Breastfeeding Q & A: Part One
Submitted by Anonymous on Sat, 11/05/2005 - 05:00.
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Question 1:
My friend just had twins five weeks premature a week ago. They haven't
actually started breastfeeding yet, but she's pumping every three hours
to get milk for them, but she's barely getting anything. The nurses
suggested Mother’s Milk Tea, but what else can she do? I told her to
get some of the tea and eat lots of oatmeal too. She says she's barely
getting anything whenever she pumps, but she's engorged. (She has a
hospital grade pump). She's got some blocked milk ducts I think too b/c
the nurse showed her how to massage her breasts to get more milk and
was rather rough with her and she heard a pop and then milk started
coming more. I suggested she try hand expressing into a bowl. I know
some women have better luck with hand expressing than pumping. Anyway,
any suggestions I can pass along to her? I told her I'd ask around..
see if there was anything else I could find out for her. I'm not sure
when the babies will actually be allowed to try breastfeeding, but I'm
sure once she is actually breastfeeding them, it will be less of a
problem for her, and I've told her that to try to ease her fears.
However, I'm not sure when the docs will let her try to bf the babies..
hopefully soon..
--Dawnygirl
“Not sure if she really needs galactogogues, but...
Fenugreek. Blessed thistle. From what I read, oatmeal is more of a
comfort thing than a true galactogogue. Marshmallow helps me, too. I
take Solaray brand of all those, from my co-op...”
--motherofpears
“My son was a preemie and I had to pump for him too. I took fenugreek
and blessed thistle, as well as Mother’s Milk Tea, and warm compresses
seemed to help for me. As well as doing Kangaroo care at the NICU, then
pumping right afterwards. Once my milk got going I could pump 540z a
day! So she should have no problems. Do tell her to work closely with
her lactation consultant when they begin to nurse. It took my ds 4
months to learn how to do it (he had tongue thrust) but w/ help from
our LC and some chiropractics he nursed like a champ. She should be
able to do Kangaroo care with them even if they are incubated. She has
to be adamant about it as it is so very important for her and for them.
I could find some links to more info if she needs them.”
--Magoo
“She should pump more often that every 3 hours in my opinion....and
increase her water dramatically....and she can also try
domperidone....(used to induce lactation in adoptive mothers). There is
a place in
that she can order it from very cheaply and it will be here in about 7-10 days.”
--jessica_momof6
“She should start taking fenugreek, blessed thistle, and alfalfa, 3
capsules of each 3 times a day, ASAP. If she can't get blessed thistle
locally here's a good place to order from:
http://www.breastfeed-essentials.com/herbs.html
She can up the pumping to every
two hours during the day. She should have a lactation consultant (IBCLC
certified) make sure she's pumping correctly.
Here's some links on pumping:
http://www.breastfeed-essentials.com/pumps101.html
http://www.breastfeed-essentials.co...umpingtips.html
Here's how to express manually:
http://www.parentsplace.com/feature..._110540,00.html
If she is still having supply
problems she should consider taking domperidone (she will have to get
it from overseas, but it's much better than Reglan, doesn't have the
horrible side effects).
http://www.kellymom.com/newman/domperidone_01-03.html
http://www.kellymom.com/newman/domperidone2_01-03.html
She should really get an IBCLC
certified lactation consultant to help her no matter what. Many NICU
nurses and docs know little to nothing about breastfeeding, and
actually give parents misinformation.
For example, it isn't true that it's "easier" for a preemie to take a
bottle than breastfeed. Studies have shown that it is less stressful
for the premature baby to breastfeed than bottlefeed. If the baby is
strong enough to take a bottle, she's been ready to breastfeed. Bottle
feeding is a recipe for disaster; nipple preference is a real threat to
the breastfeeding relationship.
http://www.kellymom.com/newman/more...hs_01-03.html#9 (see myth #9; Newman's book has more information on this).
