After several years of working as an in-hospital #LactationConsultant, I’ve had the privilege of working with many #NICU families. Their bravery and resilience was inspiring to see every darn day!
The #pumping journey can be very different, depending on the gestational age of the baby at the time of delivery and/or if there are any other health concerns.
However, the underlying principles of pumping to establish and then maintain #milksupply are essentially the same for all situations. (Hint: it’s the same as if directly breastfeeding.) Breastmilk production is based on supply and demand!
Pump both breasts at the same time AT LEAST 8x/24 hours for at least 15 minutes. (NOTE: I didn’t say every 3 hours. This seems to be the recommendation I hear parroted by a lot of hospital staff, but I have found that this isn’t realistic and sets Moms up to feel like they have failed. 8x (or more!) in 24 hours allows you more wiggle room and also can allow for a little more uninterrupted #sleep overnight (although the recommendation is to not go longer than a 4-6 hour stretch without pumping overnight). Example: pump every 2 hours during daytime hours, pump right before bed, and then maybe you’ll only have to wake once or twice that night to get in your (at least) 8 sessions for that 24 hour period. 🚨 Disclaimer: I personally know how difficult this pumping recommendation is. I understand that this recommendation may sound totally overwhelming. I feel you and am not trying to be a pumping drill Sargent! 😆 But, there isn’t really anyway around it, as this is how the physiology of human lactation works. There aren’t any cheat codes or short cuts. It’s a lot of work and very challenging, but also incredibly rewarding. (But that also summarizes parenting in a nutshell, doesn't it?)
Use a high quality double electric #breastpump. If possible, the best choice would be a hospital-grade pump. These can either be rented (this is safe for multiple users because a hospital grade pump is a “closed” vacuum system - unlike most personal pumps on the market) or purchased. The most common option for a rental is the #MedelaSymphony. If you are able to get a personal hospital grade pump to keep (either from insurance or paying out of pocket), my #1 recommendation is the #Spectra S1 or S2.
Try to do as much #skintoskin during NICU visits as possible. Ask the NICU nurse every time you visit and let them know this is a priority for you (as long as medically appropriate for baby). ***Some micro preemies will only be able to do “touch times” through the isolette window at first.*** You release #oxytocin during skin to skin and this is 1 of the 2 major hormones involved in your #milkproduction.
Other breast stimulation, such as #handexpression after #pumping (your breast is never technically “empty”), #breastmassage while pumping (hands free pumping bras are your new BFF), and #warmcompresses to breasts before and during pumping
Pumping while your baby is in the NICU is a MARATHON, not a sprint. And it is very challenging to maintain your stamina (especially if your babe will be there for weeks or months). Be kind to yourself and remember that every drop of breastmilk given to your baby makes a difference! #everydropcounts
If you are struggling with #lowsupply or #decreasingsupply while your babe remains in the NICU, here are suggestions to help increase your supply and get your baby more precious #liquidgold:
Let’s define what a full milk supply is: at greater than 2 weeks postpartum, a full supply is at least 24 oz (720 mls) per 24 hours.
Check my list of basics above… are you still pumping AT LEAST 8x/24 hours? No? Then you need to get back to that. Yes? Then try increasing your pumping frequency to 10 or more times/24 hours. Remember: more demand tells your body to make more supply.
Continuing on list of basics above… are you sleeping longer than 6 hours without pumping? If so, I’m sorry to be the bearer of bad news, but you probably need to wake up and pump! Moms that sleep longer than 6 hour stretches overnight typically make less milk than those that don’t.
Check your pump itself (or better yet, have an IBCLC assess your pumping set up). 😀 You can book an in-home or virtual visit here: https://www.moblactation.com/book-online Common issues here could be using the incorrect #flangesize and/or needing to replace pumping parts after certain lengths of use. #Valves, #membranes, etc… that are worn out can decrease the vacuum pressure which in turn can decrease milk output.
Able to increase the amount of skin to skin with baby? Do it! Able to pump at the baby’s bedside in NICU (many NICUs allow this and can put up privacy curtains for you)? Do it! Able to use a high quality hospital grade pump while visiting the NICU? Do it! (Many hospitals have these on hand for moms during visitation but this doesn’t always get communicated to moms.)
Back to list of basics above… use warm compresses before and/or during pumping. And breast massage while pumping can increase output too!
Look at pics/vids of baby while pumping, bring home clothing or blankets that smell like baby and snuggle them while pumping
Try breathing exercises and/or guided relaxation videos while pumping. If you are tense, this can definitely inhibit your letdown reflex
Can’t help but continuously look at your bottles during a pumping session and obsess over the output? Put socks or mittens over the bottles so you can’t obsess.
Back to basics list again… are you pumping for at least 15 minutes per session? If so, maybe try 20 minutes per session… you might be surprised and have another letdown! Also, still seeing some dribbling of milk at the 15 minute mark? Then keep pumping! 15 minutes isn’t a magic number that works for every woman. The best rule of thumb is to pump for 1-2 minutes until the flow of milk has completely stopped in both breasts.
If you feel that your milk flow completely stops much earlier than the 15 minute mark, then try switching up your settings to see if you can restart milk flow… increase or decrease #suction; if your pump has a “stimulation/let down” button, try that.
Try “#powerpumping”. This is trying to mimic what a #clusterfeeding baby does. You’ll see it described different ways, but basically you just need to sit down with your pump and do many pumping sessions over the course of 2-4 hours… an example would be (get ready to binge watch something!): pump for 20 mins, rest 20 mins, pump 15 minutes, rest 30 mins, pump 20 mins, rest 15 mins, pump 15 mins, rest 45 minutes, etc…
“#Galactagogues” aka any supplement/drink/tea that is ingested to attempt to #increasemilksupply. Not recommended as a “cure all” and I generally don’t recommend them unless all or most of the above has been tried and milk supply is still low. There is a lot more to say about this, so please check out my entire separate blog about it here: https://www.moblactation.com/post/products-to-help-increase-milk-supply
If you’re a NICU mama and reading this, I’m sending you my love and a long, warm hug right now! Having a baby in the NICU is one of the absolute hardest things that parents have to endure. Be kind and patient with yourself! you are doing a great job and you are the best mama for your baby - regardless of your milk production! 😘😘😘
If you have a baby in the NICU, are transitioning to bringing your NICU baby home, or have any other lactation concerns, I would be so happy to help you on your breastfeeding/pumping journey! As a RN and IBCLC who has worked in a Level III NICU setting for several years, I am uniquely qualified to help you. More info on my Virtual or In-Home consultations can be found here: https://www.moblactation.com/book-online