Questions for NICU moms who BF

McGibbon51311

Hi all, my boys were born early (33w 2d) and have been in NICU for 12 days now. The general consensus is that although it doesn't change anything officially, the boys were about 1 1/2 - 2 weeks further along than I thought (we never had an exact date of conception), which is helping them to grow stronger, faster. They were born weighing 5lb 10oz (A) and 5lb 7oz (B). They're feeders and growers. They never received oxygen as they came out breathing on their own, but did receive CPAP for a few days and then moved on to a nasal cannula, both of which were used to increase the amount of room air that they breathed. For a while both boys were having large residuals which set them back on their birth weight protocol and eventually the nurses/doctors switched their formula which they tolerated much, much better and yesterday their NG tubes came out. They were also moved to cribs and B got his IV out. I've been pumping since the night I had the c/s and rented a pump to bring home. Every day when we visit I bring in what milk I'm able to produce right now.

So here are my questions and I apologize because I'm so very overwhelmed right now but I would love to hear from some other moms.

I'm incredibly confused about the birth weight protocol. A feeding of formula (with breast milk mixed in) for B is 12cc for every hour he's been asleep and for A it is whatever step of the protocol he is on (last time I checked he was on 37cc). However, when I put them to breast, the NICU considers a full feeding 5 minutes or more. I know I'm not producing as much as the boys eat during a formula feeding. I asked the nurse about why this is and she doesn't know either. Any ideas?

I was told by the lactation consultant to pump as often as the boys eat which is 8-12 times a day, so I pump that much. I was also told it's normal to fluctuate how much you produce in the very beginning. Each pump I produce about 5-10cc per side - after breast feeding it's always on the higher end (sometimes even more than 10cc/side) and after being home without them it's always on the lower side. Does this sound right, did you produce somewhere around the same amount? I know the pain meds I'm coming off of, and the stress of the situation will have affected my supply. 

If you breastfed/feed how did you transition from NICU feedings to feedings at home? I know I'll have to supplement and I know it's possible it would just be comforting to hear success stories.

And if you were in a similar situation, how long were your twins in the NICU for? I understand the doctors not giving an estimate until they're ready to come home - they tell me my due date - but at least for baby B who is on all PO feedings with no IV, I can't imagine him being there for 6 more weeks. 

TIA ladies, you've all helped me so much through this pregnancy, and now with having the babies I'm sure it will be the same.  

bhilyer

Congrats on the birth of your LOs!  The NICU is a tough place to be.  I hope their stay is short and sweet.  

Is 5-10 cc the most you pump at any session?  If so, it sounds like your milk has not come in yet.  Did you have a c/s?  My MFM & OB told me that it often takes longer for c/s moms' milk to fully come in.

To increase the amount of milk you're pumping, drink LOTS of water and pump every 2 hours.  The more stimulation your breasts have, the more BM you'll produce and an empty breast fills more quickly.  

Here's a link to a blog several moms from the Preemie board put together.  Lots of good info on power pumping, increasing your supply and such.

https://preemiemomblog.blogspot.com/p/all-things-breastmilk.html

 

Good luck! 

McGibbon51311

bhilyer:

Is 5-10 cc the most you pump at any session?  If so, it sounds like your milk has not come in yet.  Did you have a c/s?  My MFM & OB told me that it often takes longer for c/s moms' milk to fully come in.

Thank you! Yes, I did have a c/s. That's usually how much I pump per side every 2 - 2.5 hours. Right now I get about 10 total when I'm home away from them, and about 24 total after I feed them. I am definitely trying to increase the amount of water I drink. Thank you for that link I will check it out. 

melissajo2011

There are videos on this site that helped me increase what I produced during pumping sessions:

https://newborns.stanford.edu/Breastfeeding/

Pumping alone is not very efficient - I do a lot of massage and hand expression, too.

I've also been told that oatmeal, Brewer's yeast, and flax seed help with milk production. I just made lactation cookies with the hope that it would help me produce more milk:

https://www.drmomma.org/2010/08/lactation-cookies-recipe-increasing.html

Good luck!

sunshine610

I'm not help on the BF questions (I EP), but I can tell you that I was pumping about the same volume that you are when DD and DS were the same age, and by pumping 8-12 times a day over the next few weeks, my volume increased until I was able to pump 50-60oz per day!

I agree on drinking tons of water, also I found that eating oatmeal for breakfast every day for awhile helped me a lot too. 

Also - although DD and DS were earlier than yours, by the time their NG tubes were out they were home within 5 days. Get ready for babies in your house soon momma! Congrats and GL!

McGibbon51311

melissajo2011:

Pumping alone is not very efficient - I do a lot of massage and hand expression, too. 

 

I've read that all of these can help but hearing it from another MoM definitely reassures me and I will try these.  

sunshine610:

Also - although DD and DS were earlier than yours, by the time their NG tubes were out they were home within 5 days. Get ready for babies in your house soon momma! Congrats and GL!

