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Thread: Pumping Before Birth

  1. #1
    Join Date
    Nov 2009
    Posts
    15

    Question Pumping Before Birth

    Hello to all! I am new here, and am currently 37 weeks 4 days pregnant with our second son. Let me give a little background:

    With our first son, he 9lb 0.5oz at birth. The nurses at the hospital were worried about his blood sugar levels because of his size, even though I had no signs of gestational diabetes or other complications. Unfortunately, it was after 11:00 a night, and the Lactation Consultants had all gone home for the evening. They ended up giving him formula because of this, and I was so worried that this would affect our breastfeeding relationship. It was awful, they gave him too much formula for his tiny non-elastic stomach, and he spit most of it up. I also think it affected how much he wanted to be at the breast. At the end, his blood sugar ended up being fine, and we were able to start a good feeding relationship after all (until we both got thrush, and I ended up Exclusively Pumping for 9 months... but that's another story).

    That brings me to my current pregnancy and our second son. I do not want a repeat experience with the formula. When I contacted one of the Lactation Consultants at the hospital in the recent months, she suggested that at the end of my pregnancy to start pumping colostrum to bring with me to the hospital.

    So... I started pumping the other day. I have been doing one session each day: pumping one side at a time with an electric pump 15 minutes on each side, two times each. The first couple days I got half an ounce! We're talking colostrum here, not mature milk. Yesterday and the day before, I got a full ounce each day! It was my understanding to not expect over a few drops, and it's measured by teaspoons, mL, or CCs. Has anyone experienced pumping this much colostrum, and why would I be producing so much of it? Don't get me wrong, I am happy for it, but am worried something is wrong (like placenta coming away from the uterine wall causing a drop in progesterone?).

    Does anyone have any ideas or a similar experience? Please help! Thank you.

  2. #2
    Join Date
    Apr 2011
    Posts
    151

    Default Re: Pumping Before Birth

    Maybe you or someone else can clue me in, but why wouldn't the colostrum _in your breasts_ be enough? Since there wasn't diabetes before, why are you afraid of it this time?
    Kate

    Mother to a sweet boy, born at 34 weeks on 2/11/11.
    Proud that I grew 26 lbs of baby before solids, and still counting...

    We received banked milk in the NICU. Thank you, donors!!!

  3. #3
    Join Date
    Nov 2009
    Posts
    15

    Default Re: Pumping Before Birth

    It is common practice in hospitals that, if a baby is above a certain weight at birth (8lb13oz at my hospital), they will give the baby additional food (formula or colostrum) and test their blood for low blood sugar at different intervals of time. The mother doesn't have to have gestational diabetes for the baby to be at risk for low blood sugar. Other causes can be going after the due date, being at a small birth weight, or extra stress put on baby during the pregnancy or labor and delivery. The lactation consultant has told me that colostrum is the best blood sugar stabilizer for a newborn.

    The colostrum in the breast *should* be enough, and that's why I was so upset when I had my son. In all my research I did during my pregnancy on breastfeeding, I had never come across this practice. However, when I looked it up after having him, I saw that it is common practice in hospitals. This time around, I am going in much more informed, and I can feel comfortable in my decisions.

  4. #4
    Join Date
    Apr 2011
    Posts
    151

    Default Re: Pumping Before Birth

    Huh. I'm sorry you had to go through that. I guess that isn't standard practice everywhere, but then I think there's little standardized about standard practice these days.

    Anyhow, sorry I'm not more knowledgeable, but it does seem to me that if you are getting so much milk now, at least you'll be in good shape if the hospital is worried about amount. I'm sure someone more knowledgeable will answer your questions. I hope you have a wonderful birth!
    Kate

    Mother to a sweet boy, born at 34 weeks on 2/11/11.
    Proud that I grew 26 lbs of baby before solids, and still counting...

    We received banked milk in the NICU. Thank you, donors!!!

  5. #5
    Join Date
    Feb 2008
    Location
    SoCal
    Posts
    6,467

    Default Re: Pumping Before Birth

    I'm on my phone and will try to post reasons in a few but I completely disagree with what the LC told you, it is not normal or mandatory to supplement, my children were bigger than that even and pumping can induce labor which you do not want. What is the rooming in policy at this hospital? I assume they are not baby friendly certified if they give formula for no reason?
    Mommy to Maxwell 10-9-07 weaned with love (a party and a remote control monster truck) on his 4th birthday
    My Boy 3-16-10
    And my sweet pea Sam 2-12-11

    Watch Your Language

  6. #6
    Join Date
    Nov 2009
    Posts
    15

    Default Re: Pumping Before Birth

    Mothers and babies room together with the option of sending the baby to the nursery. They encourage breast feeding at this hospital and have lactation consultants who go around to the "mother baby suites" and are available Monday through Saturday until I think 7:00 PM (could be wrong about the time). From what I've read of this particular LC's blog, they have changed some of the standards of when supplementation with formula is needed:

    "April 2010, The Joint Commission (an organization that accredits more than 17,000 top notch hospitals and health care facilities in the United States) established a new set of evidence-based core measures for quality in perinatal care. Included in these core measures is a requirement that hospitals strive to increase exclusive breast milk feeding of infants from birth to discharge. This means that in order to be accredited, hospitals will have to be more cautious about their use of formula in breastfeeding babies. Here at MoBap, we take breastfeeding very seriously (and yes, we are accredited by The Joint Commission).

