Scheduling (828) 345-0800
Request an Appointment
PATIENT PORTAL
  • 0Shopping Cart
A Woman's View | Healthcare for Women | Hickory, NC
  • Home
  • Services
    • Gynecology
      • Abnormal Pap Smear
      • Annual Exams
      • Birth Control
      • Bladder Health
      • Bone Density Screening
      • Cervical Cancer Screening
      • Endometrial Biopsy
      • Gynecologic Surgery
      • Hormone Replacement Therapy
      • Infertility
      • Menopause Management
      • Osteoporosis
      • Pelvic Organ Prolapse
      • PMS Relief
      • STD Screening & Treatment
      • Teen & Adolescent Gynecology
      • Urinary Incontinence
      • Uterine Fibroids
    • Mammography
    • Ultrasound
      • Prenatal Ultrasounds
      • Instructions for Pregnant Patients
      • Other Types of Ultrasounds
      • Instructions for Other Ultrasounds
    • Obstetrics
      • Genetic Testing
      • Instructions for Delivery
      • Postpartum Care
      • Preconception
      • Routine Prenatal Care
      • Safe Medications During Pregnancy
    • Primary Care
    • Lab Services
    • Weight Management
    • Counseling Services
  • Resources
    • Young & On Your Way
    • Oh, Baby!
    • In Full Stride
    • Aging Gracefully
    • Community Resources
    • Girl Talk Educational Sessions
    • Just Between Us Newsletter
  • Meet Us
  • Visit
    • Electronic Check-in System
    • Patient Forms
    • Patient Rights & Responsibilities
    • Patient Financial Responsibility Policy
    • Privacy
    • Insurance & Billing
    • Collections Protocol
    • Card on File
    • Online Bill Pay
    • Prescription Refills
  • Location
  • Contact Us
  • Menu Menu

Your High-Risk Baby and Expressing Milk

January 10, 2017/in Aging Gracefully, Health Library, Health Library, Health Library, In Full Stride, Resources, Young & On Your Way /by

Your High-Risk Baby and Expressing Milk

How to get ready to make enough milk if
you are expecting a high-risk baby

Breastfeeding has important health
benefits for almost all babies. And it helps you and your baby bond. But the benefits
are even higher for babies who are born high-risk. Babies in the NICU need a mother’s
breastmilk to help support their immune systems, improve their digestion, and decrease
the risk of a serious condition called NEC (necrotizing enterocolitis). If you are
expecting a high-risk baby, providing your child with breastmilk is something only
you
can do. Below are some suggestions for how you can get ready to make enough milk for
your high-risk baby:

  • If possible, start pumping
    within 60 minutes of delivering your high-risk infant. Evidence shows that this
    can help make more milk than if you start later.

  • Use breast massage and warm
    your breasts before you pump.

  • Start expressing milk by
    hand, then use a pump as needed, to get your milk started.

  • Listen to relaxing music as
    you pump. Evidence has shown that this can help women to make more milk, possibly
    by reducing stress.

Techniques for expressing milk

You will have to depend on milk
expression to establish and then maintain milk production until your high-risk baby
is
ready to breastfeed. Most mothers find they get more milk in less time when using
a
hospital-grade, electric breast pump with a double collection kit when providing milk
for high-risk newborns.

Developing a milk expression
routine

You will want to pump at least 8
times in 24 hours. Even if using a good electric pump, it’s helpful to learn hand
expression in case you are ever without some of the equipment pieces for the electric
pump when it is time to express milk. Sometimes in the early days of milk expression,
mothers find they get more colostrum through hand expression than they do with the
breast pump. 

Don’t put off or stretch the time
between pumping sessions during the first 3 to 5 days after giving birth. You may
not
see any milk during the first several pumping sessions. And you may only get a couple
of
drops for several sessions after that. Keep expressing. The milk produced before day
3
to 5 after birth is called colostrum, and it is normally produced in small amounts.
But
colostrum is especially rich in the anti-infective properties that can help your
high-risk baby. If you are able to pump or hand express even one drop, it may be helpful
to your baby. Drops can be drawn up, and stored, in syringes specially labeled as
“colostrum.”

Helpful equipment

Breast pump

It’s important to use the right
kind of pump when long-term milk expression is necessary. And not all breast pumps
are created equal. Most mothers with high-risk infants find that a hospital-grade,
electric breast pump is needed for frequent and prolonged milk expression. These
pumps automatically cycle suction with release of suction–very much like a baby’s
sucking action. Studies find mothers who must pump for several weeks, or even months,
produce a larger amount of milk when using this type of pump.

