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Pumping Breast Milk Questions Answered

Breastfeeding & the NICU

By Amalah

Dearest Amalah,

Let’s just start by stating that you are my mom hero. I stumbled upon your pregnancy calendar and got hooked on the advice column. Later, I found your blog. You are highly entertaining and uplifting. I know you don’t have any first hand knowledge of this, but I am way too exhausted to do any research and I’m hoping you can point me in the right direction.

I had my sweet baby boy at 32 weeks. He is currently in the NICU and is expected to have no long term complications. He receives all of his nutrition through a feeding tube. Our hospital has a donor breast milk program and he receives my breast milk supplemented with the donor milk through the feeding tube. Although the NICU has a few “boarder rooms” available, they make a pay by the hour motel room look like the Ritz and it is highly discouraged by staff to stay there for mom’s sanity.

My problem is milk production. My milk came in quickly, but hasn’t kept up with the baby’s feedings. In the last week, I have not seen an increase in milk production. I can only pump until next week, when my baby may be able to take in some milk orally while still being able to gain weight. I just started supplements and got the “mother’s milk” tea. I pump for 15 minutes at a time, every three hours. I only get a solid milk “flow” for the first 6 minutes or so.

So my question is, what advice do you have on how to increase milk production when you can only pump? When the baby comes home, will my milk production naturally increase?

Yours truly,

C

So believe it or not, I think it sounds like your pumping is actually going pretty well! It’s really important to remember that no matter how great of a pump you’re using, your boobs can tell the difference, and will behave accordingly. Thus, the amount of milk you’re able to pump will generally be less than you’ll produce when your baby is nursing directly from the breast.

So I would advise you to keep doing what you’re doing, with the goal of keeping your supply stable in the interim, rather than hoping and expecting a steady increase via just the pump. As long as you’re not seeing a DECREASE in milk production, you’re in good shape, I’d say.

I always found pumping was easier if I had something that smelled like my baby, so if you can snag one of his little hats from the hospital, keep that with you to sniff and see if it triggers a more forceful let-down or keeps the milk flow going a tad longer. (Looking at photos helps too.)  Give the supplements and mother’s milk tea time to start working, and try to not freak out over your output quite yet. Once your baby is able to latch on and nurse directly, your supply should naturally increase. Not sure if you’re able to hold him yet, but once you’re able to do direct skin-on-skin contact with him against your chest, do it as often as the nurses will let you, then pump immediately afterwards. Naked baby skin and head nuzzling kicks boobs into overdrive like nothing else.

At the same time, give yourself a heapload of credit for any and all milk you are able to produce, in the face of an obviously less-than-ideal situation. The donor milk program is a great, awesome thing and you’re both very fortunate to have it, so please please please don’t look at needing to supplement now or down the road as a bad thing, or a failure on your part. You’re doing GREAT, REALLY GREAT. And it sounds like your baby is too! And that’s what’s most important.

Commenters? Any other breastfeeding in the NICU tips/advice/experience to share?

 

Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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Comments

  • Jean

    No comments from the perspective of having a NICU baby but I just wanted to send MAJOR KUDOS your way…you are doing sooooo awesome 🙂 I am so glad your little one is going to be ok and I think it is such great news that he may be able to nurse from you next week. Just going to keep my fingers and toes crossed for continued success…go Mom 🙂

  • Michelle

    Lactation consultant chiming in here (Amy, not to be too stalkerish, but we met in person at the Ben Folds Five concert and I actually did my NICU training at the hospital you delivered at!)

    YOU ARE DOING FANTASTIC. As Amy said, your body knows that the pump is not your baby, and right now the focus definitely should be on just maintaining what you have. At 33-34 weeks, babies can generally be put to the breast for nuzzling/experimenting. Does your NICU have a lactation consultant? Check with them about nursing with an SNS (that’s a tube that gives the milk while they are at your breast – less work for the preemies) or even just doing skin to skin while pumping. A lot of our NICU moms found that the skin to skin upped their output.

