No breastmilk for premature baby

[topoftheworld]

Daughter arrived at 28 weeks and 1,22 kg on 11 Feb and is in an incubator in ICU, where she would probably still be for another 6 weeks.

They started feeding her formula last Monday via a nose tube and I have managed to contribute a feeble 20ml of collostrum over three days using an electric breast pump. Two days ago even that trickle stopped and my three-hourly attempts over the last 30-odd hours to convince the milk to come back have been unsuccessful.

I am so disappointed at being unable to do this for my daughter. Is there ANY way that I could still possibly get milk?

[pie]

Pump more often then every 3 hours would be a good start. Every 1.5 or so maybe, you need to get your supply going. I don't think its too late to get the milk going.

I'm sure someone else will have some better advice though.

I will be keeping all fingers and toes crossed for your precious DD. Congratulations as well.

[BadHair]

Also make sure you get lots and lots of rest, eat well, and drink much more water/fluid than usual, especially when you're actually pumping. I overdid things when ds1 was 6 weeks old and milk supply dwindled, but a few days rest and some good square meals and it sorted itself out.
Good luck, and congratulations.

[hercules]

Phone a breast counsellor - nct have them for advice.
You can take tablets as well.
Tiktok who posts here is a bfc and mears is a midwife.
hth

[prufrock]

Have you tried pumping whilst sat with her in ICU, or looking at a picture of her. There is often a big emotional factor to let down and I'm sure you are incredibly stressed at the moment which will not help you to relax enough to produce milk.
Ask the midwives about domperidone - somebody else will have more details but it's a drug that can help to stimulate milk supply and quite a few mumsnetters have succesfully used it.
Congratulations and good luck

[twiglett]

message withdrawn

[marbeth]

Congratulations on your new baby.For increased milk continue to express every 3 hours.Also get the midwife or neonatal nures to check that the pump is working efficently in case it has not got correct suction,make sure you express last thing at night and if possible once in the middle of the night.Also diet is important which can be difficult when you are making frequent trips to neonatal unit.As units are very warm make sure you are drinking plently.Also talk to neonatal nurse about drugsthat can help milk production.MAxalon can help ,some units may have a letter that you could take to your Gp to explain about it or one of the doctors may be able to prescribe it for you depending on policy.

[Crunchie]

topof the world. I did this and tried desparately to feed my prem baby. All I seemed to do was be attached to a b**y breast pump rather than spend time with my dd. Personally the only thing that worked at all was a prescription for something or other, but TBH it only increased my supply to about 20mls a time, not enough really. In the end I gave up trying as I was getting more and more upset about nbot being able to do anything for my little girl and hardly seeing her as I was trying to get some milk.

I know this is not what you want to hear, but I don't think trying to pump more often will help, it will eat into the limited time you have with her between various times you aren't allowed on the ward or whatever. Ask your GP for a prescription, but if this doesn't work don't beat yourself up, afterall your boobs weren't ready either they needed another 12 weeks too.

Good Luck

[throckenholt]

You can still stimulate your milk - it isn't too late - some women even relactate weeks after birth. Expressing is very dependent on how you feel - if you are tense and anxious it probably won't work. The best way is to try and forget what you are doing, read a good book, watch tv, whatever works for you. Try massaging your breasts first. Make sure you are drinking lots of water. Fenugreek capsules can help to stimulate supply (takes a couple of days to kick in).

Try and pump every 2.5 to 3 hours, but only for about 20 mins at a time - don't worry about how much you get - it is all stimulation.

Try and have skin to skin time with your baby as much as possible - really good for the baby and your supply.

It can be done - my twins never breast fed directly and I expressed for them for 9 months - you have to try and keep a positive frame of mind and not let it become the dominant thing.

And if you don't manage to express - well you tried - put it down to experience and do all the other things for your baby

[motherinferior]

Congratulations on your new daughter. How is she doing now?

I just looked back on some tips I posted on the 'pumps, fore and hind milk thread'; but really, I'd guess what's stopping your milk at the moment is the stress and worry. Can you get yourself into a frame of mind where you aren't too bothered about expressing at all, so that your milk might flow a bit more easily IYSWIM?

