Preemies

Breastfeeding after exclusively pumping for NICU Q

I am pumping as much as I can, but so far (baby is a week old) only producing about 15 ml a session, so I have enough milk for maybe 2 feedings a day.  That's great, and I've seen my supply increase each day to get to that point.  What I'm wondering though, is twofold:

1) Will I ever be able to pump enough for all feedings?  How can I increase my output by that much?  It seems I have leveled off and have been getting ~15 ml each session for a couple of days now.  I'm just worried that when it's time to breast feed I won't have enough production for my LO and will have to supplement.

ETA: They are feeding him 50 ml at each feeding, either breast milk or Alimentum (he was born at 34w1d and is now a week old/35w1d)

2)  Is it very difficult to get the baby to latch and start breastfeeding after being on a feeding tube? 

Not that I need anything more to be anxious about, but this keeps nagging at me every time I pump.  I know I should look on the bright side, but the fears keep rising, so I thought I'd check in and see what others' experiences were like.

TIA!


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kikijbunny (formerly kikijbird)
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Re: Breastfeeding after exclusively pumping for NICU Q

  • I also had a low pumping output (sometimes less than 10 ml/ session). I was never able to pump much although I drank a lot of water and took fenugreek religously. My DD was born at 34 weeks and a a 2.5 week NICU stay. During her stay at around 2 weeks old we started putting her to the breast and working with an LC to get her to latch. I didn't worry much about actual breastfeeding while in the NICU. She did have an NG tube. When we got home we worked on it more and I would pump after I nursed her. She ended up being EBF from about 1.5 months old to 6 months old. So it's totally possible to switch over to mostly breast after being on mostly bottle/ NG tube feedings in the NICU. Just don't give up!
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  • My milk came in pretty fast - I drank tons of water, drank mother's milk tea, and pumped religiously around the clock until my milk supply was really established. I also had a little video of DD I would watch while I pumped, it helped me let down. Stress is really bad for your supply, not much you can do about that. I insisted on trying nursing before every bottle I was there for. It took about a week to get off the bottles when we got home and we just now ditched the nipple shield. Latch tends to be an issue until the mouth gets a little bigger. Hang in there, you are doing a great thing for your baby!
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  • It has only been a week so give your body time to catch up. JuSt keep pumping every 3 hours for 20 minutes and the supply will come. Do skin to skin with your baby as much as you can, it will help increase your supply. 

    I have twins and was worried about my supply at first. It slowly increased and is now good. Both my babies breastfeed but I also still pump and supplement with formula.

    Don't get discouraged at all, you are doing great!  

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  • Thank you all very much!  I was told to do just 15 minutes but have been stretching it a little 17-18 min (at times).  Seems that's the right instinct... my 11 am pump was better!  Glad to hear there's still hope for EBF later.

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    kikijbunny (formerly kikijbird)
    Our jbunny born April 17, 2011 at 34w 1d (EDD May 28) due to irritable ute + early dilation

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  • 1.  I have twins and have been pumping for 2 weeks now and am able to pump about 4oz each time.  This still isn't enough for all feedings for both babies, so I kind of have the same question as you.

    2.  We have been breastfeeding about 3 feedings a day for the last week and the babies both still have the feeding tubes in are able to latch just fine.

    My IVF twins born at 33w6days by c-section due to twin A being IUGR Rylan born at 2:54pm weighing 2lb 8oz, 14.5 inches Emma born at 2:55pm weighing 5lb 5oz, 18 inches Baby Birthday Ticker Ticker
  • I'll check with the breastfeeding board -- good idea!  I notice that my supply is increasing slowly, I'm up to 30 ml per pumping session so far, and I'm hoping to get up to the 50 ml they're giving him, it just seems like such a far away goal.  And it will be interesting to see how well my LO will latch. I hope he will "get it." 

    Not sure if this is the case for all NICU's, but ours does have lactation consultants on staff who I've talked to and they said they would help me with breastfeeding when my baby is ready to try. 

