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Infant feeding

Get advice and support with infant feeding from other users here.

Am not allowed to put DC to breast until 48 hours old - should I pump or wait?

10 replies

farfaraway · 08/07/2007 16:19

Need some advice. I have successfully breastfeed dd1 and dd2 after elective c-sections. I am due dc3 by my third elective section in two weeks tomorrow. However we have known for most of the pregnancy that dc3 has a heart problem and will need heart surgery in the week after birth. But have been told that dc3 is not allowed to feed for 48 hours after birth and I will not be able to even see dc3 for 24 hours after the surgery. This means that for three days in the first week I will not be able to put Dc to the breast. I have been given an electric pump by a friend and the hospital (French) is apparently fully supportive of breastfeeding and said they will give ebm in a syringe when I am not there etc rather than a bottle.

Anyway my main question is when do I start pumping? Will it work if he/she hasn't even been put to the breast? Should I wait until I can put DC3 to the breast or should I pump? Should I expect to get very much out without any kind of stimulation from the DC3. It just seems a very unnatural way to start things off.

Also Dc3 will not be with me in the hosptial so I can hardly breastfeed on demand as such either. It just seems to me a recipe for diaster in terms of feeding as I remember the hours of feeding I had to do to get any kind of supply for my other dc. Anyone else had something like this and how did it work out?

OP posts:
NotQuiteCockney · 08/07/2007 16:22

As you have breastfed successfully before, your supply should be better, and your milk will come in faster.

I think you can start pumping once you have been sewn up - this is probably a good idea, to produce colostrum that can be given to your DC3. Although colostrum is produced in such small amounts, hand expressing is meant to be better ...

I am glad to hear the hospital is using syringe feeding rather than bottles. Cup feeding also works with tiny babies.

The heart problem sounds very stressful, you have my sympathy.

throckenholt · 08/07/2007 16:25

You can start straight away - you will get colostrum for the first few days- and after that it will gradually change through rich creamy yellowy milk to the thinner stuff that it settles down to (it is actually fascinating to watch it change).

At least by expressing you will feel you are doing something really important for your baby when in reality you probably won't be able to do much else. They can tube feed it if need be.

Express every 3-4 hours as you would with feeding a baby - express for 20-30 mins max, double pump if you can - and don't worry how much you are getting.

It will also mean that when you do start feeding the milk should be flowing and it won't be too hard for the baby.

The other thing is cuddle as much as you can - that will help stimulate supply as well.

Hope everything goes well.

mamacool · 08/07/2007 16:26

I too would suggest hand expressing rather than pumping. IMO pumps should only be used once breastfeeding has been fully established, I'd say at about 6 weeks. Hand expressing is much closer to bf than a pump is. Good luck, I really hope it works out for you.

babyjamas · 08/07/2007 20:13

my dd2 was born 3 months prem - straight onto a ventilator and into nicu. I was advised to begin hand expressing almost straight away - certainly the same day. Hand expressing (iirc) because the colostrum is such a tiny amount that it would get lost in all the paraphenalia(sp?) of the breast pump - and it would be a real shame to waste it. I think i carried on hand expressing for a couple of days until my milk came in properly and then moved on to the hospital provided electric pump - had to pump every 3 hours religiously, hard work (and v stressful added to the stress of a sick baby)but well worth the effort - we came home 10 weeks later exclusively bf. Good luck with your new baby.

farfaraway · 08/07/2007 20:14

I had not thought of expressing by hand and have never done it either. I think I have a book somewhere that explains how it is done. So really I should (hand) express at what would be feeding times rather than wait and not expect too much in terms of quantity. I am not expecting more than a dribble really as I always seem to take weeks of endless feeding to get the right supply.
I am certainly looking forward to lots of cuddles and am hoping to be out of bed and over to the SB ward on the same day if I can get there. It will just be strange to hold my baby and not allowed to feed/comfort her/him. Thanks for the advice and would love to hear of if anyone has succeeded in the long term after a rocky start.

OP posts:
moondog · 08/07/2007 20:15

Mears has always got good advice and links on hand expressing.
Hope it goes well for you farfar.

XX

babyjamas · 08/07/2007 20:20

x posts there - i suppose i am a success story of succeeding after a tough start. tbh there were not that many in scbu who did but then again 10 weeks of expressing is a bit of a killer! Only the very stubborn made it! Really it was a focus for me - gave me something to hang onto during those long hard days in scbu. the sooner you can get the baby onto the breast the better - dd2 was so prem that she really didn't get the sucking reflex for another 7 weeks or so, if your baby is full term that is a huge advantage.

farfaraway · 08/07/2007 20:59

10 weeks of expressing babyJ - I pale at the thought. No wonder not many on the ward made it. Well done!
My DC3 will be born at full term - it is just more about getting started without putting baby to breast and continuing when I will not be in the same building in the hosptial. And I will very quickly be discharged and home trying to get into the hospital every day with two other DC who are not allowed on the ward, find time to express on top of, as you say, the stress of having a sick baby. DH says he has images of me expressing as passanger in car as we sit in traffic.
I really need to get off to a good start as I do not think continuing will be easy either when DC3 is still in hosptial but I am not there full time. Glad to hear of your success.

