Just How Much Breast Milk Must I Pump in my Preemie

 

MY PUMPING ROUTINE! | HOW I PUMP 177ML+ A DAY! BOOSTING MILK SUPPLY

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NURSING AND PUMPING SCHEDULE FOR NEWBORN | Nursing And Pumping At The Same Time

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How much milk should I pump at 2 1/2 weeks postpartum?

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Can I pump milk to prepare for nursing before my baby is born?

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How do I keep up my milk supply for when my premature baby comes home from the hospital?

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HOW TO PUMP MORE MILK WHEN YOUR BABY IS IN NICU | LEMOMLIFE™

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NICU BREASTFEEDING EDUCATION: Premature Baby NICU Getting Started Milk Supply

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More breastfeeding makes more breast milk, so these frequent feedings help mom establish a good milk supply. To establish a good milk supply when you pump breast milk for your preemie, you need to pump often enough to mimic a newborn baby’s feeding patterns. Early on, you should pump breast milk about 8 to 10 times per day or about every 2 to 3 hours. If you are pumping eight to 10 times per day, you should be producing: Optimal: About 25 ounces of breast milk per day, or 3 to 4 ounces per pumping session. 2. Borderline: Between 11.5 and 25 ounces daily is considered borderline milk production.

You may need to use interventions to increase your milk supply. For most mothers, automatic double pumps that generate 40 to 60 suction-and-release cycles per minute are most effective at expressing milk. Getting a good pump fit is important, because your fit affects your comfort and milk flow. Pump fit is not about breast size; it’s about nipple size.

The day after I gave birth to our 29-weeker, my milk was overflowing. I will never forget the embarrassment I felt as visitors came in to find my pajamas soaked and me totally unaware. We immediately called the lactation nurse, and I had my first experience pumping breast milk for my preemie. This much breast stimulation and milk expression is the minimum required to maintain breast milk supply over many weeks (if your baby is very small, premature, or ill).

Breast massage before and during the use of the pump has been shown to improve your milk flow and may even boost your milk production. Your baby only needs tiny amounts of your milk in the first few days, and your colostrum is rich in antibodies and nutrients. As you continue to pump, your milk will come in and your supply will get stronger. You can expect to get between ½ to 2 ounces each time you pump. The importance of skin-to-skin care.

Try to make sure that you’re pumping for at least 120 minutes per day. It will take a few days for your milk to come in, and it’s completely normal to only pump a few drops in the beginning. Try not to get discouraged, and keep pumping – the nipple stimulation now will help your milk supply later. Depends: Only the debris from your weeping sores have any potential to trigger varicella in your baby.You do not pass it in your breastmilk, saliva or from a cough. If you can manage to keep the area covered & be sure not to contaminate the milk you pump, it would be okay to continue.Sometimes the NICU will have access to banked milk to help you/baby but if you quit pumping.

The more breast milk your baby has, the lower his risk of disease. 12 Each additional 10 ml (0.3 fl oz) a day, per kg (2.2 lb) of a baby’s weight, reduces the risk of sepsis by 19%. 9 And the risk of necrotising enterocolitis (NEC), a potentially fatal bowel condition, is also up to ten times lower in preemies who have breast milk compared to those who are formula-fed. 13 So every drop.

The alcohol level in breast milk is essentially the same as the alcohol level in a mother’s bloodstream. Expressing or pumping milk after drinking alcohol, and then discarding it (“pumping and dumping”), does NOT reduce the amount of alcohol present in the mother’s milk more quickly. As the mother’s alcohol blood level falls over time.

List of related literature:

After discharge, most preterm infants need approximately 180 mL/ kg/day (2¾ oz/lb/day) of breastmilk or standard infant formula containing 20 kcal/oz.

“Krause and Mahan’s Food and the Nutrition Care Process E-Book” by Janice L Raymond, Kelly Morrow
from Krause and Mahan’s Food and the Nutrition Care Process E-Book
by Janice L Raymond, Kelly Morrow
Elsevier Health Sciences, 2020

After discharge, most preterm infants need approximately 180 formula ml/kg/day containing (23⁄4 oz/lb/day) 20 of breastmilk or standard infant kcal/oz.