    The other thing to keep in mind is just exhaustion. An exhausted body isn’t going to produce as much, and while I applaud you for going every 3 hours, make sure you’re getting enough rest and fluids in as well.

    Good luck, you are doing a wonderful thing!

  • L

    As a NICU nurse – first, kuddos to you for keeping up with your pumping. Second, make sure to mention to the nurses and neonatologist that you are drinking Mother’s Milk Tea. In some rare cases, that can cause problems. Doesn’t happen often, but something to keep in mind.

  • Sara

    My baby was in the NICU for the first few weeks and once my milk came in, no amount of 20 minute pumpings or more frequent pumpings worked to increase supply. I was able to hold her once an hour with skin on skin contact but it did not help me increase supply. Once we got home however and there was a lot more holding and contact my supply did start to increase, especially once she learned to breastfeed around 8 weeks old.

    There is a word of warning in there: even when we came home, she was used to the bottle and had a really hard time transitioning to the breast. I ended up pumping at home on top of bottle feeding her for about 5 weeks, which was the hardest thing to do. But, you are doing great, and you can keep going.

  • Lorna

    I have been exclusively pumping for twins for a year (or will be a year in a week)! What I have found to be extremely helpful (and supportive) is a facebook group I found, called ‘Exclusively Pumping Group.’ The lady who started it also wrote a book recently called ‘Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby.’ You are doing great pumping every 3 hrs! The only thing I would suggest is to pump for longer, maybe 20-30 min. I get another let down after 15 min.

  • Z

    My baby was only in the NICU for a week, but i was asked to pump every two hours.  I rented a Medela pump that did both sides at the same time and once the baby was home, I was able to stop pumping altogether.  My NICU had a lactation consultant who helped to fit the different “cups” on so the pump would work at its best for my breast size.  I think the lactation consultant’s comment about exhaustion is so important though, so maybe every two hours isn’t necessary for you.  A few months later I felt my supply was getting lower (maybe when the baby was around 6 months) so I started taking tons of fenugreek pills, which seemed to help production a lot.  And, be sure to drink tons of water.  I imagine once you get to nurse your baby and aren’t in the NICU your production will be great.  Good luck and I hope your NICU stay is as stress free as possible.  

  • Tania

    Sounds like you’re doing great! I pumped for my daughter for ten months (no NICU, just a lip & tongue tie that meant no direct breastfeeding for us!) and I had an extremely slow, steady increase over the first five weeks until I was making enough to feed her entirely myself with no supplements and my supply continued to increase until 13 weeks post partum when it levelled off (at which point I made more than she needed) so don’t worry, your boobs will definitely catch up to baby even if you do continue just on the pump. There is a brilliant ”exclusive pumping” group on babycenter that has everything you need to know about pumping on it, and a truck load of lovely moms who can answer any specific questions you’ve got. I went on there a lot when I was bored during my pumping sessions and I learned everything I know about pumping on there. There’s no way I’d have managed it without that group.

    What you’re doing, Eight pumps a day, is perfect, just make sure you pump for a few minutes longer once nothing’s coming out as I found that picked up my supply. The only other thing I’d say is that 15 minutes is relatively short- if you are concerned about your supply not rising then you might have more luck doing 30 minute or so pumps. Think of it like this: 8 pumps x 15 mins = 2 hours at the pump, newborn babies spend more than 2 hours a day at the breast. Just an idea! Lots of luck, and big hugs! Pumping is so so so exhausting and boring and hard and you’re a wonderful mum for even giving it a go!! Xxxxxxxx

  • Samantha

    My baby was born at 30 weeks and spent 29 days in the NICU. By the time he went home he was half on pumped and fortified bottles and half on nursing. We gradually did fewer bottles. Now at fifteen months he is almost thirty pounds and is still nursing once a day. You can do it!! Here is what helped me. Eat and drink more yourself. Try pumping for twenty minutes. You may be able to trigger a second let down. You know how you do the pump at a faster speed until you let down and then slower for the six minutes the milk is flowing? Repeat that cycle again. So once the milk slows go back to the faster speed and either stay there until you let down or your 15-20 minutes is up. I never got more than 3-5 ounces per session ever, and I pumped at least once a day for 13 months. If you’re stressing about pumping try pumping while watching a show on your phone. Try a power hour once an evening: turn on the tv and pump for eight minutes and rest for four and pump for eight and rest for four repeatedly until the hour is up. Take a nap. Give yourself at least one five hour chunk at night to sleep. You could pump closer to two hours apart during the day if you need to. Breathe. Leave the NICU at least once a day and sit in the sun.

