Can't find enough time to pump every 2-3hrs for baby in special care

[scaredycatz]

My baby is in special care at the hospital and I'm still here as a patient after really bad preeclampsia where they can still not settle my blood pressure after a week. They've told me to pump every 2/3 hours to keep my supply up but between visiting the baby in special care every 2 hours (trying to get him to start feeding off me instead of a tube) and feeling poorly/sleeping (hardly sleep at night due to regular obs because of blood pressure)/feeding myself I'm just not finding regular 30 minute windows to pump so I've been going every 4 hours the past few days, I'm really worried about how this is going to affect my supply and is just causing me stress all day! I really really don't want to give up on breastfeeding or lose my supply

Oh forgot to say what makes it more complicated is the trying to get him to feed off me part, I don't want to me completely empty if I'm trying to get him to feed off me so I'm really struggling with where to fit it in with his every 2hr feeding schedule

You won’t be empty if you have pumped / the more you make or take milk the quicker your replace it. You can’t empty a breast it makes milk all the time. If you have a four hour gap have a cluster pump where you do a quick pump leave 39mins to an hour and another pump. Only Pumo whilst you have milk coming out - would very rarely take thirty minutes. You are better with more short pumps. Ask to speak to the feeding specialist as you should be tracking the over all pumped volume and looking to increase it every twenty four hours. It’s hard when you feel unwell

You won’t completely empty, don’t worry about that. The body will produce as much as you feed and pump. (Mothers of twins can breastfeed too). I would say every 3 hours should be more doable than every 2. I used to do 2 hours in the day. Something like this:
6:30
Go see him in NICU.
9 am.
Then wait for ward rounds.
11:30
Have lunch.
See him in SCBU and hold.
2 pm
Then an hour later at 3 pm
(I then had to go pick my other son from school).
5 pm (while my older son had dinner)
7 pm (post bath)
Back to NICU
Hold the baby.
10 pm.
Come home.
Pump at 11:30-12.
Sleep till 4 am. Pump.
Sleep till 6:30 am and pump.

And don’t pump for 30 minutes. 15 minutes is enough. It’s a question of stimulating your breasts regularly as a newborn would do and not about the duration. Especially if you are trying to feed. If the baby has had a small feed then you can empty your breasts by pump later on. You can also ask to pump in SCBU cot side.

Could you nor pump while hes on OP? I found my milk came easier while I was holding ds in NICU.

Its bloody tough though, I know, I remember in my sheer exhaustion, throwing my freshly hard won milk down the sink instead of putting lid on 😭

Pump while you hold him or while he feeds from the other side. Pump while you eat. Pump through the night. It will be a lot easier to find the time now than when you are at home. It will be so worth it to be giving him all that milk

If you can prioritise an expressing session in the early hours (between 1 and 5am) that one is particularly worthwhile as it's when the hormone is released that encourages your milk supply.

Aside from that, don't worry about being 'empty' for actual feeds. The pump is not as expert at getting the milk from you as baby is/will be. If baby is hungry and latches they'll get milk.

I'd maybe make every other expressing session shorter (15 minutes) but try to maintain every 3 hours.

I was on a feeding regime with DD for the first 6 weeks so had to manage feeding every 3 hours, each feed followed by an expressing session, then washing all the components ready for the next cycle. It was gruelling and emotionally draining so you absolutely have sympathy from me, but it's a relatively short time and if you're determined to BF it's worth persevering. It shouldn't be long before baby starts to feed better directly from the breast and then you'll be able to reduce the pumping.

Oh so shorter pumping sessions is ok then? I asked one of the midwives here and she said to stay on the pump until I'd completely emptied the breasts so I've been doing 30-50 minute sessions each time. More 15 minute ones definitely sounds more like it will fit into the day. I will try that starting from now and see how I get on. Also, does anyone have any tips on getting a 34 week old who sleeps all the time to take the breast? He is showing signs of wanting to and has put my nipple in his mouth a couple of times but then falls back to sleep almost instantly. Fully feeding off me is one of the things he has to do before he can be let out of SCBU so I'm keen to do whatever I can to speed it up

Pumping their arm gently can help keep them awake or gently scratching the bottom of their feet. But, this was advice I had for DD who was a 39 week baby so I don't know if those things are appropriate for your baby. DD was a sleepy baby and it did take us a while to establish BF.

Another thing you could try is hand expressing the boob a tiny bit until there's milk sitting on the nipple so that baby gets an immediate reward for being there and that might encourage them to look for more.

It's bloody hard work. Make sure you are pumping through the night too. I managed it while Dts were in NICU but the reality was I couldn't produce enough so I gave up. I was prescribed domperidone but I'm nit sure if they do that anymore?

Is donor milk an option to take the pressure off you a bit?

I've no advice on breastfeeding but I've had a similar pregnancy issue with pre eclampsia and an extra long hospital stay after the birth so please remember to take care of yourself and do whatever causes you the least stress.

What pump are you using? Have you got a double one? What has your schedule been like pumping during the night?

You could use a cool flannel to try to wake him up. Or maybe try a nipple shield to see if it makes as different.

Is their a specialist team that could support you more with this? Don’t be afraid to insist on getting more support. They should be the experts! Good luck and congratulations on your beautiful new baby.

That's a really good point! The hospital should be able to supply you with a double pump so you can express both sides at the same time which obviously cuts the time!

If the hospital can't, it would be worth every penny to hire a hospital grade double pump.

