Kim H. asks, "I have been on bed rest since I was 22 weeks pregnant and now at 32 weeks my OB feels I may be delivering soon. How can I make sure I have breastmilk for my baby if she is born premature and has to stay in the hospital nursery?"
A: If she is born early you can help to ensure that your milk supply will come in as fast as possible by starting to do hand expression or hand pumping right after the birth. It is recommended that you begin using a hospital grade electric breastpump within six hours after delivery. This will signal your breasts to start gearing up for making milk. When you send the signal to your breasts that there is a demand for milk, combined with the hormone surge that you experience after birth, the combination sets your body up to begin milk production right away.
When you are near your baby, this is always a good time to pump. Just being close to her will assist your body in this new endeavor. As soon as she is stable and you can hold her against the warmth of your bare chest, right next to your heart, do a technique called skin to skin or kangaroo care. This simple technique helps with milk production and also helps to stabilize the baby, while helping to reduce the stress both of you may feel from any separation.
Once you begin pumping, we recommend that you pump both breasts at the same time, for 10-15 minutes and use massage and hand pumping at the same time to help empty the breast. A hands free nursing bra can assist you with this. An example of this type of bra is the Hands Free Bra made by Simple Wishes, that we sell in our Breastfeeding Centers
It is also recommended that you attempt to pump at least eight or more times in 24 hours. Some of these sessions can be close together, while others may be every three hours. The goal is the overall number of minutes spent pumping, coupled with frequency. This includes pumping at night, when your milk producing hormones are peaking. This combined with baby contact is your best bet to make all the milk your baby will need as early as possible.
Do not be surprised if at the beginning of this process your body starts out producing very small amounts of milk; maybe even drops. Know that every drop counts and this first milk, called colostrum, is very important for any baby, but especially for a baby born early. It is a gift if this can be the first type of milk your baby receives. This will help her prepare her digestive system and protect her from possible infections, while helping get her immune system off to a wonderful start. When collecting your milk, make sure you save everything, label and date it for use when your baby is able to take your milk. Some of your milk may be frozen for use later, so this step is very important. When your baby is ready, the nurses and the lactation consultants will help you and your baby begin to practice breastfeeding. It may be short attempts in the beginning, but eventually your baby will transition to breastfeeding without the use of a feeding tube or bottle.
