping.  Pump for 10 minutes, take a 10 minute break, pump, break, pump, break for 1 hour.  A LC suggested this to me and it definitely helped!

phanatic

thanks again for all your help ladies.

looks like my little guy's going to be in for the long haul - they're talking like he might not be ready to come home until christmas or later. i'll definitely use all of the suggestions i've gotten!