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Thread: Transitioning preemies to the breast

  1. #1

    Default Transitioning preemies to the breast

    I'm the mom of preemie twins born at 34 weeks. They're now at 44 weeks gestational age and 10 weeks old. I've been working this whole time with several IBCLCs to get them onto the breast. I think we are close as they each have done some full feedings at the breast! But I'm having some challenges and would love your advice.

    -I think supply and milk flow are big hurdles for me because they feed great when I'm full, less so when I'm not. My pumping output is 24 to 28 opd plus some nursing, and I'm told this is borderline for twins. I didn't get very good pumping advice at the beginning and I'm afraid I was just under stimulated too long. I was told to pump 20 minutes on a low setting every 3 hours. I now pump at a higher setting.

    -I'd like to pump more like every 2 hours to get my supply up but that ends up conflicting with my babies' eating. They got used to eating every 3 hours and we were advised to stick with this got a while as preemies use energy eating. Can I feed closer together now that they are 7.5 pounds and 10 weeks old? (I usually wake them to eat. Sometimes they awaken first.)

    So I guess I feel like if I had better milk flow, I could do this, but I'm not sure how to get there. I'm so worried because we are at 10 weeks and I keep hearing you have to be established by 12 weeks. My IBCLC had given me some supplements. Not sure how much they've helped...

    I think our latch is decent because I have no pain and no misshapen nipple but there's always room for improvement.

    I recently got an SNS and am trying to use it a often as possible. Sometimes the babies are using the SNS and just stop/get tired.

    All advice greatly appreciated!

  2. #2
    Join Date
    May 2006

    Default Re: Transitioning preemies to the breast

    Welcome to the forum and congratulations on the babies and on breastfeeding them for 10 weeks! That's awesome, especially considering that they were such early birds.

    Please don't worry about supply being "established" at 12 weeks. It's not true. It's a little easier to boost supply in the very early days/weeks of breastfeeding, but you can increase supply at any time, given the right stimulation. Pumping every 2 hours instead of every 3, pumping for longer, and pumping at a higher setting, combined with nursing the babies more frequently- that's what will get you where you want to be. More demand = more supply.

    Throw the babies' feeding schedule out the window. At 4 weeks adjusted age, and a nice full-term weight, there's no reason to think that they will burn too many calories by nursing. Full-term babies typically nurse about 10-12 times a day, or even more often, in the first 6 weeks of life, so I think you want to aim to cram as many feedings or nursing sessions as possible into the day.

    What sort of pump do you have? For a mom who is struggling to establish supply with a young babies who are not nursing all that well (e.g. falling asleep at the breast, being lazy at the breast if it's not really full), you definitely want a hospital-grade rental with correctly sized shields.

  3. #3

    Default Re: Transitioning preemies to the breast

    Thanks for responding, Mommal! I use a Medela Symphony. Hard to say about the shield size because three IBCLCs have given me very different advice. :/ I find the left side does not feel as stimulated when I pump. Could that be too large a breast shield? I'm trying to do more frequent feedings per your advice. Sometimes feeding two babies can take over an hour and then I pump, so every 2 hours isn't always realistic but I'm trying. When I pop a baby on right after pumping, she often doesn't do much.
    Thank you again, your message was very encouraging!

  4. #4
    Join Date
    May 2006

    Default Re: Transitioning preemies to the breast

    You could definitely have too large a shield, either on both sides or on just one- we're not perfectly symmetrical, after all. Try a different size and see if there's a difference.

    I am sure you are absolutely maxed out in terms of time and effort! Feeding just one newborn baby can take an hour. Pumping on top of that... Well, there isn't always time! Just do what you can, and don't beat yourself up if you fall short of perfection.

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