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Premature baby & breastfeeding

  1. #1
    Bubbly is offline Registered User
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    Premature baby & breastfeeding

    I just had my baby girl on Saturday and she was only 33 weeks and 5 days then. Her birth weight was only 1.89kg hence is now being taken care of in the IC unit of the hospital.

    The hospital encourages breastmilk for the baby, but as I cannot breastfeed the baby directly, I have no choice but to express (by hand and pump). So far (this being day 3) I am managing to get around 45 ml per pumping session. At the moment, this amount is find since she can only take 20ml each time. However, I worry that when the time comes for the amount to increase, I will not have enough for her.

    I have a few questions about all this:

    1. Am I getting enough milk from pumping? Anything I can do to increase this amount since there will be no way for the baby to stimulate the production of milk.

    2. Since premature babies tend to have weaker digestive systems and intestines, what food should I avoid so as not to cause any irritation to the baby?

    3. I also found that one breast is giving much more milk than the other (35 ml vs 10 ml). Anything I can do to improve this?

    Would really appreciate some help as my baby is likely to be in hospital for another month, so will be needing to deliver the milk everyday to her.

  2. #2
    LLL_Sarah is offline Registered User
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    Dear Bubbly,

    When you are pumping/expressing instead of feeding the baby directly it is important to pump as many times as the baby would be feeding. That is between 8 and 12 times in 24 hours. I would suggest making a chart with 12 boxes on it for each day and filling in how much you manage to pump each time. This way you’ll know exactly how things are going and if you are making the minimum of 8 pumping sessions a day.

    Mothers who pump their milk for their babies sometimes mistakenly cut back too far on their number of pumping sessions, because even with fewer sessions at first they get the same amount of milk per day. However, as time goes on their breasts stay full for longer stretches, milk production tends to go down.

    You are looking for the amount of milk you can get to increase to around 750 mls in 24 hours by the two week mark. This is the amount of milk a full term baby needs and the amount you should aim for.

    You may find the kellymom web site useful:

    Establishing and maintaining milk supply when baby is not nursing

    http://www.kellymom.com/bf/supply/ma...pply-pump.html

    Breastfeeding your Premature Infant
    http://www.kellymom.com/bf/preemie/preemie-links.html

    If you or the baby’s father are allergic to any foods. It would be best to avoid these.

    It is very common for one breast to give more milk than the other. Prof. Peter Hartmann’s research has shown that usually it is the right breast which gives more milk but in about 10% of women it is the left breast. This is nothing to worry about – just keep going. It is the total amount you get over 24 hours which is important – not how much each time or from which breast.

    Best wishes,
    SARAH

  3. #3
    peace is offline Registered User
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    Hi Bubbly,

    Sent you a PM. Please check your Inbox.

    Cheers.

  4. #4
    Bubbly is offline Registered User
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    Thank you very much for the advice. I will follow them and update you all on how it goes. Fingers crossed.

  5. #5
    ahglad is offline Registered User
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    Hi Bubbly, congrats on yr newborn. My son was born at 31wks & was also taken care of by the NICU for a month. The up side to this, I found, was that I had all my attention on expressing breastmilk & recovering frm my C-section op at home.

    With that, I diligently express breastmilk at regular intervals that is similar to how a newborn will consume, i.e. every 2-3hrs, except for the night, which I omitted. Despite this, I had more than sufficient breastmilk to be delivered to the hospital everyday.

    Breastmilk will somehow increase in quantity to what yr baby will consume, at the different stages of their development. Therefore, at this early point, tho you may find you have little to express, with continued regular expressing, you shld have no problem receiving a continued and even an increased supply.

    Invest in a good breast pump, and this doesn't have to be an electric one. I used the Avent manual pump & had found it to be useful thoughout my son's 1st 6mths and even used it for my 2nd child.

    At the hospital, I was taught several good techniques which may help you too. For one, massaging your breasts before each expressing will help stimulate flow. Another is to use a hot wet towel and place it over yr breasts before expressing, this also stimulate the letdown. Thirdly, alternate expressing yr breasts every few minutes or so and increase the length you spend on each breast, ie start expressing w/yr right breast for abt 4mins, then proceed to the other breast for same length of time. Then return to the right breast and increase expressing for 5mins, returning to the other for the same time. Repeat again for 6-7mins each breast. I kept each pumping session to abt 30mins in total.

