Expressing for 28 weeker

[Amb3188]

Looking for any advice/stories for those expressing for a premature baby at NICU. My DS1 was born at 28 weeks after a PPROM and is doing really well albeit itty bitty.

The issue is now on day 10 after birth my milk supply is absolutely shocking. One side I maybe get a dribble the other max 60/70mls a day. Altogether I can’t express enough for him and he’s only 2lb. We’ve agreed to use donar milk for too ups which is totally soul crushing.

I pump every 2 hours a day and every 3/4 hours at night. I’m double pumping with a hospital grade pump- at least 20 mins at a time and I’ve just tried ‘power pumping’ 30 minute sessions with breaks when I can. I’m reasonably rested, eating well and drinking about 3 ltr water a day. I get plenty of skin to skin and have some blankets/picture of DS for when I pump at home. I often get to do three or four pumps with him at NICU.

I started on the initiation phase when pumping (began 2 days after DS was born) and had expressed maybe 15ml of colostrum before that point.

I don’t feel a ‘let down’ at all and don’t really feel engorged at all. If anything my supply feels like it is getting lower. I won’t pump more than 11/12 mls at a time and sometimes is only 4mls after 30 mins of pumping.

I think IGT is playing a factor especially with my non-producing side and also that I had a repainted placenta- which ended in a manual removal - so worried that might be affecting my prolactin levels as maybe my body hasn’t caught up to the fact that babies here.

I have seen a brilliant private consultant for a few times for antenatal care and he’s happy to write me a prescription for domperidone I’m going to collect tomorrow. Other than that I really am not sure what else I can do to help get my flow established.

I have spoken to a few specialists in the department and they all seem to say ‘stick at it, it’ll come!’ but not offer anything more substantial.

Did any other preemie mums have such a delay in milk coming in or supply? Feeling like the only one, certainly am in my NICU, making me feel super crappy.

Hi,
I had 31 weeker premmie twins due to pre-eclampsia..... not exactly the same situation as you, but I had a few things that helped me.

I had delay in starting to express because I was unwell after and I didn't see my babies or hold them for over 18 hours, that coupled with an emergency csection, caused my milk to not come in until day 5, and even then I struggled to make enough for a good 3-4 weeks.
Things that helped me were plenty of skin to skin and pumping at baby's bedside whilst touching baby.
I used to swop crocheted items from the incubators so the baby's could smell me and I could smell them when I had to pump without them.
I also "power pumped" as much as I physically could.
Make sure you're eating plenty of good foods ( which can be hard when you're at hospital) and drink water like its going out of fashion.
If you've been prescribed domperidone that's amazing! You could also use fenugreek capsules... I can't remember the dosage ( you can easily Google it). I took the max amount advised and saw a big improvement in pumping amounts after 2 days of using it.
You may have already.. but double check that you have the correct breast pump flange size for your nipples ( again if you Google the pump you're using, they all have advice on their websites to make sure you have the correct size). After weeks of pumping, I discovered I was using flanges that were too big for me... again when I got the right size ones, I saw an increase in pump amounts.
You'll obviously have a little way to go yet... but when we all finally got home after 5 weeks, my pump amounts massively increased. When I read about it, aparently just being in your own environment and no longer having the stress of nicu and your baby being in hospital, is a well documented thing that a lot of nicu mums report, so keep at it!!! 😁

The whole NICU experience is hard and very stressful at times, so be kind to yourself. You're doing amazing!!
Good luck 🙂

I haven't had a premature baby but the Premature Birth Section in MN is very supportive.

One thing I did want to add is that if you're expressing straight into bottles, put a baby sock over the bottle so that you can't see how much is going in. Apparently seeing how much or how little is going in can cause stress which can impact how much you do get. Once you can't see the milk going in, the stress is removed and usually Mums can get more milk.

Congratulations on your new LO

I had my son at 28 weeks, my milk was okay but sometimes it would slow right down, you'll find the tablets really do work wonders. Good luck.

Have you the correct flange sizes?

How are you today @Amb3188?

I'm not sure how to comment about your supply issues, but I just wanted to give you a boost and say it sounds like you're doing amazing and trying your absolute hardest for your little one. Well done. I know hard hard it is having spent 5 weeks in nicu.

Listen to the specialists and keep going. I'd say try to get as much help as possible and don't be afraid to seek help, but it sounds like you've got great support so carry on using them.
You got this 💪

Thanks everyone apologies for the delayed response time moves very quickly here!

@Killeen88 so much great advice thank you so much! I’ve got the scent blankets and lots of videos which is good but yes I’m thinking getting home will be the best help of all!

@BunnyRuddington yes great advice, thank you for posting. I tend to cover myself in a muslin once the pumps are sorted so I can’t see them at all!
And thank for you checking in again as well. Usually have a few good days and a few bad days but today has been filled with cuddles and a nice calm quiet NICU (a rare occurrence)

@BusterGonad I’ve had them for a few days and they’re kicking in I think seen about a 30% increase. Should see the full effect hopefully by Sunday. At the moment I can make enough for 50% me and 50% donor.