“Krause's Food & the Nutrition Care Process, Mea Edition E-Book” by L. Kathleen Mahan, Janice L. Raymond
from Krause’s Food & the Nutrition Care Process, Mea Edition E-Book
by L. Kathleen Mahan, Janice L. Raymond
Elsevier Health Sciences, 2016

To achieve a rate of growth similar to that in utero, the preterm baby needs 540–600 kJ/kg/day, equating to approximately 180–200 mL/kg/day of breast milk or standard formula milk.

“Mayes' Midwifery E-Book: A Textbook for Midwives” by Sue Macdonald
from Mayes’ Midwifery E-Book: A Textbook for Midwives
by Sue Macdonald
Elsevier Health Sciences, 2011

Each breast should be pumped every 2 to 4 hours, preferably with a double pumping system to enhance milk supply.206 Mothers should increase pumping time up to 15 to 20 minutes as the milk comes in, with the suction pressure increased as tolerated.

“Merenstein & Gardner's Handbook of Neonatal Intensive Care E-Book: An Interprofessional Approach” by Sandra Lee Gardner, Brian S. Carter, Mary I Enzman-Hines, Susan Niermeyer
from Merenstein & Gardner’s Handbook of Neonatal Intensive Care E-Book: An Interprofessional Approach
by Sandra Lee Gardner, Brian S. Carter, et. al.
Elsevier Health Sciences, 2020

Normal milk production is about 1.5 ounces per hour, so if three hours have passed since you last pumped you should get about 4 to 5 ounces combined when you pump both breasts.

“The Nursing Mother's Companion” by Ruth A. Lawrence, Kathleen Huggins
from The Nursing Mother’s Companion
by Ruth A. Lawrence, Kathleen Huggins
Harvard Common Press, 2005

If the baby does not transfer at least 60 mL or more and the mother is able to pump that amount, refer her to the baby’s physician for assessment.

“Counseling the Nursing Mother” by Judith Lauwers, Anna Swisher
from Counseling the Nursing Mother
by Judith Lauwers, Anna Swisher
Jones & Bartlett Learning, 2015

However, clinical experience has shown that mothers who intend to produce a full milk supply, exclusively breastfeed at discharge, breastfeed multiples, or have a sufficient volume to fractionate and use hindmilk need to pump about 8–12 times per 24 hours during the first 10–14 days after birth.

“Breastfeeding Management for the Clinician” by Marsha Walker
from Breastfeeding Management for the Clinician
by Marsha Walker
Jones & Bartlett Learning, 2016

Daily milk production after breastfeeding is established should be approximately 750 to 1050 mL (25 to 35 ounces) in a 24-hour period.

“Introduction to Maternity and Pediatric Nursing E-Book” by Gloria Leifer
from Introduction to Maternity and Pediatric Nursing E-Book
by Gloria Leifer
Elsevier Health Sciences, 2018

It is recommended that the mother continue pumping or expressing milk at least three times per day to have an “oversupply” to facilitate adequate volume consumption by the premature infant at the breast.

“Breastfeeding: A Guide for the Medical Profession” by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
from Breastfeeding: A Guide for the Medical Profession
by Ruth A. Lawrence, MD, Robert M. Lawrence, MD
Elsevier Health Sciences, 2015

The newborn needs to receive 10% to 20% of its body weight in colostrum, preferably within 3 to 12 hours after birth.

“Sheep & Goat Medicine E-Book” by David G. Pugh, N. (Nickie) Baird
from Sheep & Goat Medicine E-Book
by David G. Pugh, N. (Nickie) Baird
Elsevier Health Sciences, 2012

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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2 comments

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  • There are several factors in how to increase amount of milk and found. One resource I found that successfully combines these is the Hartlyn milk plan (check it out on google) without a doubt the no.1 blueprint i’ve seen. look at the super info.

  • Thank you for this. I’ve been looking for more information specifically for preemies and pumping. My baby was born a few weeks ago at 33w 6days and is in the Special Care Nursery. I’ve been pumping every 3 hours as recommended by my doctor but have reduced to 7 times a day due to how much milk I’m producing (most sessions during the day but have kept one for middle of the night). I’m on week 3 of pumping and each session provides close to 200ml (both breasts combined). Should I be worried at this amount? Is it too much? My baby is currently on an 8 feeds a day schedule and eating around 34ml per feeding (although that amount has been increasing almost daily).