Dear Cara,
What a difficult position to be in. It is hard to say how difficult the early days of breastfeeding will be, some early babies manage to breastfeed and others don’t seem to have much clue what to do. Generally mothers with premature babies need to be much more patient with the breastfeeding. Often it gets significantly easier as the baby reaches his full term date.
If your baby doesn’t suck well then it is important to get your lactation going yourself. Usually hand expression is better than pumping in the first week. Most mothers get a lot more colostrum if they express and collect the milk in a syringe. The colostrum is quite a thick liquid, with a thickness more like honey than water, and the drops just stick to the sides of the pump making it impossible to collect.
A new born baby needs to feed between 8 and 14 times in 24 hours and so if expressing to get your lactation started you also need to do it a minimum of 8 times a day. If you want to sleep a little longer in the night and only express every 4 or 5 hours than more frequent expressing is needed during the day. One way to make sure you have 8 is to draw a table of 8 boxes for each day and tick off a box each time you express.
Once your milk supply increases, usually between the third and fifth day, most mothers find that pumping will work to get the milk out, but if it doesn’t for you continued hand expressing for a few more days.
Often the doctors ask you to limit the amount of time the baby is at the breast. It can be a delicate balance between the baby using too much energy feeding compared to the number of calories he gets from the milk.
It helps the breastfeeding if bottles can be avoided until the baby has been breastfeeding well for about four weeks unfortunately this isn’t always possible in Hong Kong hospitals.
The following page from the LLLI web site answers the most frequently asked questions about breastfeeding premature infants and also lists a number of articles from our international newsletter for mothers,
New Beginnings.
Breastfeeding Premature Infants
http://www.lalecheleague.org/NB/NBpremature.html
I’ve also sent you a PM.
The hospitals in Hong Kong often let premature babies go home much earlier than in other countries. I think one reason for this is that access to hospitals is very easy here, most people live within half an hour of a major hospital and so if your baby needs extra medical help once home it is easy to return.
Letting the babies go home early has both advantages and disadvantages. Most mothers are happy to be in their own surrounding and so feel more relaxed but it often means that your baby leaves hospital before the breastfeeding is well established. You might find it helps if you can arrange extra breastfeeding support for when you leave hospital.
Best wishes,
SARAH
