Exclusively pumping for preemie - Day 5 help!

[klaw87]

Hi,

I had my baby boy prematurely at 32 weeks last Thursday - he’s doing amazingly well in the baby unit in hospital and I’ve been attached to the pump every 3 hours.

This is my first and so have never breast fed before, and also never got to my breastfeeding class as he was in too much of a hurry! I literally know nothing 😬

I started hand expressing about 3 hours after birth and by Saturday evening I was ready to start pumping.

Pumping has been going really well, I’ve borrowed the hospital Medela machine after using single medela swing and the amounts of colostrum I’m getting are great (anywhere between 90ml - 220ml over the course of yesterday. I’m currently pumping at 3,6,9,12 and with the hospital double pump and this is working well.

My main question is when will the milk come in? I’m still just getting the yellow colostrum at the moment, looks like banana milkshake although lots of it! I’m on day 5 now so thinking it should be imminent? Will I start to notice it change to white? Does anything else happen in between? I have no idea what to expect but have read thy it should have come in by now.

What can I expect from exclusively pumping? Any tips and hints and routines that have worked for you would be much appreciated at this point!

Thanks :)

[PineappleScrunchie]

If there’s a lot of it it’s probably already turning to milk. It’ll probably start changing colour veg more over the course of today/tomorrow.

In terms of strategy, just keep pumping as much as possible. If you can sit next to your baby and look at him it helps. Drink and eat lots. Be kind to yourself - having a preemie is hard.

Also, I bought a little elastic holster thing on Amazon which meant I could pump hands free which really helped.

[PineappleScrunchie]

Don’t know where the veg came from in the first paragraph!

[JillyBoel]

Hello! Both mine were in NICU (DC1, 4 months, DC2, 4 days) so I have some experience with exclusive expressing.
You sound like you are doing brilliantly, that's a fantastic amount of milk to be getting on day 5, so it sounds like your milk has "come in" (which, afaik, means that you're producing milk in decent volumes rather than teeny bits).
There is a slow transition from the yellow milk (higher in fat) to the whiter milk, it's not an immediate switch.
With me, I knew my milk had cone in when I woke up and my breasts were engorged and 'full', have you had that?
It's great that you're borrowing the Medela pump (the Symphony, I think?), if the hospital needs it back you can rent one - this was the best money we ever spent.
Other tips - you don't have to keep to a 3 hour schedule once you've established a supply, but try not to miss expressing at least once between midnight-6am as hormone levels are highest then and it'll help with supply.
Good luck!
And congratulations on your baby!

[klaw87]

Thank you both - that’s really helpful!

I got a hands free pump bra delivered yesterday, that combined with the double pump has been a god send!!

Good to know it’s a slow transition to white milk - that does make me think it’s definitely on its way already - think the yellow is slowly getting paler - really wasn’t sure how it happened!

@JillyBoel In terms of my supply being ‘established’ what sort of volumes should I be getting do you think? Saturday night was when I felt like my breasted were suddenly really full and engorged - that was when I got the pump set up and the relief after was so good - when pump first went on I actually cried it was so painful all of a sudden. It’s definitely settled though, so I can feel when my body is getting ready to need express - like someone is chucking rocks in my boobs for a few moments but it doesn’t last and they haven’t felt totally engorged since then - I had just had my first skin to skin cuddles with baby before that so I think it kick started it all!
With regards to starting to cut down the pump sessions, how did you find was a realistic way and time scale to do this? I’m currently pumping far more than he needs and the freezer is racking up bottles both here and at the hospital! Happy to continue 3 hourly for now but it’s just not sustainable for a long period of time is it!

Sorry - so many questions! I really appreciate the help x

[JillyBoel]

No worries, ask away Will try to answer, but bear in mind I'm not a medical professional!

Definitely sounds like your milk is in, so you'll see it changing over the next little while.

Volumes - iirc, "full feeds" is 150ml per kilo per day (so 300ml/day for a 2kg baby, once feeding has gotten going properly), so it's great to have some in reserve as your DS gets bigger.

Re establishing supply - it's more to do with time than amount, I think - it does take a few weeks. With a 32 weeker, hopefully you won't be in for more than a few weeks, though! After that, if you breastfeed, your supply will settle at what DS needs (in theory!). If you do want to breastfeed, btw, they probably have help available on the baby unit (and one benefit of having the NG tube in is that you can take your time learning how to breastfeed in hospital!).

Timings - I'm not sure I often managed 8 times a day , but I did express 3-hourly during the day while my babies were on the unit as it gave me some routine! Overnight I'd express last thing at night, get a 3-4.5 hour chunk of sleep, get up, express, then go back to sleep for another 3-4 hours. It seemed like a good compromise between expressing regularly and getting the sleep that's apparently so important for keeping up a decent supply! It is really important to look after yourself - I'm sure you'll work out a routine that works for you.

[PineappleScrunchie]

I pretty much followed the same routine as Jilly. I preferred to plan very frequent pumping so if for whatever reason I needed to drop/delay one I still had 7 or 8 sessions in 24 hours.

[klaw87]

Brilliant thank you both - had a chat with the nurse about it all today too and she’s basically said what you are saying too :)