12 Things I Wish I Had Known About Breastfeeding a Preemie & Establishing Supply

12 Things I wish I had known about breastfeeding a preemie and establishing supply

Breastfeeding is hard.  Like really, freaking hard.  Some women claim to love it. Sure, I believe them I guess but I do not share their sentiment.  So don’t feel bad if you despise struggle with it.  I did.  Unfortunately for those of us who hate it, it’s a super food for our babies and it is so important for our early arrivals to receive their Mama’s milk.  As a 31 weeker, Zeke missed out on 2 very important months of growth in the womb but thankfully our bodies are nothing short of amazing and will compensate by producing special milk for a few weeks following delivery. The milk of a preemie mom will contain more protein, fat, magnesium, sodium, zinc, calcium phosphorus and chloride. And lets not forget the added protection against infection every baby receives from breast milk.  What do they say when you get hurt? Rub some dirt on it? Seriously it should be “rub some breast milk on it” because that stuff is amazing!  Though I guess that would be an awkward saying…Moving on.  I had decided to nurse Zeke from the second I found out I was pregnant.  It never even occurred to me that I wouldn’t be able to.  Like every Preemie Mama learns, things don’t always go according to our plan.  Zeke never did nurse but I was able to exclusively pump for 13 months thanks to these tips I learned along the way.

Get a good pump.

If your insurance covers a breast pump take advantage that.  It’s pretty common for insurance to offer a hospital grade pump at minimal cost.  Mine was $8 a month and beyond worth it.  Keep in mind, however, that they may only cover it for the first 12 months.

Pump, Pump, Pump.  Then pump some more.

Pump every 2 hours.  I know, even I want to slap me for saying that.  Just commit to doing it.  Set an alarm if you have to.  Shoot for 8 times a day and if you are an over achiever make it 10.  I pumped 10 times a day as often as I was able but made sure to get at least 8 pumps in.  Give yourself a 4 hour block at night to get some (hopefully) uninterrupted sleep. It very well could be the case that your baby is not ready to nurse and in the mean time you need to get that supply established.  And if (or rather when) someone makes the comment “Well, at least you can get plenty of sleep until your baby is released from the NICU” try to refrain from bitch slapping them.

Help encourage your let down.

For those new mommies who don’t know what Let Down is, don’t feel bad.  I had no idea until a NICU nurse explained it to me.  Let down is the reflex that occurs when your body releases oxytocin.  This causes the milk glands to contract and fill the milk ducts.  It is common to feel a little discomfort or tingling.  Or, like me, you may not feel much at all.  Some moms respond to nipple stimulation such as the baby sucking.  I found  that massaging the breast as well as applying a heating pad for a few minutes before nursing or pumping helped encourage my let down.

Nurse your baby as soon as your able.

In my case it took 3 weeks before Zeke was even able to attempt to nurse.  In the mean time keep an eye out during your “kangaroo” time for signs that your baby is ready.  They will even begin to root around for it when they’re ready. I remember Zeke slowly crawling down my chest in search of food.  (They are seriously some incredibly little creatures!)

Use that nipple shield.

It’s so much work for those little guys to nurse so give them some help.  Preemies can have a hard time staying put and may slip off the nipple.  The nipple shields make nursing a bit more manageable until they are strong enough and coordinated enough to do it on their own.  Hand express milk into the shield to get them started and let them nurse as much as they want and are able.

Be an active pumper.

Oh man, this is one I wish I would have known from the get go.  Massage and compress your breast while you are pumping.  Once I began doing this I noticed quite a jump in my production.

Double Pump

This is another thing I wish I had figured out right away.  Pump both breasts at one time. Okay so how do you pump both breasts at the same time while massaging and compressing?  How many hands do you need to get a good pump, right?  Buy or make a pumping bra.  I’m cheap so I made my own.  I bought a pack of 2 sports bras for $10.  Cut 2 holes large enough to hold your breast shield in place. Voila! A hands free pumping bra for $5!  Honestly, I would not have made it 13 months (shoot, I wouldn’t have made it 3 months!) had it not been for a hands free pumping bra.  Just get one.  You’ll thank me later.