  • Sarah

    I want to second the comments about making sure your pump “fits”.  An LC can tell you that.  Also, definitely balance exhaustion against pumping more, but if you can do every two hours as opposed to three, that may help as you would likely be feeding that frequently if your babe was nursing.  Remember, pump parts can be refrigerated between sessions so you don’t have to wash everything every time which can cut down on the amount of time the whole process takes.  And in terms of time, an excellent LC advised me to pump until flow stopped and then give it a few more minutes, even if nothing was coming out.  A few days of that and I found I typically experienced an additional let-down to the pump….this is also what babies get, flow-flow-flow, then a break, almost as if your body is checking in to say “you full yet” and the nursing/pumping continues there can then be more output.  Definitely hydrate, definitely eat and definitely be proud of however much EBM you are able to give. You are doing great!

  • Christy

    Hey girl! First off huge congratulations on your baby. Sounds like he’s doing great and YOU are doing great. I had 31 weekers last year – twins – and have done the NICU dance with pumping and supply building and stuff. First, are you using a hospital grade pump, like a Medela symphony or something? If not you might want to look into renting one….it’s usually not too expensive and makes a giant difference. Second, echoing what everyone else said about size – try to get the lc to come watch you pump and see if she has recommendations about pump speed, cone sizes, etc. I know one of them recommended that when the milk started to taper off when I was pumping to start the “let down” part of the pump cycle again to encourage a second letdown. Third….try to focus on getting 8 pumping sessions in a 24 hour period rather than every three hours. If you can, throw a couple of sessions in every two hours….and then sleep for six hours in a row somewhere. The sleep will make a really big difference to your output. Try to relax and remember that when your baby comes home and you are freer to nurse regularly, he will get your supply where it needs to be really fast. It’s almost easier to have a little less than what he’s taking and allow him to get the supply where it needs to be rather than have a huge oversupply….because then you have to fight to get him the hind milk and latching issues can be trickier. Basically just hang on right now. Just hang on. Keep your supply where it is, take things a day at a time. You will get there. My girls are fourteen months now and I’m still nursing. 

  • Dana

    We didn’t have the NICU experience, but I had a very stubborn (and hungry!) girl that wasn’t a very efficient nurser. So we pumped and bottle-fed. My LC (who was so supportive of feeding breastmilk, regardless of the vehicle) suggested something to keep up with growth spurts that the pump couldn’t replicate: About an hour after a regular pumping session, get on the pump again for 5-10 minutes. Do this for a day or so, until you notice an increase in how much you pump at each regular session. The goal here isn’t necessarily to produce much in those few minutes, but to trigger additional production for the next regular pumping session. It’s a little daunting, but I didn’t have to do it too often – just when I noticed H taking in more at each feeding. It worked for us and I didn’t have to supplement after that, until we went to full-time formula when I had to start a non bf-friendly medication. Second to the pumping a few minutes past the end of milk flow – my LC recommended that, too. And of course, get in all the skin-to-skin and cuddle time you can – I got to the point where I could just think about my girl and trigger a let-down! Wishing you all the best as your little guy prepares to “graduate” from the NICU!

  • So much great advice here – I had 33-week twins in the NICU for a while, and my main things advice would be: hospital-grade pump for sure if you’re not already using one, get a hands-free bra to use it with, and find out if your NICU has a pumping area. It seems counterintuitive to pump away from your baby, but I found the open NICU room with nurses and other parents coming and going to be too intense for me to relax in, and our NICU had a special pumping room with big baskets of bottles, curtained-off private rooms, fairly comfy chairs, and Medela Symphonys, so all you had to bring was your tubing and stuff. I made myself relax in there with a book or movie on my iPad, and it worked better than trying to do it in with the babies, at least during the time they were in the bigger NICU room. It is super frustrating, though – you’re doing an amazing job.