    Thanks for all the input!


    Ten months: Mr. Giggles!
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    kikijbunny (formerly kikijbird)
    Our jbunny born April 17, 2011 at 34w 1d (EDD May 28) due to irritable ute + early dilation

    Mommy Blog: And Baby Makes Pi
    Pregnancy/Baby Blog: Eggs Over Anxious
    BFP chart

    Anniversary

    Lilypie Premature Baby tickers

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  • I EPed for 15 months with great supply. We had some successful BFing sessions until Andrew developed a strong nipple preference after switching to level 2 flow nipple (because he couldn't get through bottles -- too tired)

    My advice is that you do not count the ounces/mL  you are pumping.  You need to just remind yourself that you are doing everything you can, and every drop is good.  Stressing will make it worse.  Instead, focus on what you can do to keep yourself healthy - get enough sleep, drink enough water, and eat enough calories.  Take a night off from the NICU now and then if you are feeling overwhelmed.  I think these things will go far in helping your supply!

    Pumping was hard at first - I had a lot of problems with infections, blisters, etc.  They do affect your supply.  I had a surge in my supply around a month old, probably due to less stress + less pain during pumping.

    We had trouble getting Andrew to orally feed but nobody knew why - it turned out being due to reflux.  Once that was cured he switched from tube feeds to orals over night.

    FWIW Andrew had no trouble switching between BFing/bottle until we switched to the level 2 flow nipple.  While we felt we had no choice at the time, it is good to remember to use the slowest flow nipple that your baby can tolerate.  This will increase your chances of success.

    Do what you can!  Hugs!

     

  • Just keep stimulating your breasts by pumping every 2-3 hours...probably every 2 since you are having low production. It will happen!  I was just as stressed as you, and now I have a freezer full of milk we will probably never be able to use! And stress only hurts your milk production.  Try to relax and keep yourself distracted while you pump. 

    If it will make you feel better, go get some Mother's Milk tea (has other names too) and Fenugreek at Wholefoods or an herbal store. When I got stressed, my production would plummet and I'd take these things to feel better. I don't know if it was a mind trick or the supplements, but it always worked! Also, eating oatmeal every day helps production.  I thought it was an old wives tale, but it works!

    Join a nursing support group. They should have one at your NICU. It's helpful to hear other people's frustrations and questions. Talk to your lactation consultants every day. They are there to help!

    As for latching: Keep putting your baby to breast every day! The docs and nurses will push bottles, which is fine, but insist on at least one time a day at breast before using the tube/bottle. Sometimes the tube messes with latching, but once you go home you want baby to know your smell/taste/feeling of being positioned at the breast. And once you get out of the bright lights, noise, and constant interruptions, you'll be able to relax more and focus on getting baby latched.

    My son was born at 31w4d and was in the NICU for 6.5 weeks.  He was on a feeding tube the whole time, even though he was taking most of his feeds from a bottle for the last two weeks or so. I kept putting him to breast/nuzzling at least once a day, every day, while I pumped like crazy. Even though he didn't get much at the breast (if any, so we'd supplement through the tube) it must have helped him, because the day he was discharged he started nursing and hasn't stopped! We did fortified breast milk twice a day for the first two months he was home, but he was breast only the rest of the time. Now he is full time breast!  My husband gives him a small bottle at bed time with vitamins (Poly-vi-sol), but that is it.  

    Keep your chin up!  He'll do it! I was terrified just like you but it turned out just fine. :) 

  • Two more things: 

    Drink lots of water. Just guzzle it and see if you production increases.

    And ALWAYS use a slow-flow nipple with bottles. Start with the preemie nipple (Dr. Browns has one) and don't go higher then a Stage 1. All breast fed babies should only ever use a slow flow.  

  • Thank you all for this great advice!  It's true I'm probably starting to stress about this and I shouldn't.  I just don't want to mess anything up! 