OP posts:
Ellbell · 08/07/2007 21:06

I was unable to bf my dd1, who was slightly prem, small-for-dates and very sleepy and just basically not interested. She was fed by NGT for about 10 days... initially formula and then whatever ebm I could produce. I pumped every 3-4 hours (I used a hand pump as I couldn't get on with the industrial things in the hospital - reminded me of the milking parlour on my grandad's farm ). I am not a great success story, I'm afraid, as dd never did really take to bf-ing and I changed to ff after 6 weeks (mostly because she wasn't gaining weight - was still below 6lbs). However, the pumping did definitely make my milk come in and I am glad that she was able to have as much ebm as I was able to produce for those first weeks. Good luck.

kiskidee · 08/07/2007 21:19

you can try this straight after giving birth.
i found it here on mn a while ago.

i have a thought: why don't you email Dr Jack Newman's Breastfeeding clinic in Toronto? He is a consultant Paediatrician for WHO or UNICEF and may have had experience with a baby with a heart condition and breastfeeding. his website is here

Expressing Colostrum during Pregnancy

Hypoglycaemia Policy
Most babies have no difficulty in adapting to life outside the womb. However, some babies have an increased chance of developing low blood sugar, sometimes called ?hypoglycaemia?. Babies at increased chance of low blood sugar are:
Babies born early or premature ? before 37 completed weeks of pregnancy
Babies, who are lighter in weight than expected for the number of weeks of pregnancy, sometimes called ?small for dates?.
Babies who need extra help to breathe at birth
A baby who is ill
Babies whose mothers had diabetes during pregnancy
Babies whose mothers have had to take medicine for blood pressure (betablockers).

If any of the above applies to you or your baby, then we will encourage you to feed your baby as soon as possible after birth and then to feed often, at least every 3 hours as this will help to prevent low blood sugar in your baby. Your expressed colostrum can also be given to your baby after breastfeeds. Your baby will be carefully monitored and we will check his/her blood sugar regularly.

Is there anything I can do during my pregnancy to prepare for this?
Sometimes as early as 28 weeks of pregnancy, women find that they leak colostrums. The midwives will offer to teach you a very simple technique for expressing colostrum and provide you with sterile equipment for collecting and safely storing it with labels for dating it.

How much colostrum will I be able to express?
Colostrum is present in the breasts from about sixteen weeks of pregnancy onwards. Some women leak colostrum and some don?t, both are normal. Don?t worry if you don?t leak colostrum, it is not an indication that you won?t have enough milk or a reflection on your ability to breastfeed. The amount of colostrum will vary from woman to woman. It can range from a few drops to as much as a teaspoonful or more.

When do I start?
A good time to start would be when you reach 36 weeks of pregnancy.

How often can I express?
A good time to have a first practice is when you are in the bath but you can express as often as you like.

How is it Done? In 4 Easy Steps!

  1. Prepare ? gently stroke or use circular movements with your fingertips to massage your breasts, moving towards the nipple area. (It is not essential but sometimes a back massage can help. Ask someone to stand behind you with a fist either side of your spine, level with your breast and rub their fists up and down, gently and firmly).
  2. Finding the place you need to press ? You need to find where your milk collecting ducts (sinuses) are in your breasts. The best way to do this is by feeling for them. They may feel like peas or peas in a pod or just a change in the texture inside your breasts. They are often found a few centimetres from the end of the nipple or where the darker tissue around the nipple area (areola) meets the skin of the breast.
  3. Removing colostrum ? Place the flat your thumb above and the flat of your first finger below, in a ?C? shape, over the sinuses and gently press and release, building up to a rhythm. A few drops of colostrum may appear at the end of your nipple. When the drips stop move your thumb and finger around your breast to the next set of milk collecting sinuses, repeating this process of rhythmic press and release. You may need to swap hands to express colostrum from the other side of the same breast.
  4. Collecting and storing colostrum ? You will be given a package containing equipment for collecting and storing your colostrum. There will be small sterile syringes with red caps, which you can use to collect the colostrum directly from your nipple. If you chose this way to collect colostrum, carefully replace the red cap and place the syringe at the back of the fridge. Alternatively, you may wish to use the small sterile gallipot for collecting colostrum, if so when finished re-cover the gallipot and place it in the back of the fridge. If you are expressing more than once in a day then use a new sterile syringe or gallipot at each expressing. At the end of the day, you can put all of the collected colostrum into one container (universal container) and store this in the freezer at minus 18 degrees C. When you are coming into hospital to have your baby put all of the collected colostrum into the plastic bags provided, pack the bag(s) with ice. Once at the hospital give the bag(s) to your midwife who will have it stored in the hospital freezer.
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