  • Mona

    I just wanted to say congrats and add a second to the comment to pump a bit longer. My oldest stayed in the NICU for a week- not long, but it was hard and made the BF situation more challenging. I was able to BF him at the NICU several times a day, but he was already used to the bottle by the time he came home, so I ended up pumping exclusively to bottle feed. I also have some unwieldy boobs, so it just worked better for us all the way around. But I ended up pumping every 3-4 hours, minimum 20 minutes a stretch, eventually going to every 5-6 hours until we weaned. I also had a second letdown at around the 15-20 minute mark. Plus, longer (but not necessarily more) pumping sessions seemed to tell my body to produce more.
    Good luck to you and congratulations again!

  • lynn

    My son was born at 33 weeks and couldnt nurse until 35 so i know what youre going through. I would suggest nursing every 2 hours when possible and extending it to 20-30 minutes. I know it seems rediculous but it could really help if you have a second let down. Drink LOTS of water and eat well. Rest whenever possible and try to get 5 solid hours of sleep in a row. Hold the baby when pumping or right before as soon as youre able to. And RELAX while youre doing it. I think i read 12 books just while i pumping the 3 weeks he was there. I think all thats already been said but I wanted you to know someone else agrees. Try to keep pumping after baby comes home too. You could rent a pump if you cant buy one and i know local state agencies can sometimes help new moms out by loaning a free one for a little while. Just be sure to always use your own pump parts! And GOOD JOB MAMA! I know it can be a hard time even knowing baby will be fine. But youre doing great and I applaud you for both BF and reaching out for more help.
    P.S. Congratulations!

  • MR

    Exhaustion is going to be the biggest thing for you. You need at LEAST a 4 hour stretch at night. So, I’d suggest try switching to pumping every two hours during the day, and give yourself a longer stretch during the night. It will increase production. Definitely try an SNS if possible – that will help with transitioning to the breast later. And, yes, you will increase supply once baby is on the breast. It won’t happen overnight, but you’ll get there! Hang in there! You are doing FANTASTIC!!!

  • I’m right there with you! I had 26 week twin girls 5 weeks ago, so they’re still in the NICU too, and I’m also balancing pumping and spending time in the NICU. My supply took a serious dive a few weeks ago and I found out it was my allergy pills. I’ve been working hard to increase my supply since I stopped them. I found a few things that work for me. I picture running water when I’m pumping. Sounds funny, but it works! Especially if you are trying for a second let down. Pumping bedside always gives me my greatest amount. And I find the pump can really affect how much you get. My hospital has two different pumps and one works a lot better for me than the other. If you are renting see if the company has a different kind, or even a newer model. And I’ll also massage my breasts for the last couple of minutes that I pump. It helps get that last little bit out and also helps prevent blocked ducts. But also, you’re doing great! (The August issue of Parents Magazine had a great article about bottle feeding by a woman who had twins in the NICU too.  It made me feel a lot better when I read it that if I end up bottle feeding it wouldn’t be the worst thing in the world.) 

  • S

    I pumped exclusively for one of my babies while breastfeeding exclusively for her twin. It’s rough pumping and dealing with feeding issues. So first off, you don’t HAVE to. You don’t have to breastfeed, you don’t have to pump. If you want to for now, because it’s something you can do, great! But this is hard on you being away from your baby, it’s not a typical situation, go easy on yourself. We are so luck there is donor milk and excellent formulas.

    But for now, for keeping and building supply… I’m glad you’re pumping beyond the milk flow! I learned it takes time. So you’ll get to know your body better over time, but make sure you’re pumping through a second letdown, totalling around 20 minutes. You should be pumping dry for at least a couple of minutes at the end. Second letdown! That’s key. Keep up the water drinking, oatmeal, etc, and consider taking “more milk plus.”