    I'm not sure if I can do skin-to-skin or put him to the breast yet; he's still having trouble with his respiration (breathing too hard, too fast) so it's never been suggested to me, and so far he can't tolerate a bottle.  The most they let me do is hold him.  They say that we can't try the breast until he can take a bottle.  But it can't hurt to ask if I can do Kangaroo Care, I suppose.  

    Such a love/hate relationship with the NICU.  So glad it exists to take care of my baby, but it feels like it gets in the way of my bonding with him.  And I confess, it's intimidating to go in there sometimes.  Nurses know everything and I know nothing.  

    I am thankful for this board... helps prove that last sentence/sentiment wrong.


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    A10 March Siggy: Next vacation - Maine!
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    kikijbunny (formerly kikijbird)
    Our jbunny born April 17, 2011 at 34w 1d (EDD May 28) due to irritable ute + early dilation

    Mommy Blog: And Baby Makes Pi
    Pregnancy/Baby Blog: Eggs Over Anxious
    BFP chart

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    Lilypie Premature Baby tickers

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  • Question whoever is telling you he needs to take a bottle before the breast. See if they have a reason for that based on his individual condition. I can't remember what research it was (I'll look through my NICU stuff), but I had a flowchart showing babies' eating progression that showed they can better coordinate at the breast a couple weeks before they can at the bottle.

    Are you working with a lactation consultant, and/or does the NICU have a lactation staff you can use as help/advocates? I had my LC fighting for us often. Many nurses want the baby to have the quickest results - for the nurse - and they don't always consider what's best for baby/mom. Sad, but true.

    Stand your ground and be firm in your questions. Ask for kangaroo care - skin-to-skin is so, so important for your baby and you. Ask for BF attempts. If there are medical reasons you can't right do either now, fine (get your neos to make those calls), but make sure you stand up for the care you want your son to have. You're the mother, no matter what those nurses think. Any good nurse will back that statement up, too!

    Fwiw, we started "playing" at the breast with my trio around 32w, and the first took a full feed right around 34w. They were off their NG tubes and doing full breast/bottle feeds (not every time by any means) around 35.5w.

  • imageJenandtonica:

    Question whoever is telling you he needs to take a bottle before the breast. See if they have a reason for that based on his individual condition. I can't remember what research it was (I'll look through my NICU stuff), but I had a flowchart showing babies' eating progression that showed they can better coordinate at the breast a couple weeks before they can at the bottle.

    Are you working with a lactation consultant, and/or does the NICU have a lactation staff you can use as help/advocates? I had my LC fighting for us often. Many nurses want the baby to have the quickest results - for the nurse - and they don't always consider what's best for baby/mom. Sad, but true.

    Stand your ground and be firm in your questions. Ask for kangaroo care - skin-to-skin is so, so important for your baby and you. Ask for BF attempts. If there are medical reasons you can't right do either now, fine (get your neos to make those calls), but make sure you stand up for the care you want your son to have. You're the mother, no matter what those nurses think. Any good nurse will back that statement up, too!

    Fwiw, we started "playing" at the breast with my trio around 32w, and the first took a full feed right around 34w. They were off their NG tubes and doing full breast/bottle feeds (not every time by any means) around 35.5w.

    Thank you.  There are LCs at our NICU; I will connect with them again and see if they can help me.  


    Ten months: Mr. Giggles!
    Photobucket
    A10 March Siggy: Next vacation - Maine!
    Photobucket

    kikijbunny (formerly kikijbird)
    Our jbunny born April 17, 2011 at 34w 1d (EDD May 28) due to irritable ute + early dilation

    Mommy Blog: And Baby Makes Pi
    Pregnancy/Baby Blog: Eggs Over Anxious
    BFP chart

    Anniversary

    Lilypie Premature Baby tickers

    imageimageimage
  • marking for future reference
    Ellie, mommy to Kate (4.20.06), Andrew (3.18.08) & Natalie (4.19.11), born at 34w1d Lilypie Premature Baby tickers
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