All in all, I'm with Crunchie. Take care. I really hope all goes well in the next few weeks. Do let us know.

[aloha]

Mears (a midwife) always suggest tablets called Domperidone which increase milk production and are given routinely to mothers of prem babies who want to give breastmilk on her ward. Why don't you ask about that? They can also be bought over the counter under the name Motilum.
Good luck at this worrying time for you. Don't beat yourself up if nothing works - though I'm sure it's not too late for you. The colostrum is fantastic for your dd so well done for providing her with that.

[Crunchie]

That's the ones I had topoftheworld. They do work and as I said did help me a bit. I will admit I carried on expressing for 4 1/2 months in total, but it was getting less all the time. Everyone says 'look at a photo', 'try not to be stressed', 'relax' etc That is all well an good, but no matter how relaxed you try to be, it is nigh on impossible to do

I didn't relaise until DD was two weeks old and the Dr said he felt she would live, that I had been holding my breath for two weeks Long term I didn't really relax until she and I got home and we started to be a family. Yes I appeared relaxed, but I dealt with things by avoiding thinking/talking about it. I actually avoided the hospital at times as I felt DD wasn't really mine. It was only about 2 - 3 years later that i was able to rationalise my behaviour and realsie that it was my coping mechanisim. I felt guilty as I wasn't at the hospital 24/7 as other mothers were

Honestly it is hard, just do your best, that is all you can do at this time

[topoftheworld]

Crunchie, so good to hear that I'm not the only one who finds it impossible to relax in this situation. And not being able to give her milk just adds to the stress, because now I have the added fear that she will be even worse off being fed only formula.

Do you perhaps know of an on-line support group or a website for parents of premature babies? We live in Cyprus (immigrated here only 4 months ago) and if there are indeed any support groups here, they would be in Greek. I have not handled this very well thus far and I really need help to get through everything that's still ahead.

[mez75]

I sort of know how you feel I really wanted to breast feed my baby but when he came 6wks early that was somehow snatched away from me. they did encourage me to use the breast pump which I did like you but was really embarrassed when i had to take it to them (sent DH Down with it) because i thought i needed loads.
If you do it more often it does kick in and you have to take care of yourself eat well, etc. It sounds strange but try and think of your baby i know it is hard when all you can do is look at a picture but it will help.
Won't go on but feel free to e-mail me if you want. Take care of yourself and baby. (ps ds never did take to breast but i did manage to express for 16wks)

[mears]

Topoftheworld - can I say that 20ml of colostrum over 3 days is an excellent achievement. Your breasts are certainly capable of working Expressing for a preterm baby is pretty stressful which doesn't help the let down. My own ds3 was only 5 weeks preterm but was fully ventilated for a week. I couldn't get a single drop of milk expressed until he actually was taken off the ventilator. I think I was just too anxious about him even though I didn't think I was. I also realised I wasa trying too hard. I looked at his photo every time I tried to express. I also visited him before using the pump. These are really useful tactics but for me they backfired. I then just started reading womens magazines when using the pump and found that when I wasn't concentrating so hard on milk production, I actually started being able to express.
The unit I work in prescribes Domperidone 10mg three times a day for 10 days for women with expressing problems with babies in special care. It is a drug used for bloatedness but it's side effect is increased prolactin levels which increase milk production.
Before using the pump, massage the breasts and hand express for a few minuted to stimulate milk production and let dowm. Try and express 3 hourly during the day. If you can, set your alarm and express once during the night. Prolactin levels are initially higher at night and that may help you produce more milk.
The main thing to remember is that expressing is not all about getting milk out but is also about stimulating further milk production for later. As your baby gets better, you may find you start producing more milk.
Here is a website you might find helpful here

[SueW]

Hi topoftheworld. Congratulations on the birth of your daughter.

There is a premature baby email support group here at yahoogroups . It doesn't look very busy in terms of messages but has 66 members so it may be worth your joining and asking them.