  • Don’t forget that things like STRESS and SLEEP DEPRIVATION and FORGETTING TO DRINK/EAT ENOUGH can all affect your milk supply, too (which, HELLO! Are all big issues with a newborn anyhow, but even BIGGER ones when you’re in the hospital!). I always had more luck pumping if I was watching TV or zoning out than if I was looking at the bottles and seeing how much I was getting. Definitely get a hands free bra, definitely make sure the flanges fit properly, and try doing some breast compressions while you are pumping. You might want to also find a good online breastfeeding support group (I see some other mom’s mentioned ones exclusively for pumpers, which is great! I didn’t know about those!) I just belong to a FB group for a breastfeeding support group at our local baby store that is run by an LC, and that was invaluable to have other people to message for support in the middle of the night. So if you want to join the Babies In Bloom Lactation Lounge FB group, I recommend them, but it sounds like there are tons of options available to you (and hey, you could look them up on your phone while you pump!) 🙂 Best of luck to you and your baby!

  • Debbie C

    Mom of a former 30-weeker and 34-weeker (now 6yo and 3yo respectively) here. Lots of great info here and love the supportive comments.

    I don’t have a ton of advice to add other than to be gentle on yourself. It’s really tough. The pumping, breastfeeding, sleeplessness, worry, and everything. Take help when people offer or ask and always, always cut yourself a break when you need it. Virtual hugs to you mama!

  • S

    Oh yeah! One more thing. Look up Pumpin Pal flanges. I LOVED those, I mean as much as you can love any pumping thing, so I hated them with much less hate than any of my other pumping bits. And I was a total zone-out pumper, too. Internet surfing stupid sites brought the most milk for me. For some people it’s smelling baby smells and fawning over pictures. But it’s also totally ok, not abnormal, not selfish, seriously just fine if you zone out. It doesn’t have to feel loving and like oozing joy out your boobs, it’s normal to feel like a cow and still want to try for your kid.

    • autumn

      I loved the break pumping gave me at work to just chill and read celeb gossip junk and play angry birds on my phone.  

  • Autumn

    Get some sleep!  My daughter was only in the NICU for 2 nights right away, and the nurses strongly hinted that I should be in my hospital bed sleeping.  She was only a little early at 36 weeks, so we started off with her in the typical in my room, but they decided she needed more care, so she was transferred to the NICU at midnight.  At 2 her nurse told me she didn’t want to see me there until 7 AM because I needed the sleep.  

    Pump a little longer and a little more frequently during the day, so you are only getting up once at night.  Enjoy the extra sleep while you can. . . you will have the baby home soon enough!

  • Robin

    My daughter was in the NICU for one week after she was born almost a year ago. I so feel you on the up-every-three-hours-to-pump situation. I would breastfeed her for a little bit, then finish her off with a bottle of my pumped milk, then try breastfeeding again. I’m assuming that your baby is still very tiny, so you won’t need a ton of milk per feeding, an ounce or two is probably enough. (I remember my husband and I being SHOCKED when our daughter drank 2 whole ounces one feeding. She had previously only been taking an ounce, maybe an ounce and a half). So if you are pumping anything near that, you’re in good shape. When we finally went home I had a Lactation Consultant come to my house to sit down with me and show me how to get my daughter off the NICU bottle and exclusively on the breast. This helped my supply immensely. (I actually ended up with oversupply, another story for another time). We did reintroduce bottles when she was a month old, and she has been able to switch back and forth between the two with no troubles since then. SOOO…to sum all of that up: Nurse and bottle feed while in the NICU, get a Lactation Consultant to help you when you get home, try just breastfeeding for a month to establish your supply, and reintroduce bottles around one month if you would like to.

