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Thread: Mama's of Preemies

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    #1

    Mama's of Preemies

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    Hey ladies,
    So as most of you know baby T came about 8 weeks early, and is currently still in the NICU.

    I'm going crazy here at home wishing he were here, I go to see him every day but it is hard leaving him there.
    Anyways I was wondering for you ladies that had a LO early, when did they reach milestones vs full term babies?

    & when did your LO get to come home? My little boy has been in the NICU 10 days, and its driving me crazy. I just want him home.

    Also were you pumping and taking breast milk to your baby? I'm not sure how much is normal for me to be able to pump at this stage since this is my first LO.
    Is it normal to have breast tenderness? I know dry and cracked nipples are normal but is bleeding normal? I've been using lanolin & I have proper fitting cones on my pump Its pretty uncomfortable right now, but I'm trying to tough it out.
    I pump every 2-3 hours during the day & before I go to bed at night. (usually around 11-12)
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    #2
    DS wasn't a preemie but we have been pumping since day 4. Are you pumping 2-3 hours at night as well? If not, I would start.

    Does your pump have separate settings for speed and strength? If so, I would adjust them because I while tenderness is normal, bleeding is not.
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    #3
    Quote Originally Posted by His*PITA* View Post
    DS wasn't a preemie but we have been pumping since day 4. Are you pumping 2-3 hours at night as well? If not, I would start.

    Does your pump have separate settings for speed and strength? If so, I would adjust them because I while tenderness is normal, bleeding is not.
    it has a knob to adjust strength. I have wound it all the way down because I thought where I had it (1/2) might be causing the issues.

    I am not pumping at night but I wake up at 5:30 when DH leaves for work and thats when the pumping starts. Should I be setting an alarm for every 3 hours at night to wake up and pump?
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    #4
    Have you been able to meet with a lactation consultant while up in the NICU? Whenever I have a mom (especially first time pumping) who needs advice or is having problems, I ALWAYS schedule a lactation appointment. And usually, they really really help! You are supposed to pump at least every 2-3 hours for 15 minutes at a time, and then you can skip one at night, because rest is also going to help with production. Make sure you drink lots of water and pump even if you aren't getting much, which tells your body to produce more. At 10 days, your milk should be fully in, so you should be producing at least an ounce or more with each pumping session (ideally 2-3 ounces). Some pumps work better than others (our hospital grade ones I've been told work SO much better than say a manual pump at home), so see if maybe that is causing issues. There are also herbs and supplements your LC can recommend if your production isn't what it should be, so that's another reason I recommend a lactation appt.

    As far as milestones, Neonatologists say to expect the baby to meet them based on their corrected gestational age. So, say a baby was born 8 weeks premature. They may be 2 months old, but are just now term and should follow those milestones of a now term baby. Some develop faster than others, and some are more affected, depending on oxygen requirements, brain bleeds, etc. But at 8 weeks early, hopefully your little one doesn't experience any of that.

    Good luck and PM me if you have any more questions that I can maybe help you with. I'm a NICU nurse, so I can sometimes offer a little advice.
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    #5
    Quote Originally Posted by Picklejuice View Post
    it has a knob to adjust strength. I have wound it all the way down because I thought where I had it (1/2) might be causing the issues.

    I am not pumping at night but I wake up at 5:30 when DH leaves for work and thats when the pumping starts. Should I be setting an alarm for every 3 hours at night to wake up and pump?
    What I was told when I started pumping is that I should be pumping, for the first 12 weeks, as often as he was eating. Which for us was every 3 hours. This establish your supply and tells your body how much to make to ensure your LO is getting enough. Having it all the way down is good if thats the max you can go without having a lot of pain. If you can handle more, I would try to turn it up a little bit. I would talk to the LC at the hospital about the bleeding issue, since your LO is still in the NICU, I believe you still have access to their help.

    As far as how much, I really don't think there is a "normal" amount you "should" be getting. As long as its enough for him, your fine.
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    I would say you are doing a good job! We advise to pump at least once between midnight and 6am, so if you are doing 530ish, then thats fine as it is very important to get your rest too.

    Make sure you are drinking plenty of water too!
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    #7
    Quote Originally Posted by Sooner*twin View Post
    Have you been able to meet with a lactation consultant while up in the NICU? Whenever I have a mom (especially first time pumping) who needs advice or is having problems, I ALWAYS schedule a lactation appointment. And usually, they really really help! You are supposed to pump at least every 2-3 hours for 15 minutes at a time, and then you can skip one at night, because rest is also going to help with production. Make sure you drink lots of water and pump even if you aren't getting much, which tells your body to produce more. At 10 days, your milk should be fully in, so you should be producing at least an ounce or more with each pumping session (ideally 2-3 ounces). Some pumps work better than others (our hospital grade ones I've been told work SO much better than say a manual pump at home), so see if maybe that is causing issues. There are also herbs and supplements your LC can recommend if your production isn't what it should be, so that's another reason I recommend a lactation appt.

    As far as milestones, Neonatologists say to expect the baby to meet them based on their corrected gestational age. So, say a baby was born 8 weeks premature. They may be 2 months old, but are just now term and should follow those milestones of a now term baby. Some develop faster than others, and some are more affected, depending on oxygen requirements, brain bleeds, etc. But at 8 weeks early, hopefully your little one doesn't experience any of that.