Good luck!

[justtheone]

topoftheworld, I read your message last night (I have not been on mumsnet for a few weeks) and it brought back all my memories of breastfeeding my ds. He was 8 weeks early and in ICU and SCBU for 10 weeks. Anyway after a sleepless night thinking of you I thought I should send a message.

I found it incredibly difficult to express. I started hand expressing drops into a syringe and then progressed onto hand expressing into a small bottle. After about 5 days I starting using the pump and found it very slow going. There was a room with electric pumps at the hospital and I would see other mothers get in 5 minutes what it would take me 20 minutes or moer to obtain.

The most important thing for me was to massage the breast and hand express for a few minutes before using the pump.

I also checked with the nurses each day how much milk my ds required at each feed. This slowly increased over the weeks and surprising so did my milk production. I used to express enough for each feed (and very occassionally a little surplus) so in my mind when I expressed at 3pm I pictured ds guzzling it down at 4pm! The little surplus I would put in the fridge and sometimes I had enough to freeze a backup bottle.

Somebody else mentioned expressing at night. I found this essential and could not maintain the quantity required unless I expressed at 2.30am and then again between 6 and 7am. This was when I produced the most. I also religiously expressed every 3-4 hours.

I continued to express for 3.5 months as ds needed some expressed milk to mix with his medicine. I breastfed him exclusively until he was 4 months old and he had his final breastfeed at 28 months!!!!

Having a premature baby in ICU is so stressful and it is not surprising that it is difficult to relax. There may good news one day and maybe
some not so good news the next; it is such an emotional roller-coaster for you, your family and friends. When ds was born, I was encouraged by stories from many, many people who had also experienced premature births and whose babys are now perfectly healthy children or adults.

If you do not already have one, I can recommend a comprehensive book 'Preemies - The Essential Guide To Premature Babies' by Dana Wechsler Linden, Emma Trenti Paroli & Mia Wechsler Doron. Perhaps you can order it via the internet. There is also a US website www.aapi-online.org which you may find helpful.

Finally, on the breastfeeding side La Leche League is fantastic. You can contact them via the GB website www.laleche.org.uk.

Good luck, I will be thinking of you and your dd.

[tiktok]

Topoftheworld, yes, yes, yes, you can make milk. Mears is right - getting gallons at the moment is not relevant, as your dd only need tiny amounts and what you have produced so far is about par for the course.

• continue pumping, 3 hourly is fine, you need to do it at least once at night
  
• check pump's functioning
  
• ask for better technique on the pump - you can switch from side to side as the flow slows
  
• don't bother worrying about fluids, rest or diet apart from looking after yourself. There is no evidence any of this has an impact on milk supply (though of course individual experience might differ) and nor should it - what matters is regular and frequent stimulation of the breasts
  
• go to this site about skin to skin contact and see how this can help
  
• yes, see about medication - can be very useful
  
  Good luck.

[wayward]

Hi, just thought I would put in my two peneth worth here!!
I had two prems, one at 29weeks and one at 31 weeks. I expressed for them both. Slow and hard job at first and only managed a few drops. I actually found it easier to hand express than use a manual pump Uhg!
I found that the electric pump the hosp. lent me really useful, once I had got over the feeling of feeling like a human cow. I did it more frequently 3-4 hourly day and night and by three weeks was producing over 50ml a time so that it was being frozen and used in the milk bank for other prems who could not have their mums breast milk. I had to gradually reduce the amount of time I used the pump when they came out of scbu and had a sucking reflex because I was producing far two much and as I fed from one breast the other just dribbled continually. I can laugh at it now but I really do understand your embarrasement. Oneday you will look back on these days and smaile-honestly.
Just try to relax, and I found that if I drank, then it helped, (not alcohol!!), I think it was psychological, but get yourself comfy, with a nice cup of tea or glass of milk and just gently express it in the way YOU are most comfortable and soon you will find that dh is putting it in his tea by mistake, when you leave it in the fridge!! (It does happen honestly) -Goodluck