    On another note: I just want to give you a big NICU mom hug. It is SO hard, but all the ups and downs are truly worth it. My daughter will be a year old in three weeks, and I can’t believe how much she has thrived. The NICU stay is now just a blip on the radar, and she is doing amazingly. You are a good mom, and it will get easier! 🙂

  • Bertine

    I had 32 week twins. They are three now, and totally healthy and on track developmentally.  I know how stressful the NICU can be. I pumped for my daughters and I found that getting enough sleep really helped! Also, if you can get your hands on a medela hospital grade double breast pump I found those really helped my milk production and pumping efficiency. Seriously,  I could pump 2.5 oz per side in 5 minutes. (My hospital had the double breast pumps for moms, but if yours doesn’t,  look for rentals.  I pumped for eight months for my girls and they were fed ebm for about four. Best of luck to you and your little man. You are doing great!

  • Annie

    Yup. I spent HOURS and HOURS pumping away in the lactation room while my daughter was in the NICU. You’re doing GREAT!! Hang in there!

  • Avalon

    The exclusive pumpers board on babycenter is a great resource. Here’s a post about the importance of pumping to empty (not a specified length of time) and getting 2-5 letdowns: http://community.babycenter.com/post/a51646597/pumping_to_empty

    Many people recommend the Simple Wishes hands free bra and I just got mine tonight and it is great!

    Best of luck!

  • Caroline

    There is medication that increases milk supply, not sure whether it’s available in the States but it’s called Eglonyl here, and it works like a bomb. It’s also very *very* mild anti-depressant, which doesn’t hurt!
    It might be an idea to see if you can get some of that. Herbal stuff is all lovely and obviously it works in many cases… but sometimes serious pharmaceuticals are warranted! Best of luck, hope he’s feeding from the breast soon and it all becomes academic as he grows and gets big and strong x

  • MindyP

    From what I’ve been told by a lactation consultant, the teas don’t generally have enough stuff in the them to help much, but lactation COOKIES (YAY!) do! 

    Also, like others have mentioned, relax in a comfy chair and take the pumping time to practice your meditation. Imagine your healthy baby coming home <3

    Here's a blog post on "extreme pumping" from a NICU mom who exclusively pumped: http://happyhomefairy.com/2013/06/07/extreme-pumping-tips-and-tricks/

  • Katy

    I had a NICU stay earlier this year for my 35-weeker. I found I produced the most when pumping right next to her in the NICU so that I could look at her (if you are able to do this — our NICU provided us with a pump and privacy shields). Also, lots of skin to skin, and her smell really helped. Good luck!! 

  • Christy

    I had a 31 weeker and pumped until he was ready to try it straight from the source. (About 3 weeks of exclusive pumping) I had similar issues, but once he was able to learn to take feedings by mouth we were good to go. We went on to successfully nurse for almost 15 months! Keep up the good work and congrats on the baby! 🙂

  • Kimtoo

    One thing that helped me was bringing receiving blankets into the NICU. I slept on one, I put the other in the bassinet for my girl to sleep on, and then I swapped them out so that we could smell each other. Plus, having my baby on her very own blanket, rather than a hospital issue, marked her as mine, made her more of a person to me.  I know, it sounds weird, but I was out of my mind with worry and hormones, and having her on something that I picked out made my connection with her that much stronger. 
    I know it’s not pumping related, but it did make our time in the NICU easier.

  • Leslie

    It might sound a little insane, but I always had SOOO much better luck with a little manual pump than any of the nice hospital pumps. Perhaps you could switch one session out for a manual session? I think I had a tendency to get really discouraged by the electric pump, which didn’t help the situation, and I never could get another let down, whereas I could kind of pump my boobs forever with a manual. Not at all practical in the long run, I know, but it might give you a helpful confidence boost if you’re able pump more!

  • Theone

    Congrats on your baby! My son was born at 34 weeks and spent 18 days in the NICU (although it seemed like soooo much longer!). Get lots of rest, cuddle your little one as much as you’re allowed, and pump at your baby’s bedside if you can (that definitely helped with my milk production). You’re doing a great job and just remember that as long as you’re feeding your baby, either with your own milk, donor milk, or formula, you are a great mother and you’re doing an awesome job. The NICU is really stressful, so cut yourself lots of slack. If there are any social workers wandering around, talk to them. They want to help and they’re wonderful, caring people who are incredibly kind hearted. Good luck to you and your sweet baby and keep reminding yourself that you’re doing the best you can (which is totally good enough).