There are many good
mini-electric, battery-operated and hand (manual) breast pumps on the market. But
these pumps were not designed for frequent and long-term use. These pumps were
designed to get milk for an occasional “relief” feeding. Most of these smaller pumps
require a mother to invest more time and effort to obtain an adequate amount of milk.
Many don’t cycle suction automatically, which often leads to complaints of breast
soreness or tenderness. The motors of mini-electric pumps can burn out with frequent
use. Frequent changes of batteries are needed when battery-operated pumps are used
frequently. And these pumps become sluggish and less effective at milk removal as
batteries wear down.

Getting a pump

Most maternity units and newborn
intensive care units (NICU) have electric breast pumps available, so you can start
pumping right away. They will also provide a double collection kit, which you should
take with you when you leave the hospital. The collection kit is then used with the
hospital-grade, electric breast pump you will rent for use at home. You can also
bring your collection kit with you when spending time with your baby in the NICU,
so
you won’t have to miss any pumping sessions.

To find breast pump rental
stations in your area, look online. Or ask the NICU staff, a lactation consultant
(IBCLC–International Board of Certified Lactation Consultants), or a breastfeeding
support leader. Many healthcare benefit plans, including Medicaid, cover the cost
of
breast pump rental and collection kit purchase. But you may need to include a letter
from a neonatologist or a lactation consultant with the request for reimbursement.
This letter should explain your baby’s need for milk expression. Because of the many
benefits of a mother’s own milk, health insurance companies know they ultimately save
money if you pump your milk for your baby. Contact your health insurance company to
find out if they have certain requirements for reimbursement or pump rental station
referral. If health insurance won’t cover the cost, remember that the equipment
needed to maintain milk production still costs less than the infant formula you’ll
have to buy if you don’t pump. (A high-risk baby is more likely to be given a more
expensive, special formula for a longer time, too.)

Breast pump collection kit

A breast pump collection kit
includes tubing, breast flanges, and collection bottles. The tubing attaches to the
pump itself and transfers suction to the breast flange, which may also be referred
to
as the “breast shield” or “milk funnel.” The flange is the piece that is in direct
contact with the breast. It is centered over the nipple and areola of the breast.
A
hard plastic bottle connects to the breast flange piece and collects milk flow. Clean
collection bottles should be used for each pumping session.

Double collection kit

A double collection kit allows
you to pump both breasts at once. Studies have shown that mothers tend to produce
more milk in less time when they use this type of collection kit with a
hospital-grade, electric breast pump. This may be because mothers find it’s easier
to
pump often enough when using this combination of breast pump equipment. Many mothers
also like to use a hands-free bra or hook. This allows you to have the flanges held
for you so that you can do other activities with your hands.  

How often and how long?

A full-term, healthy newborn
typically breastfeeds for the first time in an hour or 2 after birth. And they will
want
to eat about 8 to 12 times in 24 hours for the next few weeks or months. A milk
expression routine should closely follow this pattern. So you’ll want to start pumping
as soon after your baby’s birth as possible:

8 times a day

Pump at least 8 times, or for a
total of at least 100 minutes, in every 24-hour period. The more pumping sessions,
the better. More frequent sessions may be needed if you’re pumping milk for twins,
triplets, or more.

Freeze any extra milk

At first you may find frequent
pumping produces more milk than your high-risk baby needs. But extra milk can be
frozen for later use. It’s better to stay ahead of your baby’s current intake. If
you
pump less than 8 times a day, you may find milk production begins to drop after
several weeks. Then, 10 to 12 daily pumping sessions may be needed for several days
or weeks if you want to increase production to meet your baby’s growing appetite.

A typical cycle

Most mothers pump for about 15
to 20 minutes, every 2 to 3 hours during the day, with one, 4- to 5-hour stretch of
uninterrupted sleep at night. You could pump for about 15 minutes without
interruption. But you may find it helps to take a “massage” break when milk flow
slows after 5 to 10 minutes. Stop, massage your breasts, and then reapply the pump
until a minute passes without any milk flow. Some women pump longer than 15 to 20
minutes and wait until there has been no milk flowing from the breasts for
about 1 minute before stopping. 