    The foods to avoid, I was told, is ginger cos it tends to cause jaundice in the baby. You still have to eat well inorder to maintain a good enuf weight and also to supply nutrients in your breastmilk. Of course stay away from alcohol & caffeine.

    One thing I'd like to share w/you is that, having been tube-fed and then bottle-fed for a whole month, my baby had lost its instinct/ability to suckle from my breast even after he was home. That meant I had to continue w/expressing breastmilk & feeding him from the bottle. Again there are up & down sides to this.

    Lastly, I'm not sure if you've heard of Kangaroo Care, which came highly recommended by the hospital staff. It entails putting your baby (clad only in diapers) on your bare chest, and draping the both of you to keep warm, for a session of about half hr. It is beneficial to both premie baby & mother as it helps create bond, keeps baby warm, stimulate breastmilk production, helps baby grow/heal faster. I enjoyed these sessions w/my son when I visited him at the hospital.

    Above all these, steer clear from worries. Instead, focus on getting yrself healthy & well again, in good preparation for your baby's return home. It will be totally different, and more tiring for you, once you have a baby requiring yr full attention day & night. Get yr hubby to give his total support too.

    My son is now 2half yrs. He's healthy, has no complications and is now within the 75 percentile in terms of growth.

    I hope this is useful to you, and best of luck! Let me know if you need more help.







    Quote Originally Posted by Bubbly View Post
    I just had my baby girl on Saturday and she was only 33 weeks and 5 days then. Her birth weight was only 1.89kg hence is now being taken care of in the IC unit of the hospital.

    The hospital encourages breastmilk for the baby, but as I cannot breastfeed the baby directly, I have no choice but to express (by hand and pump). So far (this being day 3) I am managing to get around 45 ml per pumping session. At the moment, this amount is find since she can only take 20ml each time. However, I worry that when the time comes for the amount to increase, I will not have enough for her.

    I have a few questions about all this:

    1. Am I getting enough milk from pumping? Anything I can do to increase this amount since there will be no way for the baby to stimulate the production of milk.

    2. Since premature babies tend to have weaker digestive systems and intestines, what food should I avoid so as not to cause any irritation to the baby?

    3. I also found that one breast is giving much more milk than the other (35 ml vs 10 ml). Anything I can do to improve this?

    Would really appreciate some help as my baby is likely to be in hospital for another month, so will be needing to deliver the milk everyday to her.

  6. #6
    Bubbly is offline Registered User
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    Ahglad,

    Thank you so much for your advice. It is definitely comforting to read them. I have been trying to get more rest yesterday and the supply seemed to have improved. Will see what happens over the next few days.

    Just wondering, you mentioned the Kangaroo Care, did the hospital suggest this? Which hospital were you in? Just wondering whether the hospital (Queen Elizabeth) will let me do that. So I just bring a blanket for the visit and place the baby on my bare chest? Not sure if the nurses will let me do that since there will be other dads in the unit during visiting hours. Will see. Sounds like a lovely suggestion to me.
    Thanks again!

  7. #7
    Nula is offline Registered User
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    Bubbly,

    Have sent you a PM

  8. #8
    ahglad is offline Registered User
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    Hi Bubbly, it was in S'pore that I gave birth to my son then. Thus I can't advise you on the hospital situation here. But I'm sure the HK NICU is aware of kangaroo care. You could approach them & ask for private time/space with your baby. I was given a private room within NICU to do kangaroo care w/my son. Sometimes when this room was occupied, the nurses pushed a movable partition around my son's crib & this provided privacy too.

    A big enough towel to cover yr chest & son will suffice. Also recommended that you wear a front-buttoned up shirt (rather than a t-shirt) as it'll be easier.

    One more thing, my son had to be in a stable condition before I started on this, ie. able to be taken off machine/drips inorder that you can carry him out of his crib & onto yr chest.

    If you want more info on this (& other issues concerning preemies), take a read at http://www.prematurity.org/baby/kangaroo.html

    Gd luck. Send me a PM if you need further info.

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