If the babies won't latch on, feeding them via finger feeding or a
lact-aid/supplemental nursing system is much better than bottle feeding.
http://www.midwiferytoday.com/articles/ffpreemie.asp
Here are some LLL links on breastfeeding the premature baby:
http://www.lalecheleague.org/FAQ/FA....html#Premature
Infants: Again, I think the best thing for her to do is get a lactation
consultant ASAP! And call the local La Leche League for a leader who
can help. Maybe you could help her out by tracking down some IBCLC
certified lactation consultants for her? Here's where to find them:
http://www.iblce.org/us_regional_registry.htm”
--Jane
“She really needs to work with a lactation consultant now! There are
some good ideas here-but breastfeeding is tough enough for some people.
Pumping until your preemies can nurse is tougher. If she is getting
engorged and getting plugged milk ducts she is at risk for mastitis,
which will make everything more complicated. She needs hands on help
from someone who knows what they are doing.
I think that Kangaroo care, and then pumping afterwards is a great
idea. (I also think that nursing them NOW is a great idea). I also have
heard from many moms in my La Leche group that a manual pump like the
Avent Isis worked much better for them than a mechanical hospital grade
pump. If she is really desperate...and can find a friend who has a baby
that she can nurse to help get flow--then I say go for it.(I realize
that is not for everyone...)
I agree that many NICU and nursery nurses know nothing about
nursing...(I am a nurse) If you think about it what real experience can
they get in a NICU?
Jane has given some very valuable info that I wholeheartedly agree
with. Take it from a mom who didn't have preemies, but who had MANY
problems breastfeeding and would have most if not all of my problems
eliminated if only I had the help that I needed!!!”
--Linda
“I wanted to add too that long before my DS could nurse (or was even
being fed breastmilk by nasogastric tube) I held him (Kangaroo care)
with his face laying against my breast so that he could nuzzle, etc.
The skin to skin contact was great for him and helped me to pump and
some days he was strong enough to "play at nursing" as my LC said,
which meant he was interested but couldn't quite do it. I got a lot of
peewee kisses So just them being that close is a good idea too. I know
a lot of the time Kangaroo care is done with their head on your upper
chest. Oh, and I second the Avent pump. It is awesome!”
--Magoo
“I've never pumped for a preemie, but I had one thought. . .
If she's engorged, then taking Mother’s Milk Tea, oatmeal, etc is only
going to make her more engorged. She needs help getting the milk OUT.
I know she needs to have the pumped milk saved, but I could never get a
pump to work for me when I was engorged. The only thing that would get
the milk flowing for me was to fill two bowls with warm water, put them
on the bathroom counter, and lean over into them. Maybe she could try
this to get the milk flowing and then dry off and start pumping?
Also, I agree that every 3 hours is not really enough. . . I've not yet
had a newborn go that long between feedings! I would tell her to shoot
for 2 hours. . .
And where is she pumping? Many mothers find it hard to get a let down
in the beginning if they are under stress, or physically uncomfortable.
I'm assuming that she wants to be with her babies as much as possible,
but if the hospital doesn't have a comfortable place to provide her,
she might want to consider finding one, at least until she has some
success. Even her car might be a bit more familiar. She could bring
blankets with her babies scent on them to hold, that helps let down too.
Above all, stress to her that a rough start doesn't mean she will have
to give up on breastfeeding. I've known 2 mothers that had their babies
in NICUS that preferred the bottle feeding method in the beginning, and
for many good reasons, decided not to argue the case too hotly. They
just made it known that they only wanted the babies fed EBM, and that
they wanted to "try" nursing as early as possible, even if the babies
couldn't sustain a suck long enough for nutrition purposes. Both have
fabulous nursing relationships now. It was more work, and it took a
while to establish a relationship, but after a little bit, no one would
have known that neither of these babies breastfed for the first few
weeks (actually for one it was 2 months) of their lives.
I agree with holding them as much as possible barechested. When my baby
was born, she was in the NICU stepdown unit of our (in my definition)
very breastfeeding unfriendly hospital for her first night. Because it
was stepdown, we were able to hold her the whole time, but the nurse
put up a screen for us and had me hold the baby up to my chest as she
slept. lol, she kept walking by and saying, ‘get that breast in her
face! You want her to smell you as she sleeps so she can wake up good
and hungry!’ It worked that baby latched on, and nursed for 2 hours
straight, then again for every 20 minutes for the first 48 hours of her
life.”