Just wanted to jump on and say you’re doing a fabulous job in a really difficult situation. It’s amazing that you’re pumping and breastfeeding but remember your maternal mental health is also really important and supplementing with formula to actually enjoy your baby is no bad thing. Speak to a lactation specialist and be honest about the issue and see what they recommend they may be able to come up with a more realistic plan. Good Iuck and congrats on the baby

Hi - I went through this too. Severe pre eclampsia and 2 weeks in hospital while baby was in NICU then SCBU. As she was born at 32 weeks I didn’t even try to get her to feed from me until after 34 weeks and she was taking a bottle. Feeding didn’t really establish itself until 36 weeks.

Personally I pumped every 4 hours and did both breasts at each pump (later once feeding from me DD only feed from one breast each time). A hospital grade double pump made life a lot easier (once home I hired one) as I pumped for about 15 mins then stopped.

You may find you’ve way more milk than baby can take at this time so as long as you’re keeping supply going it will adjust once baby can feed from you.

I didn’t wake in the night to pump so had 6-8 hrs gap but was always so full first thing that I woke desperately needing to pump. In part the pre eclampsia and then the mediation I was on meant I needed that sleep and was lucky it didn’t seem to cause any issues with supply. I took the view I would do what I could manage whilst unwell and just take things from there. Don’t underestimate how hard this is on your body. You need to ensure you’re well.

Are you able to take his clothes off before feeding? It really helps them stay awake for the feed as they aren't so warm and snug. It was the advice we were given for our newborn in hospital and even now my DS is 4 months I still take him out of his grobag to feed otherwise he'll fall asleep after 2 minutes!

Also, rub your finger under his chin when he stops sucking. Try blowing lightly on his face or tickle his feet. All this was midwives' advice that worked well for us.

My 33 weeker nearly killed me trying to get him to latch, I really wish I'd had the strength to stop earlier and just expressed milk for him.

Your mental health is really important. Take the time to rest and express, don't worry about the latch.

(Also I found a hand pump more effective than an electric one)

My 26 weeker only really latched from 35 weeks. Don’t put pressure on the latching. As long as he’s trying and you are pumping it will come. We persevered and one day he just ‘got it’. Breastfeeding is hard work and much harder work than being tube fed. That plus your warm skin means he falls asleep. You can do a nappy change mid feed to wake him up as well. But as I said, it might be easily another week or so before he learns the art of latching. If it helps think of it as a skill BOTH of you are learning.

And try a nipple shield! It’s easier for them. It didn’t work for me because I have oddly shaped boobs but my preemie was my second baby so I had some breastfeeding experience anyway.

Oh yes nipple shields really helped me. Only way my two could feed.

Hi OP, I really feel for you and your baby. It's such a tough time when they're in SCBU and you're also unwell. I had similar with my DS and it was just draining in every way.

DS was born at 33 weeks, he went from NG tube to bottles, then from bottles of EBM to the boob when I brought him home after his due date. In regards to pumping, I went on how my breasts felt but never went over 30mins, usually up to 20mins max. I used the medela double pump at the hospital and hired one when I got discharged. I also got myself 5 spare pump parts so I didn't have to sterilise after each session. Instead I'd have a dirty and clean box of parts in rotation. I also made sure i ate a lot and drank lots of water. I pumped next to him and also when I was in SCBU.

Try not to worry about being empty. I found it easier to get DS latched when the boob had been expressed as his mouth was tiny and he could cope with the volume of milk.

He was also very sleepy hence why I brought him home on bottles as it was easier for him to take. Once he "woke" up a bit after his due date I then started to be able to breastfed him. I'm sorry I don't think I can offer any advice on how to try and rouse your little one to take the boob as preemies seem to do everything in their own time, until one day things click

He's almost 9.5 months actual, 8 corrected and I'm still breastfeeding him. You're doing so well to be pumping when you're so poorly. Be kind to yourself and reach out to the SCBU nurses on pumping advice. I found them more knowledgeable than the midwives.

I used to pump after every attempt to feed. Had my baby at 29 weeks and the nicu nurses said most babies aren't really ready to feed till 36+ish weeks. Just getting lots of skin to skin and mouth to nipple even if not actually sucking will help. You'll probably find that when ready something just clicks with lo and you'll be home in no time.

Do you have a double pump? My mum bought me one, they’re not cheap but it definitely kept me pumping/enabled me to eventually exclusively breastfeed as it took my 40 minutes sessions down to 15-20 minutes as I was finding the longer sessions unmanageable.
I used to do 4 hourly, along them lines of 6am, 10am, 2pm, 6pm, 10pm, 2am as I was told that waking in the night was the most important one and I’d pump in my baby’s room as often as possible as that helped my supply, when I couldn’t be with her I would look at photos. I probably produced enough for 3/4 of her feeds through pumping but once she could feed directly my supply really upped which I don’t think is unusual as pumping just doesn’t produce the same hormones as feeding directly.
Things like tickling their cheek will encourage them to feed and tickling their feet will keep them alert. The nurses told me that one day something will just click and they will suddenly feed well (maybe a sleepy day the next day through the effort) but after that they will have just got it which I found to be very true and once my DD got it we were out within a few days.

Couple of other things, my 26 weeker came home on half bottle of EBM and half breast. And then I transitioned to the breast at home when I could sit on the sofa with a cup of tea and watch endless box sets. It’s hard to do the endless newborn feeding in SCBU.

And your NICU will have a discount code for the Medela if you want to rent it. Some babies will require you to pump after a feed for a week or two past their due date. (And some people might want to pump anyway so that their babies can have a bottle. Mine had a bottle for his 10 pm feed that DH gave him so I could sleep from 8-1/2ish and then he would breastfeed for the rest of the night shift.