Expressing

[LadyKooKoo]

After a week of losing my waters, baby girl was born by EMCS last Thursday at 32+2. Milk finally came in on Tuesday evening and had twelve hours of very successful expressing and since then virtually zilch. Am feeling emotional and all over the place as it is and this is making it worse as I just sit there crying as I express nothing. Anyone had a similar experience?

Hello! Congratulations on your daughter's arrival. And poor you, what an ordeal.

My son arrived this summer at 29+6. Like you I had some warning as I was admitted to hospital at 26 weeks with some problems. I had lots of problems getting my supply going - and it was so hard and emotional at the time too. I looked up stuff on kellymom website which was helpful. I found this helpful:

1. pumping around the clock (I did every 2.5 hrs in the day then go to bed after 11:30pm pump then set alarm for 3am, pump, wake at 6:30am... Crap especially when you get 10mls at 3am).
2. I hired the same machine for home that they had at hospital so I just had one to get used to (medela symphony - stupid name...)
3. I did double pumping (supposed to be good for supply but I am very clumsy so took me a while to get used to it)
4. I bought extra pump parts to reduce washing/sterilising all day (just did one mass wash in the evening)
5. I ate lots (was on hospital food and quite sick for 3 weeks before DS arrived so lost weight from pre pregnancy... Put it all on with cake and nature valley bars eaten in the night pumptimes and then the night feeds)

Good luck and please feel free to message for any help I can give. I'm not an expert and DS is only six months but hope I can help as I remember how very very hard the first weeks were. Also please do be reassured it gets better. We had a milestone today as DS is in "age appropriate" clothing for the first time - well... He fits 3-6 months baby grow and he is only a few weeks older than 6 months!!

I am in the same position as you. I have birth via c-section on Wednesday at 30+2 days to my beautiful fifth baby (but first preemie) who weighed a good 2lb11oz.

Yesterday I was managing to express a few drops every three hours but today it feels as though it's getting less and less, and just tried for half an hour and haven't got any milk for my beautiful girl.

I'm concerned that the pain I am in from the section and my inability to eat much at the moment could be the reason I'm struggling. And I am desperate to be able to do this one thing for her. Any tips are very gratefully received at this point.

LadyKooKoo, welcome to your baby girl. I'm so sorry to hear you're having expressing difficulties on top of everything else . Can I just check whether you've been using the same pump all along, or whether you've switched? I'm asking because, if your supply seems to drop really quickly, I think it's always worth checking it isn't a problem with any of the pumps you're using. They can sometimes seem like they're working okay but actually have a problem with the suction pressure (this happened to me as an experienced expresser and I didn't realise what was happening for a few days). Other than that, I second SparklyOctopus's suggestions. Do they have a lactation consultant in the NICU you're in?

dances, so sorry to hear you're in pain :( Is there anything your DH could bring you in that you fancy eating? Am in right in thinking you've been hand-expressing? Can I ask whether you've also tried a pump (and if not, it might be worth a shot, as hand-expressing cam be difficult for some people and it's possible to express colostrum with a pump too - they did that in my NICU, and then suctioned the pump parts with a syringe to catch any colostrum that got lost)? Also worth asking whether there's a lactation consultant around. The midwives/nurses can be a bit hit-or-miss in their advice, I found.

Sorry for a bit of a technical post. You should both be giving yourself a massive pat on the back for managing to give your girls colostrum/milk during their first days, at such a difficult time for you. I didn't have a c-section and I found it rough enough.

Thank you for your response. I am now using a pump and will keep going. The midwifes and nicu nurses keep telling me it's early days, it just seems like such a little amount and I have already consented to my beautiful girl being given donated milk, but I wish I could produce enough for her. She is starting on the SIFT study program tomorrow, which will determine how quickly they will up her milk feeds, so I really think I need to be providing as much as possible.