    If any breastfeeding baby may need supplementation, their mothers are encouraged to pump or hand-express their own milk for use as a supplement. We have state-of-the-art, hospital-grade breast pumps for use by any mother that may need one while she is here. Our goal is that every breastfeeding infant receives as much of his own mother’s milk as possible before anything else is given. A Lactation Consultant visits every breastfeeding mother everyday that she is here, providing support and encouragement and addressing any questions or concerns that these mothers may have. We are very proud of our more than 85 percent breastfeeding rate and will continue to provide the very best for our breastfeeding families. We believe The Joint Commission will be quite pleased with our breastfeeding practices and other core measures of quality in perinatal care!"

    As far as when to start pumping, she did recommend "in the few days prior" to birth. I chose to start at 37 weeks. My baby is doing well, has done well throughout the pregnancy, and is estimated to currently be anywhere from 6 to 8 pounds. My first baby was much larger than what they estimated (by a pound and a half over the "high" end of their estimate). I am prepared (and would actually prefer) to go into labor within the next couple weeks.

  7. #7
    Join Date
    Feb 2008
    Location
    SoCal
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    Default Re: Pumping Before Birth

    Ok but why did they say your baby needed supplementation? Simply because of size and unconfirmed issues with blood sugar which turned out to be false? I'm not trying to argue I promise I just want you to be confident that your body can make enoughto feed a large baby from day one...without pumping out colostrum prior to birth. Putting baby to the breast almost constantly at first is what gets your body in the milk production mode and tunes mom and baby into each other, pumping off sets these natural cues. While yes supplement when necessary with BM is beter than formula it may be counter productive to ease the beginning of nursing. Your body can do it mama don't let that LC or anyone undermine that.

    Just also wondering if you know if the LC is a IBCLC?
    Mommy to Maxwell 10-9-07 weaned with love (a party and a remote control monster truck) on his 4th birthday
    My Boy 3-16-10
    And my sweet pea Sam 2-12-11

    Watch Your Language

  8. #8
    Join Date
    Nov 2009
    Posts
    15

    Default Re: Pumping Before Birth

    Thank you for your response, and I'm sorry I seemed a little defensive - I've been a hormonal ball of pregnant lady lately, lol. I'm not pumping for long-term supplementation at the moment, and I agree with you - I should be able to naturally produce enough milk for my baby directly from the source. After my mature milk comes in, I will be pumping to build up a supply for when I go back to work, though. As for now, I wanted to pump enough to cover if they want to do the blood sugar testing in the hospital. As of right now, I do think I have enough for that.

    However, this is where I am torn... I'm pumping colostrum. Isn't this "la creme de la creme" of milk? If I continue (and especially since I'm producing so much), couldn't I donate it to a bank? If the banks don't accept the colostrum, I have one friend with a preemie (discharged from the hospital and doing well), and I have another friend who is expecting an adopted baby in the middle of March. It seems like such a waste that I can collect this stuff now until I give birth in these amounts when it can do so much good. If I don't deliver until full term, I could possibly donate 17 more ounces than I already have.

    I just looked on the hospital's website, and the LC at my hospital are indeed IBCLCs.

  9. #9
    Join Date
    Nov 2011
    Posts
    429

    Default Re: Pumping Before Birth

    I didn't read all the responses but I thought I would respond to your initial question about colostrum. I also pumped at the end of my pregnancy. I have this fear that for some reason my baby wouldn't be able to nurse or something bad would happen or something so I figured I'd store up some colostrum just in case. Well with my two pregnancies I started producing colostrum with the first at about 20 weeks with the second at about 15! With my second when I pumped the first time I got half an ounce total. And just like you it kept increasing to the point where I got an ounce to an ounce and a half per side. It was crazy. (on a side note I saved the collostrum and didn't end up needing it and gave it to my aunt who adopted a baby that came 5 weeks early and the colostrum was a life saver for her! ) Anyway the only down side to this is that when DD2 was born there was already so much colostrum available that it was hard for her to keep up with it. She did fine and was nearly 4 weeks early so she needed it but next time around I won't pump so much. Probably none at all. Because if DD2 hadn't been such a pro nurser from the minute she was born then the excess colostrum could really have complicated her learning. Like with my first she had to really learn how to latch on (plus I hadn't learned yet either) but I think that would have made things more difficult for her if I had pumped with her. See what I'm saying? So if it was me I wouldn't keep pumping because it increases how much you make and that could be really hard for your LO to keep up with. GOod luck! PM if you wanna hear any more details
    Melissa

    Young SAHM of
    Afton (A1) (1/24/09) and
    Autumn (A2) (8/29/11)

    Sealed in the SLC Temple

    and and now CDing!

  10. #10
    Join Date
    May 2006
    Posts
    21,114

    Default Re: Pumping Before Birth

    Colostrum is the creme de la creme, but obtaining it is not worth the price of inducing labor at just 37 weeks. Pumping can be quite effective at inducing labor, so much so that most midwives and OBs recommend that it be done only with medical direction.

    In your shoes, I think what I would be doing is talking about neonatal management with the docs and nurses at the hospital where you plan to give birth. If they are going to walk the walk with respect to evidence-based care, and not just talk the talk, they can't be routinely supplementing large babies just because they are large! There is so much hysteria surrounding gestational diabetes and large babies that many practitioners automatically assume that every big baby must have been born to a mom with undiagnosed GD, and that is a total misunderstanding of the statistics. Somewhere around 75% of macrocosmic (i.e. Large babies, variously defined as being >4000g or >4500g, see: http://www.aafp.org/afp/2001/0115/p302.html) are born to women with totally normal blood sugar. Your hospital's policy seems unnecessarily rigid. Many places adopt a more observational approach to large babies, meaning that they look at the baby for signs of low blood sugar, and do a quick blood test for sugar levels before supplementing. If you are faced with a second large baby- and having one large baby predisposes you to having another, ad you probably know- I think it makes sense to stand up for your mommy rights and demand that you see an actual reason to supplement before being told to supplement.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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