Expressing advice

[grainmum]

Hi I'm on day 3 of expressing for my 30w son. I've been advised to aim for 10-12 times in 24h but between being with him doing cares etc, sorting me out, eating, sleeping I've only managed x6 so far per 24h. Volumes are going well though, getting to 60ml each time.

So how hard should I push myself to increase the frequency? Thinking might do one more in a little while (7th today) then set alarm for 3am, then first thing. Or set alarm for twice overnight? Any advice gratefully received. Aware that sleep also important and struggling with that - brain racing once I wake up overnight and awake for a couple of hours.

[IwillrunIwillfly]

Thats great youre getting as much as that, well done! Its not something i know a lot about (sure more helpful people will be along soon!) but i know that expressing at least once over night is the most important as it helps youre body know how much to produce for the next 24 hours so i'd say def at an alarm for 3 and then first thing. Like you said sleep is important too! As long as your producing enough milk to feed him (which it sounds like you must be?) then it sounds like youre doing just fine! Advice is just a guide and everyone is different so try not to worry too much!

[grainmum]

Oh yes he's only having 3ml per hour at the moment!

[Dragonfree]

Wow. 10-12 times. Gosh that's a lot!

Are you bf LO at the same time? If so, getting (roughly) 360ml on top of feeding him is amazing!

When I started expressing, I did it straight after LO fed (on both boobs) to try and "fool" my body that he wanted more. I then moved to expressing at roughly the same frequency he fed at, including once overnight. After about 6 weeks of regular expressing about every 3.5 to 4 hours and getting roughly the same amount each day, I dropped the night feed. There was no effect on volume, just a few mornings of discomfort whilst the boobs adjusted the supply.

I keep a record of the volume and if it ever drops at all, I just spend a day expressing more frequently (2.5-3 hours), I only wake once in the night though (if that).

Does that help? What's your ultimate goal?

[Dragonfree]

Btw when I saw "moved to expressing at roughly the same time as he was feeding" I should clarify. I went back to work, so wasn't feeding him anymore, just solely expressing.

[MoreProseccoNow]

Hello, I had a 29-weeker & just expressed 6x daily - 11pm, 3am, 7am, 11am & 3pm etc. Apparently the 3am feed is critical to maintaining supply & you will become engorged if you don't express overnight.

I think the aim is to be getting 700ish MLS daily, as that's roughly what a newborn takes in, so you want your supply established at that level before they come home - even if they are taking in tiny amounts now. Hopefully it will increase further as you express, but supply can be affected by the whole NICU experience- there is Domperidone if your supply reduces.

You can freeze the rest in a big chest freezer (excuse the pun) for 6 months, less in a normal domestic freezer, or consider donating the excess to a donor milk bank.

It's really hard work expressing, and having a baby in NICU, be kind to yourself. Hoping your wee one goes from strength to strength & is home with you soon.

[MoreProseccoNow]

Ps yes, ideally it would be 10-12 times daily, in order to mimic how a newborn feeds, but that might not be realistic for you in terms of travel, spending time with your baby in NICU, your own health & recovery from a premature baby.

[grainmum]

Thanks xx

[grainmum]

That makes sense was wondering about the disconnect between supply and demand.

Also wondering about a small celebratory drink when I go home tomorrow any views? Obviously ample supply to "pump and dump" next feed.

[Dragonfree]

A celebration drink is fine Just don't drink so much that you drop the baby.

There's a recent thread here www.mumsnet.com/Talk/breast_and_bottle_feeding/2957049-Tommee-Tippee-Express-and-Go where someone has linked a good article.

[grainmum]

Now day 6. Milk has well and truly "come in" expressing around 100ml x7/day!

If I was breast feeding a term newborn there would be a certain amount of self equilibrating i.e. supply would adjust to demand. My DS is just having 3ml/hrs so one lot of milk would more than do him for 24h!

So should I reduce my expressing? Maybe limit the time I'm on the pump? Any advice gratefully received

[Dragonfree]

I've never tried to decrease the amount I produce .

This is only based on my experience, so hopefully others will offer their views too.

I would consider expressing less frequently (maybe morning, mid morning, lunchtime, early afternoon, evening and overnight) that way you have a bit more of your day back. To reduce the volume, try expressing only a set amount (say 50ml each time) then stop. It may be uncomfortable waiting for the next session for the first couple of days but it will adjust.

HOWEVER....

Breastmilk does freeze, and in my experience it's a real faff to increase supply (a couple of days expressing every 2 hours). Maybe consider keeping at this level and either freezing or donating the excess? You could be glad of a supply if, in the future, you want to go out.

Also, if you're expressing long term, I'm not convinced the overnight session is essential. I know someone earlier said they express at 3 am for their 29 week old, but I stopped my night sessions at when mine was 15 weeks as he was sleeping through. There was no impact to the volume and, after the first ~very~ uncomfortable mornings, I didn't have an issue with engorgement.

[Her0utdoors]

On a slight tangent, as I didn't know this when I was pumping for my first, and it would have helped me meet my breast feeding goals; the pump parts only need sterilising once in 24hours, they can go in a ziplock bag in the fridge between expressing. Well done, keep up the good work.

[Dragonfree]

Her0utdoors that's a useful tip, however it may depend on your pump. Mine says you only have to wash the milk connected bits after every use (although I sterilise too) and the pump connected bits don't need anything as they're never in contact with milk.

I like your idea of putting in a sterile bag in the fridge though - that does make sense.

[MoreProseccoNow]

I tried to stop the overnight express when my DS was in NICU & ended up with mastitis. I forgot to set the alarm for the 3am feed & got 600mls out the next morning.

The idea is to achieve & maintain enough supply to feed a newborn - so it's exhausting. But if you reduce/stop expressing at this stage, your supply will reduce too (as it's not established). Plus NICU is so stressful that it may decline anyway despite your efforts.

I found the BLISS website/forum/helpline very good - perhaps try them?

[Dragonfree]

Good point Prosecco reference establishment of milk. I would only recommend stopping the night feed if you're confident about your supply .

Even then I became obsessive about recording my amounts to make sure I'd not gone down.