Expressing Breast Milk: Pumping for Your Preemie

The shock and stress of having a baby born prematurely is difficult in and of itself to deal with. The frequent trips to the hospital are exhausting. And the worry you feel about the health of your son or daughter can be overwhelming. If you had hoped to breastfeed your baby, you will no doubt want to use a breast pump to initiate and maintain your supply until your baby is strong enough and developed enough to start short attempts at breastfeeding and hopefully eventually transition to exclusive breastfeeding, but until this point, a breast pump will be a necessity. The requirements of expressing breast milk in the early days and weeks post-partum can add additional stress to what is already a difficult time, but having good information on how to best establish your milk supply will assist you to build a strong milk supply and provide the best nutrition possible for a pre-term baby: mother's milk.

The benefits of breast milk for preemies have been well researched. Not only can breast milk decrease the risk of necrotizing enterocolitis (a serious intestinal infection which is a very serious complication for any baby), but the breast milk from mothers of preemies is uniquely suited to the needs of these tiny infants. Breast milk contains an high level of antibodies which can decrease serious infections and illness in preemies. Breast milk also has growth factors which are very important for premature babies who are often very small and may have difficulty gaining weight. Mothers of premature babies also produce milk that is higher in nitrogen, protein, lipids, fatty acids, vitamins, calcium, and other vital elements important to the development of preemies.

It is important to begin using a breast pump to provide stimulation as soon as possible after the birth of your baby. It is best to use a hospital-grade double electric breast pump at least until your supply is well established. Your baby's neo-natal intensive care unit (NICU) should be able to help you locate a place you can rent a hospital-grade breast pump. When starting to use a breast pump following delivery you will want to follow, as closely as possible, the feeding patterns of a full-term baby in order to establish a strong milk supply. This means that it is important to use a breast pump 8 to 10 times within a 24 hour period for at least the first couple of weeks. Frequent stimulation is crucial to establishing a good supply; just as a full-term newborn would nurse on demand frequently, but likely for short periods, you must provide frequent stimulation to your nipples, breasts, and areolas. It is important to pump around the clock: both day and night. Although at night you can go for slightly longer periods between sessions. When beginning to pump soon after delivery, you do not need to pump for lengthy sessions. Ten to twelve minutes per pumping session is enough. Initially, you many not express too much in the way of colostrum or milk, but it will increase over the next several days with dedicated pumping.

At first, the milk you express is colostrum: a thick, yellow milk that has a very high concentration of antibodies and fat. While there is not a large volume of colostrum, it is worth its weight in gold! It can sometimes be difficult to express colostrum with a breast pump because it is thick and somewhat sticky. If you are finding it difficult, try hand expressing to see if you can express more. Use a syringe to collect as much of the colostrum as you can.

Your baby's NICU will give you instructions on storing and transporting your breast milk. Since preemies are more susceptible to bacteria, viruses, and other illness, it is important to carefully follow the guidelines the NICU gives you. Always use sterile collection bottles and sterilize your pump kit regularly. Fresh breast milk is almost always best, so try to deliver your expressed breast milk to the hospital as often as possible.

Usually within the first week or two, you should see your milk supply start to increase. You may find that you become engorged frequently. Frequent pumping is the best way to combat this. It will subside as your body starts to regulate its milk production. When your daily volumes start to increase, you will need to increase the length of your pumping sessions to ensure you are emptying your breasts as fully as possible. A general guideline is to pump for 120 minutes per day divided by the number of sessions you are pumping. Therefore, if you are pumping 8 times a day, you would pump for approximately 15 minutes per session. This is just a general guideline though and you may need to pump longer. The breast pump you are using can also vary the length of time y