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Pumping for preemies



 
 
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  #1  
Old October 11th 05, 11:40 PM
Gorgon Park
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Default Pumping for preemies

Hi. I mostly lurk here, but I am trying to help my sister-in-law and
I feel over my head, so I thought I would ask here.

My sister in law gave birth to twins 2 weeks 3 days ago at 26.5 weeks
gestation. They were born via c-section because of an incompetent
cervix. The babies are holding their own and are now above birthweight
(which was 1 lb 12oz for one and 1 lb 14oz for the other).

She is pumping every three hours and is getting about 12oz in a 24 hour
period. The babies are now taking 12 oz in a 24 hour period. So she
needs to increase her output.

She is taking fenugreek caplets and drinking nettle tea. I have told
her about the PumpMoms group, but I am unsure if she has checked it
out. I will ask if she is still seeing the LC at the hospital. Is
there anything that an LC would be able to advise her on at this point?


Other than that, is there anything else she may be able to do to
increase her supply enough to provide exclusive breastmilk for these
babies?

Thanks for any advice,
Stacey

  #2  
Old October 12th 05, 12:08 AM
Donna Metler
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Posts: n/a
Default Pumping for preemies

I didn't have a micropreemie, but it took several weeks to even get my
supply up to equal my daughter's demand (born at 34/35 weeks due to
pre-eclampsia and pre-term labor,unable to nurse due to low oral tone and
sucking reflex). And, until just recently, as she's changed her demand, my
supply has matched. So I wouldn't panic. The body is very good at meeting
the needs of the baby, even when pumping. Remember, her body wasn't exactly
expecting to have to produce milk quite this soon either, and really, 12 oz
a day of colostrum is doing quite well.

I would suggest that she find a LC who specializes in pre-term babies. Not
all IBCLC's have any knowledge whatsoever when it comes to preemies or
pumping. I know that it made all the difference in the world when I found
one who really understood my daughter's issues and saw getting her breast
milk-not necessarily getting her to breast feed-as the top priority.

--
Donna DeVore Metler
Orff Music Specialist/Kindermusik
Mother to Angel Brian Anthony 1/1/2002, 22 weeks, severe PE/HELLP
And Allison Joy, 11/25/04 (35 weeks, PIH, Pre-term labor)


  #3  
Old October 12th 05, 01:28 AM
Kim E
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Posts: n/a
Default Pumping for preemies

The babies would increase supply by nursing more, so the best way
to increase supply is to pump more. It is really best at this
early stage to be pumping every 2 hours since that is more what the
babies would be doing, and it keeps prolactin levels higher, which
is vital to increasing supply. (Some LCs will say every 3 hours,
but that is not sufficient for many women, unless you have a crazy
oversupply or something.) A few more tips:

- use a hands-free set up to allow easy double pumping
- compress/massage breasts while pumping to get the most out.
- drink plenty of water
- eat lactogenic foods like oatmeal, rice, barley etc (There is a
book called _Mother Food_ that details just about every food or
herb that has been known to increase supply, as well as those to
avoid that decrease supply)

There is also something called "power pumping" whereby you
basically mimic a growth spurt to increase supply. A couple of
ways this can be done. Either
- pump 10 minutes, rest 10 minutes, pump 10, rest 10, and repeat
for a couple of hours several times a day in addition to the
regularly scheduled pumping.
- pump every hour for 2 - 3 days

Good for you for helping out your SIL!

-kim


"Gorgon Park" wrote in message
ups.com...
Hi. I mostly lurk here, but I am trying to help my
sister-in-law and
I feel over my head, so I thought I would ask here.

My sister in law gave birth to twins 2 weeks 3 days ago at 26.5
weeks
gestation. They were born via c-section because of an
incompetent
cervix. The babies are holding their own and are now above
birthweight
(which was 1 lb 12oz for one and 1 lb 14oz for the other).

She is pumping every three hours and is getting about 12oz in a
24 hour
period. The babies are now taking 12 oz in a 24 hour period. So
she
needs to increase her output.

She is taking fenugreek caplets and drinking nettle tea. I have
told
her about the PumpMoms group, but I am unsure if she has checked
it
out. I will ask if she is still seeing the LC at the hospital.
Is
there anything that an LC would be able to advise her on at this
point?


Other than that, is there anything else she may be able to do to
increase her supply enough to provide exclusive breastmilk for
these
babies?

Thanks for any advice,
Stacey



  #4  
Old October 12th 05, 08:57 AM
Anne Rogers
external usenet poster
 
Posts: n/a
Default Pumping for preemies

My sister in law gave birth to twins 2 weeks 3 days ago at 26.5 weeks
gestation. They were born via c-section because of an incompetent
cervix. The babies are holding their own and are now above birthweight
(which was 1 lb 12oz for one and 1 lb 14oz for the other).


just wanted to say here that it's not normal to give a c-section for an
incompentant cervix, more the babies are going to be born because the cervix
is incompetant and the position or health of the babies means delivery needs
to be by c-section, you could try posting on misc.kids.pregnancy, there is a
lady known as Paula J who had 26 week twins and pumped for them.