    Good luck and PM me if you have any more questions that I can maybe help you with. I'm a NICU nurse, so I can sometimes offer a little advice.
    Thank you so much for your advice and encouragement!! They haven't offered me a chance to make an appt with a Lactation Consultant, nor have they really even asked if I'm having trouble?
    Yesterday I was able to take in 8 oz, So I thought "okay this is good my supply is going up" but today so far I have only been able to pump 4 oz and some change....
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    #8
    I'm also a NICU nurse, and I agree, lactation is very helpful for pumping issues! If your hospital doesn't have a lot of lactation resources, you could try a local La Leche League branch.

    Has anyone talked to you about if you're able to do kangaroo care (skin-to-skin)? I know sometimes kangaroo care can help increase your milk supply, as well. At 8 weeks early, hopefully he just needs a little bit of growing and support before he's stable enough to go home, but it all depends on the baby and the individual problems he's having. I know we always have a hard time giving parents an exact time frame for home-going because there can be so many variables. Maybe look into seeing if there are support groups or parent nights that the hospital offers? I hope his stay isn't much longer. Stay strong mama
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    #9
    Quote Originally Posted by RebeccaLea View Post
    I'm also a NICU nurse, and I agree, lactation is very helpful for pumping issues! If your hospital doesn't have a lot of lactation resources, you could try a local La Leche League branch.

    Has anyone talked to you about if you're able to do kangaroo care (skin-to-skin)? I know sometimes kangaroo care can help increase your milk supply, as well. At 8 weeks early, hopefully he just needs a little bit of growing and support before he's stable enough to go home, but it all depends on the baby and the individual problems he's having. I know we always have a hard time giving parents an exact time frame for home-going because there can be so many variables. Maybe look into seeing if there are support groups or parent nights that the hospital offers? I hope his stay isn't much longer. Stay strong mama
    No no one has talked to me about kangaroo care. I've only gotten to hold him twice...

    I'm going to look into a La Leche Leg branch. I think Ft. Hood has one

    He's off his breathing tube now and breathing on his own, but still having apnea's & heart rate drops. A lot of them he brings up on his own, but several times a day the nurses have to touch him to bring him back up, He is gaining weight consistently(3 lbs 11 oz today!!), and steadily eating more every day. However he won't take a bottle yet. He doesn't know what to do with it, so he he still has a feeding tube (though he is off all his IV medications) in. He's getting better at regulating his temp. but is still currently in a heat box.
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    #10
    Quote Originally Posted by Picklejuice View Post
    No no one has talked to me about kangaroo care. I've only gotten to hold him twice...

    I'm going to look into a La Leche Leg branch. I think Ft. Hood has one

    He's off his breathing tube now and breathing on his own, but still having apnea's & heart rate drops. A lot of them he brings up on his own, but several times a day the nurses have to touch him to bring him back up, He is gaining weight consistently(3 lbs 11 oz today!!), and steadily eating more every day. However he won't take a bottle yet. He doesn't know what to do with it, so he he still has a feeding tube (though he is off all his IV medications) in. He's getting better at regulating his temp. but is still currently in a heat box.
    Sometimes, nurses are hesitant to do skin-to-skin if the baby won't keep his temperature, is septic, or has a lot of "episodes" (bradycardia and desaturation episodes). But honestly, there is really no reason you shouldn't have been offered kangaroo care at this point. I will almost ALWAYS skin-to-skin, even with a ventilator (except for oscillators, arterial lines, things that are incompatible with KC). But like the other poster said, it will help your milk production! I don't know if the NICU your baby is staying at has curtains or private rooms, but it's recommended to do skin-to-skin (which even if you baby is in an isolette, he should be fine to kangaroo). Not only does it help his vital signs, but he can also "practice" breastfeeding and nuzzle, which also helps your milk production. The nurses should monitor his temperature every 15 minutes or so while you're holding him to make sure he isn't getting cold. After doing skin-to-skin, immediately pump and I guarantee you'll get more than you have been.

    The bradycardia and desaturation episodes can in large part, be due to apnea of prematurity. Babies born prematurely don't have fully developed central nervous systems and still have to grow, so sometimes they forget to breathe, and we have to stimulate them by rubbing their backs or flicking their feet to start breathing again. There are also certain medications that can help with this (caffeine), although eventually, he will be weaned off of it. It really is par for the course. As long as he isn't presenting with signs of an infection and his lab work is good, just try and take it day-by-day and spend as much time as you can with him. Sounds like you are doing really well and coping well! Don't be afraid to ask your nurse for a lactation appointment or to do skin-to-skin. After all, he is YOUR baby and you need him as much as he needs you.

    ETA: Since he's only a little more than 33 weeks corrected gestation, it's perfectly expected that he doesn't know what to do with a bottle yet. Normally, a preemie won't be able to coordinate enough to even try to bottle feed until 34 weeks, and even then, some have issues coordinating sucking, swallowing, and breathing. Like I said, practicing holding him and having him nuzzle while they gavage (tube feed) his milk will help him associated getting full with nuzzling/breast feeding. So it will help him in the long run.
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