Calling tiktok/other experts - need advice on expressing while newborn in SCBU

[stillfrazzled]

DS2 born on Tues night, 5 weeks prem and with IUGR so weighs only 3lbs 5ozs.

It's been absolutely hideous but he seems to be doing quite well. HOwever, earliest he'll be home is likely to be his due date in early Feb.

SCBU v keen on bf, as am I. Have already expressed some colostrum for him and he's getting that at rate of 1ml (!) every four hours.

How should I approach this for the next month, given that eventually I would like to ebf him?

Hosp bf person said:

1. Express at least eight times a day
   
2. Aim for ten mins on each breast, each time
   
3. Aim to produce 750ml or more.
   

Does this sound right? With combo of hand and pump expressing have managed to get 6ozs today and don't feel so horribly engorged, but don't want to over- or under- do it.

Any thoughts would be very very much appreciated.

[Bramshott]

Congratulations! I'm sure Tiktok or someone else knowledgeable will be along soon, but from my experience, it will be very tricky without a proper electric pump.

Are you still on the ward? Do they have a pump for you to use, and will they loan you one once you're discharged? If not, there are other places which loan them out.

DD1 was in SCBU for 3 weeks and went onto EBF fine after tube feeding. I was keen that she was only ever tube or cup fed there, not bottle fed to avoid confusion. I expressed every 3 hours I think, but once my milk was in and I was producing well (more than she could ever use - wish I'd known about donating it!) I didn't get up to pump overnight.

Good luck!

[NotQuiteCockney]

The advice from the hospital BF person sounds pretty good - but I would also add that one of those eight times per day needs to be at an antisocial hour of the night. (Sorry!)

Did you BF your first? If so, it should make building up your supply easier than it would be for a first timer.

[tiktok]

Not my specialism, but the bf person sounds clued up. Look at the 'performance' of the breast - if you are still producing a good stream after 10 mins don't stop :) You can swap back and do each breast again, if you have time. Agree with NQC about night time.

Keep your baby kangaroo'd if you can, for as much time as feasible.

You may well build up to 750 mls a day with a good pump - don't expect to do it straight away.

Have fun and congrats :)

[RubyBuckleberry]

I don't know much about it an I am sure there will be someone along soon. Congratulations and good luck with it all!

The videos on this website are pretty good though and this one on hand expression implies that if you can crack expressing by hand you will get lots more milk than just using a pump.

Again, good luck!
hth

[Lavitabellissima]

Congratulations Stillfrazzled

Not an expert at all but my twin girls were born 9 weeks ago at 34+3, I used the hospital electric pump whilst I was there but once home I used this double pump and it was great.

The girls didn't have much of a sucking reflex to start, so I was advised to put them to the breast first every time, they would do 2 sucks and then give them the expressed milk in a bottle. It was mostly like pouring it down there necks but it got better and better, they slowly got better at sucking and after 3 weeks I solely breast fed, it's gone really well and long may it continue. They did have some prem baby formula though in the first few days as well as the colostrum to help them put on weight before my milk came in. I followed the nurses advice as they were so little but I know some people are very anti formula but they are breast feeding well now and hasn't made any difference imho.

Hope the experts come and tell you exactly what to do but this worked for me, first week they would only take 40ml to 60ml every three hours, which went up to 100ml when I got home. They are putting on weight now and thriving. I still express once a day so DP can do the 11pm feed and I can have a good sleep

[japhrimel]

My DD wasn't premie (39+2) but spent some days in SCBU due to fluid on her lungs and stomach and an infection, all of which really messed with feeding.

A double pump makes a huge difference. And breast massage and compressions before and during pumping really do increase output significantly.

Don't beat yourself up if your LO needs formula. It doesn't mean you won't be able to end up exclusively bfing.

750mls a day is what a bf-ed baby averages from 1 month, so you'll build up to that amount. I wouldn't even think about oversupply right now - if you do express extra, freeze it if you can and your supply will sort itself out when you are bf-ing.

Get as much skin-to-skin and bfing attempts as possible. This may involve pretty much living at the SCBU as it has to be fitted in between tube feeds IME - it's not like you can just get into bed with baby unfortunately.

Make sure you look after yourself really well. Dehydration, poor diet and getting really stressed or overtired can really impact your supply.

Good luck!

[stillfrazzled]

Thanks all for the good advice.

I am doing kangaroo care as much as possible - at least twice a day, for an hour or so.

The things I prob should have mentioned are that he is currently restricted to 1ml of ebm every four hours - and has yet to start digesting it properly - and that I have DS at home so won't be able to spend all day every day in SCBU. Also can't drive there as just had a c section.

Realistically I think I'm looking at maybe trying him on the breast next week, if we're lucky, and then building up to a mixture of breast and tube feeds.

Would love to think we could make the switch to full time bf at home, but if not I will have lots of frozen stocks to mix feed with, I guess.

I'm not anti formula, BTW - just v keen on bf, esp since the hospital staff keep stressing it's absolutely the best thing for him.