She is pumping every three hours and is getting about 12oz in a 24 hour
period. The babies are now taking 12 oz in a 24 hour period. So she
needs to increase her output.


the first thing that strikes me is that I've always heard you should pump
every 2hrs with a newborn, they would usually feed that frequently, so you
have to mimic that. Is 12oz the most she has produced? it surprises me, as
when I was pumping (but also fully breastfeeding), in the mornings, even
after feeding Ada, if I didn't check on the pump and stop I would get that
much in about 10 minutes, admittedly it's my 2nd baby, but when your milk
comes in you usually have gallons of the stuff, so it makes me wonder if
either her milk hasn't come in properly, or if she is not responding to the
pump. Do they do Kangeroo care, where they put the babies on the mum or dads
bare chest, it is good for the babies and for the mum's milk supply. Where
does she pump? often a photo of the babies can help, if she is away from the
babies.

I'd need more details, such as what type of pump she was using, how long
each session is etc. but like everyone else, I'd recommend trying to work
with and LC on the spot.

Anne


  #5  
Old October 12th 05, 01:38 PM
Donna Metler
external usenet poster
 
Posts: n/a
Default Pumping for preemies


"Anne Rogers" wrote in message
...
My sister in law gave birth to twins 2 weeks 3 days ago at 26.5 weeks
gestation. They were born via c-section because of an incompetent
cervix. The babies are holding their own and are now above birthweight
(which was 1 lb 12oz for one and 1 lb 14oz for the other).


just wanted to say here that it's not normal to give a c-section for an
incompentant cervix, more the babies are going to be born because the

cervix
is incompetant and the position or health of the babies means delivery

needs
to be by c-section, you could try posting on misc.kids.pregnancy, there is

a
lady known as Paula J who had 26 week twins and pumped for them.

She is pumping every three hours and is getting about 12oz in a 24 hour
period. The babies are now taking 12 oz in a 24 hour period. So she
needs to increase her output.


the first thing that strikes me is that I've always heard you should pump
every 2hrs with a newborn, they would usually feed that frequently, so you
have to mimic that. Is 12oz the most she has produced? it surprises me, as
when I was pumping (but also fully breastfeeding), in the mornings, even
after feeding Ada, if I didn't check on the pump and stop I would get that
much in about 10 minutes, admittedly it's my 2nd baby, but when your milk
comes in you usually have gallons of the stuff, so it makes me wonder if
either her milk hasn't come in properly, or if she is not responding to

the
pump. Do they do Kangeroo care, where they put the babies on the mum or

dads
bare chest, it is good for the babies and for the mum's milk supply. Where
does she pump? often a photo of the babies can help, if she is away from

the
babies.


My guess would be that her milk hasn't come in and she's still getting
colostrum, which would be expected since the babies aren't anywhere near
their due date yet. Alli was almost 2 months old before I started getting
really mature milk and before I really started to get engorged, and she
wasn't nearly as "preemie" as these little ones were. Remember, she was only
a bit over halfway through the pregnancy. Not only were the babies born
prematurely, but normally she wouldn't have had to produce milk for several
months yet either. Once I started getting mature milk, I could easily pump
12+ oz at a sitting until my supply regulated itself a few months later, but
those first weeks where I wasn't getting "milk" exactly yet were tough. And
that was with a much older preemie. I remember calling my LC at one point in
tears because I was only getting about 12-15 oz a day, and having her tell
me that was actually a LOT of colostrum.

I do agree with the pump every 2 hours. My LC recommended pumping every 2
hours for 10-15 minutes on the fastest speed setting, but with low suction,
with one 4 hour stretch of uninterrupted sleep. I did that for at least the
first 3 months or so, then once my milk was in, started stretching things
out farther.

And, I certainly hope she has a good hospital grade pump with a double kit,
variable speed, and suction. If they're driving back and forth to
appointments frequently or from home to the hospital, a car adapter would be
a good thing. She should be pumping directly into whatever containers the
hospital wants used to avoid contamination.




I'd need more details, such as what type of pump she was using, how long
each session is etc. but like everyone else, I'd recommend trying to work
with and LC on the spot.