Feed Your Supply

There are certain foods and vitamins that can help boost your supply.  You can find lists all over the internet so check some out.  Every body is different so you’ll have to find what works for you but the following are foods that were most helpful for me…

  • Water (and LOTS of it)
  • Brown Rice
  • Oatmeal
  • Brewers Yeast (I took it in pill form because the powder is seriously nasty)
  • Nuts
  • Fenugreek
  • Beer (Before anyone freaks out, this was a tip given to me by one of our NICU nurses.  She suggested that I drink a beer during my last pump of the night.  It would encourage my supply and by drinking it at my last pump it would give my body several hours to work the alcohol out of my system. ***Please consult your doctor before adding beer to your lactation diet.)
  • Medication (eventually my supply started to plummet and  I was put on medication to temporarily boost my supply.  If you find yourself in a similar situation, ask your doctor about the different medications available to you.)

I began working out again at 6 weeks PP.  In order to maintain my supply I had to increase my water intake even more and take in an extra 500 calories.  Most of those calories were made up of the foods that I listed.

Journal your pumps and talk to a lactation consultant.

I kept a journal of when I was pumping, how much I was producing at each pump as well logging what I was eating and drinking.  When my supply started to dip my lactation consultant and I were able to go to my journals and spot trends that could be affecting the lack of production.  Here’s the pumping log I used with Zeke. PumpingNursingWorksheet

Let It All Hang Out

At this point you are probably becoming a bit more familiar with the NICU enviroment. The first week Zeke was in the NICU we had a private room which was awesome because, well, it was private but it also meant that he was more critical.  As he became less critical they moved us to a shared space.  They had no separate room for mother’s who needed to pump so we did it right there.  On occasion a father of the neighboring baby would come for a visit while I was mid pump.  Yes, it was awkward for me and probably more so for the poor dad who just wanted to be with his baby and instead gets the most unsexy nudey show of his life. At first I would cut my pump short or postpone it until they left but it was interfering with feeding my baby.  Quickly I learned to get over it and did what I needed to do.  Throw a blanket over your shoulders or get a hooter hider. Or don’t and just let it all hang out.

Every body is different.

I was told that I should be able to empty my breasts in 15-20 minutes.  So, for the first couple of months I would only pump for 15-20 minutes.  After a while I started to notice that it took 5-10 minutes of pumping before I even began to produce anything. Over time I pumped longer and found my personal sweet spot.  My pumps would take anywhere from 25-40 minutes.  Keep pumping for a few minutes after you are empty.  Your body responds to the demand and will try to produce more to accommodate it.

Stock Up On Kleenex

Okay….maybe you don’t need to stock up on kleenex but you should definitely keep some near by.  Nursing your baby can be emotional, painful, frustrating and incredibly gratifying.  And nursing a preemie can be down right heartbreaking.  We, as mothers, want to do what’s best for our babies but sometimes things just don’t work.  From the moment he was able, I tried nursing Zeke. I continued trying for the first 2 months at which point I decided to let go of the idea and just continue to do what I could. Pump. From there on out, it was exclusively pumping for this Mama.

By incorporating these tips I was able to pump for the first 13 months of Zeke’s life.  I was happy that I could do that for him but honestly, I hated every second of it.  I pumped at home. I pumped at work. I even pumped in the car. My daily schedule revolved around my pumps. Social outings, date nights, work meetings, church. I got clogged ducts.  My nipples bled, they cracked, they scabbed.  Like I said in the beginning…breastfeeding is freaking hard.  So, I’ll leave you with this last piece of advice.  Stop when you need to stop. Whether it be 3 months, 6 months or 1 year.  Do what you can and at the end of the day, let that be enough. Because Mama…you’ve worked hard.  You should be proud.

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***Disclaimer. I am not a doctor nor do I have any medical training.  These are simply the tips I picked up through my personal experience in the NICU.  Consult your doctor before taking any medication, vitamins or otherwise.