Regular pumping as advised before (double is good if you can do it)
Masssge your breasts pre pumping, do some hand expressing to start with for a few minutes and stroke towards the nipple gently whilst pumping. (All aroung your breast, awkward but just a couple of fingers will do)
Pump near your baby if possible (not easy on a Nicu or just after seeing her) or near a picture of your baby.
Plenty of fluids including fennel tea which is good for stimulating milk.
Keep going, it will come. Your body has been through a lot and stress alone doesn't help.
Check the pump as suggested before and try to talk to a lactation consultant.
Remember being a good mum is not just about producing milk. It feels like it when it seems to be the only thing you can do to help her, but being there each day and talking to her and most importantly loving her all count too. It is well documented babies respond better when in contact with their mothers. And they will slowly get you more involved in her care as time goes on.
A big fat congratulations on your baby girl.

30+5 is 17 weeks old now. I pumped like a crazy person for weeks! I was lucky that I had loads if the stuff but had supply issues when the little chap spent 2 weeks in icu with bronchiolitis. My advice is EAT and DRINK water like it's going out of fashion! Easier said than done when your head is planted up your bum due to stress of having a premmie( my water went a week before he arrived too-my 3rd prem!)
Flap jacks, proper porridge and fennel tea are great. But just good old tap water is the daddy(or should I say mummy!)
Oh and a little side note... If you're planning on breastfeeding your premmie, it can be done. My LO was ebf from 9 weeks old! It's bloody hard work but it CAN be done.
Good luck and congratulations xx

Just saw you're opting for sift. We declined that and didn't regret it because they tailored his feed volumes to him rather than some study guidelines that were for any baby.
The baby opposite us in hdu was on sift and he was quite sick after feeds because they were too much for him.
See how you go with it, but don't be afraid to pull out at ANY time if you're unhappy about anything. You can feel a bit pressured sometimes x

The consultant has been brilliant and told us that if a baby was struggling they would definitely put the baby ahead of the study, and I trust him. He's been fabulous so far and so supportive. He has told us we can withdraw from Sift at any point and that's totally our decision to take.

Oh that's good. Hope your little one(and the pumping!) is coming on nicely z

OP and dance if you struggle the GP can give you tablets donperidone (sp?) to help with the milk supply. I was told the reason you can struggle with supply is because when babies are incubated you don't get as much skin to skin as a full term baby.

Metoclopramide (by prescription) also stimulates milk. (it is usually used to stop nausea in pregnancy. Hopefully you are starting to see results with out any of that though!

The only thing that gets more milk is more expressing. You need at least 12 sessions a day in the early days. Even if they're just 10-20 mins. Every two hours daytime, hourly during the eve and once or pref twice overnight. It took me half an hour to get my first 0.5mls for my dd but by the time she left the nicu I was collecting 1.2 litres! It is a total 'mental' game, it's hard to keep expressing when you're getting nothing but that's when it counts the most as you're putting in the order for the next day - if you stop expressing when you hit empty you're training your supply to reduce. Other things that helped were barley water, boob massage and giving up the pumps and doing it by hand as pumps just didn't work for me. She repaid my hard work by bfing for two years. It was all worth it x

Not a whole lot more to add but key for me has been expressing regularly and frequently, at least 8 times a day, but regularly - make sure you keep it up during the night. Premmie DS1 33+5 had real feeding issues and partly due to my seriously lacking milk supply which, looking back, I wasn't strict enough with regularity of expressing. DS3 34+2 my milk supply has been loads better (although I did have a full term superb feeder in between) having been much more regular and frequent with the pumping. Try not to worry about how much you are getting - a lot more about the stimulation at the moment! Meanwhile, DS3, now 37 weeks, is still struggling with the latch and it is proving pretty tiring.... Hopeful when I hear stories of others who have persevered and conquered!! Try to keep going at least until a little after due date and then reassess x

The things that made a big difference for me were massaging while pumping, skin to skin with DS and domperidone. Wishing you all the best.