--pmjmomma
Question 2:
“What is Kangaroo care?? My friend was not able to hold the babies very
much at all the first week. They had the babies in two different
isolettes across the room from each other. But they finally moved them
into the regular nursery over the weekend and put them in a crib
together. She really hasn't been allowed to just go in there and hold
them.. During different times the nurses won't even let them in to see
the babies and they can't hold them much either when they are there!!!
Hopefully in a week they will be released. The docs said they would be
in the hospital for two weeks.”
--Dawnygirl
“Kangaroo Care is when you hold the babies without clothes on your bare
chest. Skin to skin contact. Your friend can DEMAND in a nice way--but
without budging--whatever she wants for HER children. If she wants them
in the same crib they should do it. Even when they were in isolettes
they could be near each other. This is the standard of care in many
NICU's. She has the right to be with her babies whenever she wants to.
Her babies need that closeness. Her babies need to be held by herself
and her husband...That is outrageous. My best friend held her preemie
twin boys with all the tubes, bells and whistles right from the start.
Just because she is talking to a lactation consultant--if her problems
are NOT resolving--then that is NOT the right lactation consultant. She
needs to see another one until her problems are solved. It is annoying,
it is inconvenient, but it is up to her to find the help that she needs.
She is the mama--she needs to follow her heart and her instincts. I
know it is hard...I am a nurse and couldn't believe how stupid and
unhelpful my own medical community was when I needed help. I basically
got the "keep up the good work--breast is best ' line....and no help
when I had purple cracked an bleeding nipples, mastitis, etc. I was so
exhausted...my c-section incision was wide open and I had a newborn
after 5 months of bed rest. I say this not to dwell on ME, but rather
to illustrate how even I got lost in the shuffle, because I didn't have
the energy to advocate for myself. And I didn't know who to ask for
help. Hadn't I already asked the pediatrician, OB, hospital lactation
consultant, and the nurses for help? (And received no real help). Just
because the medical staff may be taking care of her babies in the
hospital, and just because the hospital has a lactation consultant
doesn't mean that is the right place for help.
So, your advice about contacting La Leche League is wonderful. And I
agree, if she doesn't like one group, she can probably find another. If
you can help her, make phone calls whatever, I bet that she can really
use it. Maybe you can drive her to see another Lactation consultant
(though they could go to the hospital or her house.) It will cost
money, unless she gets a volunteer one from La Leche. That was a slight
barrier for me--because so many people had already failed me and I
didn't want to spend money for someone else to be useless...but she
will get the help she needs if she perseveres. La Leche League leaders
will talk to her on the phone and even meet with her. She doesn't have
to go to a meeting.
I am sorry this is so lengthy. But when I hear about bad medical care I
get very upset. The hospital may be taking care of that family in a
technical manner, but not in a spiritual manner. That is not right.
And, the whole breast is best is true, and who needs it more than
preemis? However, the Doctors and Nurses say that, then they don't know
anything at all about breast feeding...or even refer you to people who
do know what they are talking about that is how MANY people fall
through the cracks. Because they think that the hospitals and medical
staff should have all the answers and don't.”
--Linda
“I totally agree. I just would not have said it so nicely LOL I am a
total Mama Bear when it comes to babies in the NICU, and they are her
kids, the nurses cannot tell her when she can hold them. They can
suggest when is a good time to do it, but they cannot make that
decision. Those babies need her contact, and especially contact with
each other. They were all cuddled together in the womb, I am sure they
are missing that contact. My sons isolette was moved twice to
accommodate for putting twins side by side. (I did not mind this) and
those twins were snuggled all the time, usually together by mom so they
got her contact and from each other as well. Kangaroo care should
continue at home too.
http://www.geocities.com/roopage/
http://www.prematurity.org/baby/Kangaroo.html
http://www.breastfeeding.com/all_ab...t_Kangaroo.html
The last one is from breastfeeding.com- also another good site for her. HTH Kate
I had to be very adamant that I would nurse DS come hell or high water.
It was not easy but luckily I had an LC who believed in my DS and me
and was a lifesaver!
This is a great link too... I print it out for every new mom who wants to or is breastfeeding. I think it's great!
http://www.bflrc.com/ljs/myths/glct_dum.htm
p.s. It is a funny.”
--Magoo