@Garman yes seems so but I wasn’t originally I swapped up a size and that was more comfortable.

@LF2239 thanks for posting, it means a lot. Hoping the next few weeks pass quickly ♥️

And thank for you checking in again as well. Usually have a few good days and a few bad days but today has been filled with cuddles and a nice calm quiet NICU (a rare occurrence

Sounds like you had a lovely day. Here's to many more to come

My DD was older at 34 weeks but had 4 weeks in NICU and donor milk wasn't offered as an option - I was so upset. I did find expressing immediately after seeing her, so whilst still at the hospital, was better than at home. And oats were recommended so I ate porridge and flapjacks!

Hope things are getting better for you both x

I had a bit of a supply issue and used donor milk for a little bit but it did come in enough a few days after.

What pump are you using? Is it the hospital ones?

If so, maybe try a manual pump so you have a bit more control and you can be a bit 'gentler' on your boobs. Sometimes I find the electric ones a bit harsh and got more out with a manual pump.

I haven’t had a premature baby so can’t help with that but please don’t feel crushed by using donor milk. I was a milk donor some years ago and it was an honour to donate and try to help mothers/babies going through such a rough time. It may sound a bit cheesy but it was sent with love. You are doing the absolute best you can for your baby, and it sounds as if things are turning in the right direction.

My first son was premmie 31w3d my milk supply was quite crazy and I over produced. I don't know if I just naturally produced a lot or if it was what I did. But I was recommended to do every 2 hours but was just too tired so at night I gave myself a 6 hour gap to properly sleep and pumped every 4 hours otherwise. So for example I would wake up at 6 to pump after being asleep for 6 hours then I would get to the hospital at 9 to attempt to breastfeed then I would pump just after incase there was more. He was being fed every 3 hours so I would do the same every feed so it would be roughly 4 hours. Once we were in transitional care it was much easier as he was with me all the time. I drank and ate a lot. I also gave myself an hour break from being by his side in hospital and would read a book in the common room. Fingers crossed your supply gets better. With a full term baby it can take about 2 weeks for supply to settle so it's reasonable to assume it would take longer with a premmie as you can't be with them all the time

I had my 31 weeker in November, my milk didn’t come in until day 5/6, I think the key thing is to make sure your really hydrated and I found eating plenty of oats helped my supply!
As stressful as nicu is, the more you stress the worse your supply is.
When I expressed in nicu I got much better output, do plenty of skin to skin if allowed that will also help.
It gets easier I’ve been home 5 weeks with my little one and he’s still on expressed breast milk, and breastfeeding the other half of the time! X

Sounds like you’re doing wonderfully and doing all the right things. Mine wasn’t premature but my milk didn’t come in and baby had a awful tongue tie so ended up bf’ing, pumping and using formula to top up for a few weeks. Alongside the things mentioned like fenugreek capsules , huge amounts of water (i was told for 2 glasses for every bf or pump season and extra in between.. I also found oats really helped, had them uncooked added to smoothies (oats, banana, spinach, berries, greek yoghurt and oat milk), porridge and lots of homemade flapjacks..! Also fennel tea, added this at about 4 months and gave my supply a big boost. Water water water though..!

Hello everyone, just posting an update as to my supply story in case another mum is sat in a NICU ward worrying about the same thing.

All in all I tried: power pumping, pumping every two hours, cuddling DD before or during pumping, lots of water, eating and sleeping well, oats, fenugreek cookies (actually really yummy) and one of the doctors on ward helped me get a prescriptions for domperidone from my GP. The most I ever got in a day was about 160ml total. I did find that domperidone made a big difference, so do your research there if you’re interested and ask a medical professional.

We did a combination of donor milk and my milk until DD was about 2 weeks away from discharge and then started supplementing with formula instead of donor. I honestly was too traumatised with the whole experience that I never felt well enough for the challenge of trying to breastfeed as well though I have seen mums say that it helps your supply. I did let DD latch for comfort/bonding and pump after but personally didn’t see a big difference in my supply after and he was too young to properly feed then.

I did find (albeit right at the end of my expressing journey) that in-bra pumps are brilliant. It meant I could get about and didn’t feel chained down. You don’t have to spend a fortune and I even managed to pump on my drive to/from NICU!

Support on the ward was hit and miss for me. Supply issues being relatively rare there didn’t seem to be much first hand experience in dealing with the issue and I got handed the same pamphlet from about four different nurses. I would overhear nurses complaining about doing the maths on how to split my supply over his feeds or how expensive donor milk was. I would be in tears on ward about it but look back now and think I was being a daft cow- I did my best and that’s all anyone can do.

A few weeks after he came home we slowly weaned onto all formula feeding as it was very difficult for me.

Ultimately I look back on my expressing efforts with much kinder eyes and wish I hadn’t been so hard on myself. DD is three months corrected and doing super well. I am very proud of the 12 weeks I was able to give him some of my milk but I know that he will thrive either way.

Low supply can make you feel very lonely so if you are in a similar situation please post here and I’ll get back to you as soon as I can.

Thanks to everyone that replied to me, it was a great comfort in a very stressful time x

*DS! Poor guy, sleepy mum 😂