Expressing for a prem and over supply

[KD0706]

So, I have gone from hand expressing and just keeping up with DD2, to pump expressing and having masses.

Her feeds will go up, but at the mo she gets 12ml every three hours.
I've just used the pump, just did five mins either side, stopping before I was properly 'empty', and got 110ml. Admittedly this was after skin to skin.

With my first baby, also prem, I ended up binning ten litres of breast milk once she started feeding directly from me (no milk bank in my area ) and I also had to combine expressing and feeding her, because my supply was so out of synch with her.

Anyway, my garbled question is - am I risking supply, mastitis etc by not fully 'emptying' each breast at each expressing session (presumably a newborn sometimes stops when mum is still flowing), and any other tips for coping with this oversupply?

Thanks.

I think expressing as much as you can is great for your supply and will stand you in good stead once your DD2 is home. Like you, I binned loads of milk and wished I'd done more research into milk banks.

Even if you don't have a bank nearby the nicu or scbu will have freezers themselves and may take it. No harm in asking

I'm in Aberdeen. The only Scottish milk bank is Glasgow and I did contact them last time but they said I was too far.

Oh well I'm Inverness (well that's my local hospital anyway) and they took the extra milk when I had my 2. Maybe its just different hospital policy or something

Bear in mind you can always freeze it yourself for when baby comes home. Not sure on freezing guidelines but its at least a month I think

That's interesting about Inverness. Aberdeen definitely don't want it, depending in how we're getting on I might give Inverness a call. I'd be more than happy to express to donate.

I'm just conscious I don't want to get too far ahead of DD in the expressing. If I kept this up I'd be expressing more than 10x what she's taking.

The trouble is some babies then go and need lots more quite quickly which is difficult to manage if you are only expressing and are trying to increase your supply, plus there is a switch from hormonal to supply and demand at around 3m so if you aren't removing enough milk then you may well struggle to up your supply later.

A full term baby goes from taking very small amounts on day 1 to about 700ml on day 5, rising to about 800ml at 6m (so only a small increase in just under 6m of bfing) so you can see how setting up a large production very early is a good thing. Though I can see how it can be tough expressing so much so frequently knowing what you pump from one side in a few minutes will do your baby all day, it's not about the now baby but the future baby (if that made any sense!)

I can't believe that a SCBU/NICU would bin 10 litres of EBM from a prem mum given that that milk is tailored to a prem's needs not a full term baby (great though full term baby milk still is, prem baby milk is a bit more in tune with the needs of a prem baby), that is such a shame and if you can find a bank/prem unit that will take it so many babies will benefit. Totally not your fault that they didn't want it last time though.

Thanks truthsweet
I'm expressing five mins from each side at the mo. getting around 80-100 ml per session.
Even allowing for the minimum of 8 sessions a day, I think that means I'm currently removing 640-800 ml a day. She is taking 120ml a day.

What do you think I should do? Keep going as I am or up the quantities?

The hope is that she'll be on the breast before she's term, so within 7.5 weeks, and my intention had just been to keep up with her (plus protect my supply with frequency of expressing) till then.

I appreciate there's maybe no black and white answer, but what do you think?

Depending on how things go I may contact organic carrot cake if I again find myself with a baby who is happily taking the boob and an un-needed supply of prem breast milk.

Personally I would keep expressing until there is no more milk coming out - how ever much that is. But of course you may decide that's not what you want to do (and that's fine by me )

The only concern is in the early days it really is a case of use it or lose it so if you are leaving milk in the breast after pumping you are telling the milk making cells that they are making too much milk and to dial it back, if you don't use all/most of the cells then the 'excess' cells can be pretty much permanently switched off and it can be a struggle to get them working again.

This is a really helpful booklet on bfing a prem baby so if you get a chance have a read. You may also be able to get a copy on from the Infant Feeding Co-ordinator/Bfing Specialist MW at the hospital (it's the Bliss guide to bfing).

No advice but i'm so jealous! Never got near that much when expressing for my Dts, v.impressed!

Thanks peeling

I'm in need of random compliments. Yesterday's best nugget from my (lovely but socially inept) mother was 'gosh is that all you get?' after sitting there watching me express.

