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Expressing breast milk for your premature baby

As soon as you walk onto the NICU to meet your premature baby - for what is possibly the first time - the nurses will be hounding you about how you intend to feed baby. Whether you had always wanted to breastfeed, express and give a bottle, or just give formula milk, your nurses are there to help you in your feeding journey. 

Why breast milk for your premature baby?

Your premature baby will have a very immature gut, so making sure that they are receiving the nutrition that they need is paramount to everyone looking after them. Giving premature babies expressed breast milk is a way to enhance their health, growth and development. Your milk will be tailor-made for your little mouse, full of fat - to help their brain development; protein and minerals - which are easily absorbed; and full of antibodies - made to help avoid infections in their intestines.

Even if you had never considered breastfeeding your baby, if they had been full-term, really take the time to sit and think about expressing your breast milk for your tiny premature baby. In this instance, it really is giving them the best start in life.

I want to breastfeed my premature baby…what next?

If you had always thought that you will breastfeed, your nurse will be able to arm you with all the tools necessary to get your milk supply flowing - right through to the correct positions for feeding a smaller-than-usual little mouse. You’ll be handed an expressing kit pretty much as soon as you have seen your baby. This normally contains tiny syringes, some bungs, some labels and two bonding squares. The nurse or midwife will go through what is expected of you, how to hand express, when you can use the pump and how to label your milk so it is used or stored before it goes out of date.

Tips for expressing for your premature baby

We have put our heads together to come up with some top expressing tips to make your expressing journey run as smoothly as possible. 

  • You must express at least 8-10 times in a 24 hour period. we usually hate being strict with parents, but this is really non-negotiable. Especially in the first few days, when you will be exhausted from the run-up to the birth, the labour, and the recovery, its tempting to relax into new motherhood, and then think about expressing. Its really important to get your milk supply going as soon as possible - your premature baby is counting on it!
  • Those first precious drops of expressed breast milk - Colostrum - will seem like tiny amounts, but that stuff is liquid gold! 
  • Another non-negotiable (sorry about all these rules folks!) is expressing overnight. Your hormones are at their highest in the middle of the night, so you really must use this to your advantage and express between 1am and 3am….however much you would like the nights rest!
  • Make sure that you take lots of pictures and videos of your Little Mouse. You can use these when youre not with your baby to help your let-down reflex, and increase the amount of expressed breastmilk you produce. Where possible, the nurses will encourage you to express by the bedside for the same reason. This is also where the bonding squares come into play - leave one with baby, stick one down the front of your bra, and swap them every time you express. Baby will grow used to your smell, and the smell of your baby will help your supply. 
  • Expressing is thirsty work - and the hunger is like nothing on this earth! Make sure you have a refillable water bottle that you can take to the NICU with you. If you can’t get up to get yourself some water - just ask! It’s really important to take care of yourself - if mummy isn’t being looked after, how can she look after Little Mouse! Take a bag of snacks with you and make the time to go to the Parents’ room and have ten minutes to yourself refuelling. Food that helps increase milk production include spinach, porridge oats, carrots and garlic. 
  • Once you’re using the pump - or if you’re thinking about investing in one - consider if there is a double pump facility. By pumping from both breasts at once, you are halving the time you have to pump - increasing the time you can doing other things, like trawling Little Mouse to find lovely things to dress your baby in! Medela pumps come highly recommended from many NICU and from personal use, we know that they are gentle on your breast and easy to clean.
  • If you can’t double pump, consider investing in a “milk catcher”. NatureBond make a silicon based, suction cup to catch milk from one breast, so you express from the other. Saves changing breast pads each time you express, means you can build up a supply quicker and helps you to realise how much milk you could have been losing to your nightie.
  • Massaging your breasts, with small circular movements before and during a pumping session will help to improve your milk flow. Start gently on the outer edges of your breast near your chest wall, and make your way towards the edge of your areola. Don’t be too rough, you want to avoid too much friction and pain
  • It is important to express regularly to avoid a condition called Mastitis - an inflammation of the breast tissue, and can make you very unwell - but if any lumps do appear, consider using an electric toothbrush to massage them out. Also, warm flannels, warm showers and baths help to ease the pain. You can take paracetamol when expressing, but make sure if the pain worsens, you seek medical advice.
  • If you are struggling with establishing a supply of expressed breast milk for you premature baby, speak up! The nurses deal with this all the time, and will have even more hints and tips to help you. If you are feeling up to it - or have family who are dying to be given a job - ask them to make lactation cookies. These are usually oat-based biscuits which can help increase you productivity. are great and tasty too! You can make a batch and take them for snacks with you. 

Breastfeeding can be emotionally draining, but support is available

Caring for and learning to breastfeed a premature baby is emotionally draining for any new mother. Coupled with the recovery time after giving birth, its understandable that you might feel overwhelmed. It's important to take some time for yourself if you feel this happening. There are lots of support groups out there to help you with any concerns you might have (often called BEARS - Breastfeeding Experience, Assistance and Reassurance). Make sure that you are utilising the care and support of your love ones, it will go a long way in achieving your breastfeeding goals.

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