Anne




  #6  
Old October 12th 05, 04:45 PM
Anne Rogers
external usenet poster
 
Posts: n/a
Default Pumping for preemies

My guess would be that her milk hasn't come in and she's still getting
colostrum, which would be expected since the babies aren't anywhere near
their due date yet. Alli was almost 2 months old before I started getting
really mature milk and before I really started to get engorged, and she
wasn't nearly as "preemie" as these little ones were. Remember, she was
only
a bit over halfway through the pregnancy. Not only were the babies born
prematurely, but normally she wouldn't have had to produce milk for
several
months yet either. Once I started getting mature milk, I could easily pump
12+ oz at a sitting until my supply regulated itself a few months later,
but
those first weeks where I wasn't getting "milk" exactly yet were tough.
And
that was with a much older preemie. I remember calling my LC at one point
in
tears because I was only getting about 12-15 oz a day, and having her tell
me that was actually a LOT of colostrum.


really? I always thought that milk production was triggered by the removal
of the placenta and that it comes in after a similar time regardless of when
the placenta is removed, which is why mums with late losses often have their
milk come in and the engorgement is similar to a full term mum who isn't
breastfeeding, but having not been though it I probably don't understand all
the factors, sorry to ask this, but what happened to you milkwise after
Brian? The only data point I have is a friend who had 34 week twins, and she
produced gallons.

Cheers

Anne


  #7  
Old October 13th 05, 04:55 AM
Gorgon Park
external usenet poster
 
Posts: n/a
Default Pumping for preemies

Thanks everyone. I have passed on your comments to my SIL.

Stacey

  #8  
Old October 17th 05, 03:13 PM
Jake Mysterio
external usenet poster
 
Posts: n/a
Default Pumping for preemies

I was told you do produce "milk" just that it is the right kind of milk for
a premmie which is often rich in colostrum as well. at day 3 with my twins
(34weeks) I was pumping 10oz + a sitting. I could have fed all the babies in
the nursery!

Cheri
"Anne Rogers" wrote in message
...
My guess would be that her milk hasn't come in and she's still getting
colostrum, which would be expected since the babies aren't anywhere near
their due date yet. Alli was almost 2 months old before I started getting
really mature milk and before I really started to get engorged, and she
wasn't nearly as "preemie" as these little ones were. Remember, she was
only
a bit over halfway through the pregnancy. Not only were the babies born
prematurely, but normally she wouldn't have had to produce milk for
several
months yet either. Once I started getting mature milk, I could easily
pump
12+ oz at a sitting until my supply regulated itself a few months later,
but
those first weeks where I wasn't getting "milk" exactly yet were tough.
And
that was with a much older preemie. I remember calling my LC at one point
in
tears because I was only getting about 12-15 oz a day, and having her
tell
me that was actually a LOT of colostrum.


really? I always thought that milk production was triggered by the removal
of the placenta and that it comes in after a similar time regardless of
when the placenta is removed, which is why mums with late losses often
have their milk come in and the engorgement is similar to a full term mum
who isn't breastfeeding, but having not been though it I probably don't
understand all the factors, sorry to ask this, but what happened to you
milkwise after Brian? The only data point I have is a friend who had 34
week twins, and she produced gallons.

Cheers

Anne



  #9  
Old October 17th 05, 04:47 PM
Donna Metler
external usenet poster
 
Posts: n/a
Default Pumping for preemies




"Jake Mysterio" wrote in message
...
I was told you do produce "milk" just that it is the right kind of milk

for
a premmie which is often rich in colostrum as well. at day 3 with my twins
(34weeks) I was pumping 10oz + a sitting. I could have fed all the babies

in
the nursery!

Cheri
"Anne Rogers" wrote in message
...
My guess would be that her milk hasn't come in and she's still getting
colostrum, which would be expected since the babies aren't anywhere

near
their due date yet. Alli was almost 2 months old before I started

getting
really mature milk and before I really started to get engorged, and she
wasn't nearly as "preemie" as these little ones were. Remember, she was
only
a bit over halfway through the pregnancy. Not only were the babies born
prematurely, but normally she wouldn't have had to produce milk for
several
months yet either. Once I started getting mature milk, I could easily
pump
12+ oz at a sitting until my supply regulated itself a few months

later,
but
those first weeks where I wasn't getting "milk" exactly yet were tough.
And
that was with a much older preemie. I remember calling my LC at one

point
in
tears because I was only getting about 12-15 oz a day, and having her
tell
me that was actually a LOT of colostrum.


really? I always thought that milk production was triggered by the

removal
of the placenta and that it comes in after a similar time regardless of
when the placenta is removed, which is why mums with late losses often
have their milk come in and the engorgement is similar to a full term

mum
who isn't breastfeeding, but having not been though it I probably don't
understand all the factors, sorry to ask this, but what happened to you
milkwise after Brian? The only data point I have is a friend who had 34
week twins, and she produced gallons.


I didn't get much milk at all after Brian, but there was absolutely no
demand, and the nurses had me binding my breasts almost from delivery. I did
get some spontaneous letdowns and leaking for quite some time afterwards,
but never the engorgement and producing enough milk for three babies that I
got with Alli once my milk came in.


It also may make a difference as to WHY the babies were premature-my LC told
me at one point that sometimes mothers with a lot of fluid retention due to
pre-eclampsia had delays in milk production, and I definitely had major
fluid buildup with both pregnancies. And I still wish the nurses and LCs at
the hospital had realized that I needed to start pumping earlier, so I
wouldn't have had such a supply hit due to lack of demand at the beginning.





 




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