I'm also generally feeling down as this is DD2. My second prem baby, and in feeling one prem can be put down to misfortune but two feels very firmly my fault so I'm a bit wallowing. Never mind, just have to get on with it with a toddler and a teeny prem to take care of.

KD0706 - It may not be a gallon of milk but then you aren't a Freshian (well if you are you are very good at typing with hooves!) and anyway you are pumping more than your baby needs right at this moment which quite frankly is absolutely amazing.

Does your mother know be relaxed helps milk flow - that might get her to keep her disparaging remarks to herself!

This may help with relaxing as can pumping straight after skin to skin (if appropriate).

You may find you are able to bf your daughter earlier than full term. I have heard of babies coming home at 34w ebf after doing kangaroo care (this was in a Scandinavian country but I can't remember which one as there are hospitals that do KMC from birth and even operate with baby on mum's chest!

Hello, I was pumping way too much for DD2's needs when she was in neo natal. Once she had started feeding from me at 35 weeks-ish I had to express after I'd fed her. I gradually stopped expressing after each feed and only did it once at home on our first night back when she was 35+6.

In our unit they froze milk for us to take home. I remember the bag of frozen milk was way heavier than the carseat with DD in it!

Good luck. You'll have her home before you know it.

I had two prem babies. Luckily dd was born at 36and avoided scbu but its not your fault. Dd did nearly end in scbu though. It's a shame their is no milk bank. I am now pumping as I am back to work and I wish I could pump as much as you!

You obviously know just how important your milk is for a prem baby. Forget why you've had two prem babies - your body is working wonderfully to sustain your little one and you should be really proud of what you are achieving. :)

There is a facebook group "More Milk Banks for Scotland", which is a campaign run by a mum in Scotland. She's very knowledgeable about milk transporting and sharing within Scotland. www.facebook.com/pages/More-milk-banks-for-Scotland/217164941653696

Oh, and if the milk is frozen at -18 or colder it's fine for 6 months.

As Organiccarrotcake said it doesn't matter why the babies were premmie it just means they need your milk even more. You can use the milk for weaning with foods in 6 months time. I didn't stupidly enough not sure why in hindsight.

Congratulations again, KD. I was following you on your birth thread. Ask the staff about becoming milk donor and shove it all in the freezer. Your milk, even more than that of a full-term mum, is liquid GOLD! It it completely perfect for premature babies and any baby receiving your milk would be a lucky baby. Far lower risks of nasty bowel disease, and they grow better on it. In fact a friend of a friend had her baby at 24 and luckily, like you, expressed tons. Her baby never had any formula, only her milk, grew perfectly and had very few health problems and went home 3 days before due date weighing 7lbs+ completely healthy. Truly miraculous, and miraculous food.

I just read your bit about the Glasgow milk bank turning down your 10l last time. Are they insane???? Seriously. That stuff is worth over £150/litre (that's what it would cost them to buy it in anyway)

KD, I hope you don't mind but I just emailed real baby milk .org to ask them who you could contact about donating if that's what you wanted to do. It seems such a huge shame if it can't be used.

Thank you for all the messages.

I'm doing a mixture of expressing till nothing comes out , and stopping short sometimes. My theory is that if I was feeding a baby directly the boob wouldn't be fully 'emptied' each time. No idea if this is right or not.

At the moment I have 1 litre frozen at the nnu and over a litre in my freezer at home!! I hope I will manage to breastfeed DD2, and assuming I do, I'd love for somebody to use my surplus.

I will check out the Facebook page thanks organic
I was speaking to one of the nurses today in the hope she would have some grand idea of what I can do with any excess but she had no ideas. But she did say what a shame it was, especially since prems need such small quantities, and what I binned last time could have fed so many babies.

DD2 is still doing well, they're hoping to move her out of her incubator into a hot cot soon. And this afternoon while she was having her tube feed she sucked her finger.

That's all really good, excellent news.

I would suggest expressing until your milk stops, for the time being, each time. You can adjust the supply and demand in due course but right now the important thing is to retain the supply and avoid blocked ducts. Because expressing is less efficient than direct breastfeeding you will be likely to be leaving more milk in the breast anyway, even if your flow stops, compared to direct breastfeeding.

You could also check out the UKAMB page on facebook and ask if anyone is travelling from where you are to where the milk bank is and can take it for you. There are volunteers who do this, or people who do it randomly if they happen to be going in that direction.