Preemie baby and pumping

I had my baby boy last Friday, so he is a week old today, he was premature at only 32 weeks!! We are working on breastfeeding him and feeding him with a bottle but currently he is being fed primarily from a tube! I have been trying to pump and I do get milk but I am getting frustrated because it is hard to keep up with what he is eating! He is currently taking 40 ml every 3 hours and I am currently pumping about every 3 hours and getting anywhere from 30-70 ml! Every once in a while he has to recieve formula in the NICU where he is at! Some of the nurses had told me to sleep at night and not pump but as of today I am going to pump every 3 hours even at night! Does him being premature have anything to do with this? I also read the the longer the labor the quicker the milk comes in and my labor was very short! My water broke at 7:20 and I wasn't even feeling contractions and then around 12:00 the contractions were stronger and I was 4cm and then he was born at 12:38!! I'm just wondering if an average of 40 ml every 3 hours of pumping is normal one week after delivery and when most people really feel their milk "come in" The lactation nurses I have worked with say it is completely normal but it worries me that I am going to just completely dry up and he really needs my breast milk especially since he ended up being a preemie!!

[DoulaSummer]

First, relax!!  I have not heard of a connection between length of labor and time of milk coming in.  If you have the links I would be interested in reading the information.  Continue to work with the lactation consultant for advice and encouragement.  Second, get a good pump.  You can find Medela pumps for over half off on craigslist, otherwise they will run about $275 or $300.  If you buy a used one, you MUST buy all new tubing which is about $50, so factor that in when looking.  The hospital may supply you with a pump to use while you are at the hospital, but ask.  You may be able to rent one from the hospital as well.  It is by far the best brand of pumps and will offer you the best performance.

I think you are not pumping often enough.  You need to be pumping as many times as he is eating.  So if he is eating every 1 1/2 or 2 hours, you need to be pumping every 1 1/2 to 2 hours and always around the clock.  Babies eat at night too :)  Eating oatmeal - the real stuff not instant or fast cook - will help boost your supply.  The lactation consultant will be able to help you will herbs and supplements as well.

I cannot believe the NICU nurses told you to stop pumping!!  I would speak to whoever is over their head.  The best thing for your baby right now is your milk!  Those nurses need to do some research and update their information before handing out wrong advice!  I would set up a meeting to make sure your baby is ALWAYS offered your pumped milk before he is offered formula.  Unless its noted, nurses sometimes just automatically go to formula.

When you are in the NICU with you, talk to the lactation consultant about the possibility of using a supplemental nursing system (SNS) (look it up on medela's site).  It will allow you to have your baby eat at the breast to familiarize him with eating at the breast, but allows you to give pumped milk at the same time.  Preemies have a lot of issues with actually being able to extract milk directly from the breasts, but the SNS will help baby associate the breast with milk with the breast and make the breastfeeding relationship stronger.  There are enzymes in baby's saliva that encourage breastmilk production, so getting some latching will definitely benefit you.  Using the SNS will make your life SO much easier when transitions to the breast full time and going home in a few weeks.

(I had a preemie myself, although a 35 weeker, so my thoughts are with you during this rough time.  Stay strong mom and trust your instincts.  Feel free to private message me anytime.)

[tiredbuthappy]

In addition to the good advice provided by doulasummer, I would add that you should do skin to skin contact as much as possible, as it is good for both the baby and you supply. Kangaroo care where the bare baby lays on your bare chest. You can cover ip with a blanket. You should be pumping 8 to 10 times daily, which obviously isn't possible if you go all night without pumping. It is generally advised you pump every 2-3 hours during the day and sleep up to 1 4hr stretch at night. Besure to make one of thos night pumps btw 1 and 5 am, as that is when prolactin levels are the highest.
In addition to a good pump and pumping frequency, it is important to pump long enough. In general, they recommend 10-15 or a few minutes past the last let-down. While you are not getting anything in those last few minutes, you are signaling your body to make more.
I don't think there's a connection between labor and milk as I had 2 sections and was able to pump/nurse. It is good habits that brings milk in.
Finally, massage you breasts before pumping and do compressions while you pump. You may need to go hands-free to do that, but compressions makes a huge difference.

Congrats on the arrival of your little one. I hope the you can bring the baby home soon! Don't worry about your supply too much. It's still very early on and it's not too late to build your supply!

[tiredbuthappy]

Sorry about the typos. Getting used to the ipad

[pertykitty]

wow your little guy is eating quite a bit, my dd was a 34 weeker and is eating 32-34mls a feeding!  congrats on your baby, im sure you are feeling like i am, mine has been in the nicu for a week now :(

my nurses didnt tell me to not pump, but they also have informed me to get more rest than i have and relax.  i am doing that now and im feeling much better. the nicu can get a lc in the room to help you, take use of them as much as you can but remember, your son may take weeks to start nursing.  when he is at the gestational age he should have been born (lets say 36 or 37 weeks for an ex) he may suddenly get it.  boys take longer, my son was born at 37 weeks and i used an sns nurser for those 3 weeks then bam he got it!

i dont have much to offer with pumping as tired or doula as i am just a newbie to pumping myself.  i wanted to say that in the hosp where i had my dd, they have a store/lc service.  there i bought a medela pump that is excellent!! it normally sells for $279 but i bought mine for $225 because they had a few that came without the tubing and attachments, but i was given those parts while in the hospital.  check it out, see if they have something like that.  to rent was $75 a month and it wasnt as transportable, mine comes built into a cute shoulder bag and you can use batteries so its always available no matter where you are.

i too just bought some oatmeal to help boost my supply.  i am doing great keeping up with what she needs right now, but if they up her feeding i know i need more.  again congrats on your new bundle and try to relax and not stress!

[30something13]

I had a 30 weeker and pumped alot almost 6 oz from each side from 3 days on. I was todl to pump at the same times she eats and never let her go past 2 hours at all ever!!! The NICU she was in Good Sameritain in Cincinnati OH said that bf babies have to eat every 2 hours and bottle feed babies can eat every 3 so that might be your hang up. It was hard with driving, feeding and sleeping to pump every 2 hours but it worked for me! I also was told to drink a bottle of water 20 min before I would pump to help with the let down. Also you need to rent a pump from the hospital while he is there. I did that and used the double pump as it is way better then the single to get milk out. WHen it looks like the "flow" is gone you are not done pumping either as the hind milk sometimes takes a while to get out and you have to do compressions on yoru breasts while pumping. This only happens when you ahve to pump beofre baby can ever nurse and latch on. It is harder work for baby to nurse then to suck on a bottle nipple and they wear out fast as preemies. Don't give up!!!! Also if you are not on babies schedlue then your milk will not come in good at all and will start drying up can just not know waht you are needing! UNDER NO CIRCUMSTANCE sllep longer at night and pump when baby eats!! They should of never told you that! You can be in tune with him if you are there or not! Really! I would tingle when she would stir and not even be there! She was in the NICU for 15 days