  • Andee

    Congratulations! I’m so happy for you.
    Oatmeal. Eat oatmeal. It can increase your milk flow. I ate so much of it with my 3rd, I can’t eat it now. But I did see an increase in my flow when I was eating it.Good luck to you, and congratulations again!

  • lindsay

    I second everything the other commenters said about supply.  My recommendation to you is that when you can nurse your baby from the breast, get your own private lactation consultant, not the hospital’s to help you.  Most of the hospital ones vary in terms of knowledge and experience, as do the nurses.  Get a recommendation for a private lactation consultant, perhaps from your local La Leche League chapter.  They can help you now with pumping and supply issues, and they can help you nurse.  It can be expensive, but it is worth it.  Exclusively pumping in the long run is no fun, and formula is expensive!  

  • Emily

    First off, big hugs headed your way. My oldest was a NICU baby because he was premature. I know it can very hard, and extremely scary. Keep doing what you are doing. It will get better. This might sound ridiculous, but some night when you are at home, drink a beer. Just one, and wait an hour or two…and then try pumping. This was an “old school” remedy that was suggested to me when I was afraid that I was never going to produce enough milk (I was only getting an ounce after pumping for half an hour and I was very frustrated). I was skeptical about it, but was shocked when my milk production skyrocketed. The Brewers yeast supposedly triggers increased production. After that I drank one beer every 4 or 5 days until I found out I was pregnant with my second. I know this advice is a bit unconventional, but maybe give it a shot. It worked for me. Good luck and God bless you and your baby.

  • Lindsay

    My son spent 19 days in the NICU and I was also pumping every three hours during that time. Breastfeeding was so important to me because I felt like it was the one thing I could do to really mother my baby while he was being primarily cared for by nurses and doctors.

    I don’t have much new to suggest, but I agree that you should try pumping a little longer (I pumped for 20 minutes at a time and always had a second let down near the very end) and skip one pumping session to get a longer stretch of sleep. Staying hydrated and eating well makes a big difference. I also found that I pumped lots more right after having skin to skin with the baby. At home, I kept pictures of him by the pump (not sure whether it worked, but it can’t hurt to try). “Hands on pumping” (massaging your breasts while pumping) definitely upped my output as well. A hands-free pumping bra makes that much easier. 

    A few of the previous commenters mentioned that their NICU babies were hooked on bottles by the time they went home. I was super worried about this and requested that my son not be bottle fed at all. He received all of his feedings by tube and breast only. So that’s an option. 

    Mostly, just hang in there. I remember the first time I pumped enough to fill one the little 2 oz bottles the NICU gave us. I was so excited and then I knocked the bottle over, spilled it all over the NICU floor and burst into tears. I also worried about supply but it all turned out fine. In fact, when my son went home we had to buy coolers to take home all of the pumped milk the NICU had stashed in the freezer. I had NO IDEA I’d pumped so much! 

    He’s now 15 months and still nursing lots. The NICU experience is a rough start to parenthood, but it doesn’t last forever and you and your baby will be fine. 

  • I know this is way late, but I had to chime in.  My oldest was born at 33w.  The best thing my NICU LC told me was to pump 10-12 times per day.  I pumped every 2hours with one 4hr break at night.  I also pumped in the NICU as often as possible directly after holding my son.  That skin to skin time really helped.  I also know how hard it can be to be able to eat and drink enough,  make (or better yet have someone make) lactation cookies and eat them for a quick snack.  And make sure you are drinking lots of water.  I know it’s hard but you can do it.  My preemie is still nursing at 3.  

  • anusha

    Hii..i’m anusha from india.. i just stumbled upon your blog tonight..i have my repeat elective caesarean section tomorrow morning.. i’m sooo grateful to you for your awesome blog posts..many of which i could relate to..hoping to feed my second baby well..thanks for all the great advice.. take care!