Gosh, I really hope so that would be amazing! And thank you, knowing that you were producing about the same amount (and went on to produce more) is very reassuring! 

hunt2005

McGibbon51311:

melissajo2011:

Pumping alone is not very efficient - I do a lot of massage and hand expression, too. 

 

I've read that all of these can help but hearing it from another MoM definitely reassures me and I will try these.  

sunshine610:

Also - although DD and DS were earlier than yours, by the time their NG tubes were out they were home within 5 days. Get ready for babies in your house soon momma! Congrats and GL!

Gosh, I really hope so that would be amazing! And thank you, knowing that you were producing about the same amount (and went on to produce more) is very reassuring! 

BF is all about hormones too. Your body doesn't get the same hormone release from a plastic cup and machine as it does from a live baby against your skin. Try to look at a picture or video of them if you can, and do as much pumping while you're there as you can. Pump after BF them at the NICU, it'll help increase production. My NICU nurses suggested pumping for 3-5 minutes after the last drop comes out (massage while you do if you can) to help stimulate extra production, drink water, and eat lactation cookies. If you're a beer drinker, drink a dark beer - it has lots of good brewers yeast which helps too!!

I had a HUGE amount of colostrum the first time I pumped, and then it took me almost 2 weeks to even get an ounce on each side. C/S mess with your hormones and everything because your body does go through the labor process that spurs those hormones to start. Keep up the hard work, mama, you'll get there!

megs_glo

McGibbon51311:

So here are my questions and I apologize because I'm so very overwhelmed right now but I would love to hear from some other moms.

I'm incredibly confused about the birth weight protocol. A feeding of formula (with breast milk mixed in) for B is 12cc for every hour he's been asleep and for A it is whatever step of the protocol he is on (last time I checked he was on 37cc). However, when I put them to breast, the NICU considers a full feeding 5 minutes or more. I know I'm not producing as much as the boys eat during a formula feeding. I asked the nurse about why this is and she doesn't know either. Any ideas?

You may not be pumping as much as they normally eat but they are much better at getting milk out of you then a pump, so that would be my guess for why they consider that a full feeding.

I was told by the lactation consultant to pump as often as the boys eat which is 8-12 times a day, so I pump that much. I was also told it's normal to fluctuate how much you produce in the very beginning. Each pump I produce about 5-10cc per side - after breast feeding it's always on the higher end (sometimes even more than 10cc/side) and after being home without them it's always on the lower side. Does this sound right, did you produce somewhere around the same amount? I know the pain meds I'm coming off of, and the stress of the situation will have affected my supply. 

Are you pumping for a full 20 minutes?  I find I have a 2nd let down after 15-18 minutes, so that may help you get more out.  My lactation consult recommended this supplement to help increase my supply: https://www.amazon.com/gp/product/B000K6JZUA/ref=oh_o04_s00_i00_details I think it helped

If you breastfed/feed how did you transition from NICU feedings to feedings at home? I know I'll have to supplement and I know it's possible it would just be comforting to hear success stories.

My one daughter was in the NICU and wasn't able to nurse until she was about 7 days old and she did such a great job of latching on, she was better than her sister who nursed the whole time.  Being at home was great and helped increase my supply.  It took awhile for everything to work itself out, but at about 10 weeks I didn't have to supplement anymore.  So I think it takes longer than if you just have one, but it is definitely possible.

And if you were in a similar situation, how long were your twins in the NICU for? I understand the doctors not giving an estimate until they're ready to come home - they tell me my due date - but at least for baby B who is on all PO feedings with no IV, I can't imagine him being there for 6 more weeks.

I agree, I can't imagine them keeping them much longer once they are up to full feeds.  Good luck! 

vgreet

My pumping situation was very similar to yours and I was on fenugeek and drinking tons of water.  I could just barely keep up with the boys when they were in the NICU.  I needed donor milk one night, but after that, I pumped enough to stay just ahead of them.  When we came home, I tried to keep the same schedule as when I was at the NICU, but my pumping output dropped for a while. I tried EVERYTHING.  I quit pumping and went solely to BF with the exception of one bottle a day. 

I started pumping again a couple weeks ago.  The big deal for me has been not to worry about my output. My boys get some formula anyways as a calorie supplement.  I have to tell myself that it doesn't matter and to relax.  I think it has taken my body this long to respond to the pump.  I still only get about three ounces in a good session, but I've been able to build a little stash for when I go back to work.  I gain a little more everyday.  Keep at it.I just remember how excited I was to count in ounces instead of cc's.   Everyone is different, but if the babies are breastfeeding well, you have little to worry about.  Good luck and I hope you get home soon!

erinruns

Your NICU protocol is drastically different than ours was.  How much breastmilk they were given was calculated by a nutritionist and the neonatologist and it was based on birth weight, days of life, and how they were tolerating their feedings.  When I did breastfeed they weighed them before and after to see *exactly* how much they had eaten.  The difference they were given in their ng tubes.  Those tubes didn't come out until they day we left.  To leave they had to take all feedings by mouth, gain weight with doing that, and have no desats.