From ajpr2 ~ My daughter will be very sick when she is born. She may or may not need surgery right away, definitely within six months. I really want to nurse her. I have the Purely Yours Pump so if need be I can keep up my supply that way, but I know that the baby is still the best way to keep up supply. Any advice on nursing sick or preemie babies?
From Shelley: ~ I delivered my three year old at 32 weeks, and I knew he would be very ill at birth. I have severe RH disease. He was on a vent for two days and oxygen dependent for another two weeks after he came off the vent. I didn't get to put him to breast until he was about five days old. I started pumping about six hours after he was born. I had an emergency c-section. I slept through that first night and got back on the pump early in the morning. I pumped every three hours during the day, and woke up at least once during the night to pump while he was in the hospital.
Definitely rent the best pump available; your hospital should be able to help you with that. It's not too expensive, about a dollar or two per day. You will need the strong hospital grade pump to get your supply started. You need to double pump; the LC at your hospital should be able to teach you that. It makes a huge difference, and also cuts the time that you are on the pump down by half. I recommend double pumping for 10 minutes every three hours during the day, and once at night.. It's not really too hard.
Your NICU should have a pumping room available so that you don't have to lug your machine around with you; you just need to bring your accessories. Even when I would forget mine, the nurses would break open a new pack for me.
I have had to do this with my last three babies, all of whom were born early and in the nicu for a week or more after birth. I have all kinds of tricks and tips on how to pump with a baby in the NICU:
* Get the baby to the breast as early and as often as possible. Try to schedule the LC to come in with you for that, just having her there will give you more courage.
* If you can, get a tour of the NICU now. Meet the doctors and nurses and talk to them about how important this is to you. Getting them on your team now will save you some stress in those early, emotional postpartum days.
* Another thing . . . I don't know what kinds of treatments your little one will need right away, but some of these necessary evils do interfere with feeding. If your nurses are telling you that you can't try her at the breast for whatever reason, and you think they are wrong, ask your baby's doctor directly. I found that the nurses were so "protective" of their babies, they sometimes erred on the side of conservatism. Try to be diplomatic though; you need those ladies on your side.
From Carolina: ~ My daughter was born seven weeks premature and because I was on mag sulfate, I was unable to see her for 24 hours. In that time, I pumped like a mad woman. Even after that, I pumped very frequently while she was in the NICU, and even once she got home. Everyone is right though; try to get her to the breast as much as possible, even just for practice and for her to feel close to you. Breastfeeding wasn't easy for me or my daughter, but we stuck with it and she is doing wonderfully at 4 months! Definitely get your hands on a good quality double pump!
From JenT: My daughter was born 8.5 weeks early. My advice, in addition to what the other ladies have already said, is to make sure that you pump often if you can't get your baby to breast. Pump at least every three hours during the day and at least once at night, if not more. Also, make sure to stay very well-hydrated while pumping - well, while breastfeeding too.
From JKY: I had two preemies (my first two), one at 33 weeks, one at 31 weeks. They both had some difficulty learning to nurse, but I kept up my supply by pumping, and I think it's true that you need to use the hospital grade pump. Practice putting her to the breast every chance you get. Even if she doesn't actually get any milk that way, it is great for baby's health to be close to mom skin to skin whenever possible.
From Shelley: I would like to add a tip for pumping at night while baby is in the NICU. A lot of moms skip the night time session while their baby is in the NICU. Understandably, they are physically and emotionally exhausted, but I have found that it is the key to keeping your supply going during those early days.
The trick is to get everything ready before you go to bed so that you do not have to do anything but sit up and turn the machine on for the middle of the night feed. Have the machine all set up, clean accessories, attached and ready to go. Get a small cooler and fill it with ice to put the pumped bottles of milk into when you are done; it'll save you a trip to the kitchen. I prelabel the bottles with the time I have set my alarm for too. Have the bottle caps sitting where you can easily find them also. Don't forget some water to drink. Have all this set up right at your bed side. I barely even woke up, and it is easier to get right back to sleep when you don't fully wake up.
I invested in extra accessories to cut down on the time I spent washing stuff out. I had the second set clean and ready to go before bedtime too. That way, I could pump at 2 am, and again at 7 am or so without having to get up and wash things and set up again.
Doing it this way was a huge help to me during those trying days.
From Celia: Here is a list of articles from our Breastfeeding Cubby on this topic