Single vs. double

Some mothers prefer single
pumping of each breast separately, especially when first learning to use the breast
pump. These mothers pump one breast for 5 minutes (or until milk flow slows), then
pump the second breast for 5 minutes (or until milk flow slows). Then they repeat
the
whole process but continue to pump until a minute passes without any milk flow for
either breast. Single pumping lets a mother massage each breast as she pumps, which
can increase milk flow. If a mother wants to massage both breasts at the same time,
she can use a hands-free bra or hook to hold the flange to the breast while she
massages the breast tissue. 

How much milk?

After 7 to 10 days of frequent
pumping sessions–at least 8 times a day and for a daily total of 100 minutes or
more–expect to produce between 16 to 32 ounces (about 500 to 1,000 ml or cc) of
breastmilk a day. This may be more milk than your high-risk baby needs just now. But
you
will be glad to have extra milk in the freezer if milk production drops at some point,
which is not abnormal after several weeks. Then any stored milk can be used.

Don’t be surprised if you get more
milk at some pumping sessions than others. Many mothers find they get more milk earlier
in the day. And you can expect some variation in the total amount pumped from day
to
day. But if you find the daily total keeps dropping for several days in a row, talk
with
a certified lactation consultant, your baby’s healthcare provider, or a breastfeeding
support leader.

Helpful hints

Mothers of high-risk newborns have
found some or all of the following suggestions helped them create and stick to a routine
when expressing their milk for days, weeks or months:

Stick to a schedule

Many mothers find their milk
lets down more quickly and they soon get larger amounts of milk when they pump at
about the same times every day. But don’t be concerned if there is some variation
in
the schedule from day to day.

Set a timer

It’s easy for time to slip away
and for pumping sessions to get a late start. It’s helpful to set an oven timer, a
digital watch, or cell phone to remind you when the next session is to start. If a
session is delayed, pump a little earlier next time.

Chart pumping sessions

Keep track of when you pump, how
long you pump, and how much milk you get by using a simple checklist chart to note
pumping sessions. A written record will help you pick up early any drop in number
of
sessions, time spent pumping, or volume of milk obtained, so you can make changes
before a real problem develops.

Get comfortable

You are more likely to continue
a routine if you pump in a comfortable, yet convenient, spot. Have a snack and a
drink in reach. Listening to relaxing music has been shown to increase breastmilk
production. Or you could distract yourself by talking with someone over a
speakerphone or watching TV. You can also use the hands-free pumping equipment and
do
other activities at the same time as you are pumping. 

Create a ritual

Follow the same routine for most
or all of your pumping sessions. Your ritual might include:

  • Pumping in a certain
    place

  • Putting warm compresses on
    your breasts and doing breast massage before pumping

  • Dimming lights

  • Turning on soft music

  • Using relaxation
    techniques, such as slowing your breathing and imagining a beautiful waterfall
    that turns to milk after a minute or two of pumping

Include your baby in the
ritual

You might want to look at a
picture of your baby or breathe in the scent of a blanket or cap he or she has worn
as you pump. Some mothers listen to audio of their babies’ cries when they begin to
pump. Others simply think of their baby while pumping. Skin-to-skin contact with your
baby (called kangaroo care) in the NICU has been found to increase milk
production.

Plan ahead for night
sessions

Nighttime pumping sessions will
seem less annoying if the pump and collection kit are set up and ready to go when
it’s time to wake up to pump. Some mothers save steps at night by placing bottles
in
an insulated cooler with an appropriately sized freezer pack to keep milk chilled
correctly until morning.

Be positive

It’s easy to get discouraged,
bored, or frustrated when pumping at least 8 times, or more than 100 minutes, in 24
hours for day after day–especially if you are having any trouble producing milk.
There may be moments when you’d like to throw the breast pump out the window. Know
that such feelings are normal. But don’t throw that pump away. It’s an expensive
machine, and it’s allowing you to provide the most valuable food your baby can get.
Remember, by providing your high-risk baby with this exceptional milk, you are a
vital member of your baby’s healthcare team. It also maintains your milk supply so
that you can bond with your baby through nursing when they come home from the
hospital. 

Share this entry
  • Share on Facebook
  • Share on Twitter
  • Share on WhatsApp
  • Share on Pinterest
  • Share on LinkedIn
  • Share on Tumblr
  • Share on Vk
  • Share on Reddit
  • Share by Mail
  • English Resources
  • Recursos españoles
  • Privacy
  • Careers
  • Patient Portal
  • News
  • Contact Us
  • Employee Store Login
  • Facebook
  • Twitter
  • Instagram
Adding to Mother’s Milk Breast Milk: Pumping, Collecting, Storing
  • Facebook
  • Twitter
  • Instagram
Scroll to top