BF'ing + expressing prem baby

[Pigeonpost]

I wonder if anyone can help me advise my friend please. Her DS1 was born 6 weeks early and was quite small, just under 4lb I think. On NICU for a couple of weeks. Friend refused to allow formula feeding by tube so used bank milk and her own expressed milk. Baby is gaining weight but v slowly (somewhere just under the 0th centile I think). Baby is feeding every 2 hours but is a slow feeder. Uses nipple shields to assist with latch. No TT that I aware of. Friend then expresses with a hospital grade pump straight after each feed as she has been told (or certainly believes) that she needs to do this to improve her milk supply. The Kellymom website which I referred to a lot with my own DC seems to suggest this too. Friend also gives her DS a top up of a specialist prem formula which is prescribed by the dietician for 50% of the baby's overall intake. She only gives him the formula top up at night though

My friend is SHATTERED as the whole feeding/pumping/topping up process pretty much takes two hours before it starts again. She is starting to become very tearful and irrational and convinced that she's not making milk properly and that combined with her existing concerns that she's failed somehow to have a 'proper' pregnancy and a 'proper' labour (emergency section) are making me really worried about her. She spoke to a lactation consultant whilst still in hospital but seems reluctant to talk to anyone else. Friend is usually very sensible and level headed and is a medic with experience in this area but is so exhausted that all logic has gone out of the window.

From what I remember from my own DC, I would have thought that lying on the sofa with drinks and snacks watching Netflix box sets with the baby to her boob as and when and ditching the pump altogether was the way forward, obviously she will still need to add in the special prem formula feed.

I'm absolutely rubbish at knowing what to say in these circumstances as I don't want to upset her further but I'm sure that what she's doing isn't the best for her or her DS as she's going to make herself ill. Her DS is fine by the way, no other issues as a result of him being prem.

Anyone got any pearls of wisdom please?

be her biggest cheerleader and keep her going. this is really important to her and it's so so difficult but she needs cheerleaders, extreme ones, and no room for doubt. she can succeed at this.

She can get the babies on the boob but it could take anything up to 3 months. and she's going to need all the enthusiasm of her support network if she is going to succeed.

she's going to have so many worries and doubts but these will only reduce her supply thus causing more problems. are the babies still in hospital?

does she have anyone who can do a midnight formula feed?

I have just had a very similar experience with my baby and only left the NICU recently. I didn't know any babies that left on 2 he feeding schedules though! That usually stopped way before you were allowed home. She should be having frequent follow up visits from the NICU liaison nurse and the health visitor and maybe she could talk to them? We had a traumatic time with ours and have been offered to have some appointments with the NICU psychologist, maybe that's also an option? The thing about expressing after each feed is the advice you are given because such small babies don't 'empty' the breast properly apparently. With tiny babies the problem is you can't demand feed them because you can't tell if they are satisfied or too tired and weak to feed properly. We had this problem with our little one and it was so stressful. But I do agree that maybe your net flicks idea combined with a few rounds of expressing and formula bottles could be the way forward!