Breast-Feeding: While Baby Is Hospitalized

If your baby is premature or ill and not able to nurse frequently and vigorously, you will need to pump your breasts regularly to keep producing breast milk. The amount of milk that your breasts can produce and release is affected by your emotions, your physical condition, and your pumping routines. The following hints should help increase your milk supply and condition your let-down reflex. They will help you to provide enough breast milk for your baby and to prepare for breast-feeding when your baby is ready.

1. Ask for help from a lactation professional.

   Seek the advice of a lactation professional as early as possible. Many hospitals have lactation consultants on staff who can help you create a plan to produce plenty of milk. This person will also be able to help adjust your plan to your baby's changing needs and abilities.

2. If possible, get a hospital-grade electric breast pump.

   It is best if you can use a hospital-grade electric breast pump with a double collection system that allows you to collect milk from both breasts at once. This saves you a lot of time. To find where you can rent a pump, contact Medela at 1-800-835-5968 (http://www.medela.com); or Ameda at 1-866-6332 (http://www.ameda.com).

   The fully automatic electric pumps sold for personal use generally are very effective and comfortable. You can also get small electric, battery-powered, hand-operated, or foot-operated pumps. Although these pumps are cheaper, generally they are less effective and less comfortable than rental electric pumps or fully automatic personal pumps.

3. Follow a pumping schedule that is similar to a healthy newborn's feeding schedule.

   This means you will need to pump every 2 to 3 hours, allowing one 4- to 5-hour interval at night. You will pump 7 to 10 times each 24-hour day.

4. Pump each breast at least 10 minutes.

   Pumping each breast 10 minutes is usually enough to drain the breasts well. However, some women need to pump longer. If milk is still flowing well after 10 minutes, pump another 5 minutes. Even if milk stops flowing before 10 minutes have passed, keep pumping for at least the full 10 minutes. If you pump both breasts at once you not only save time but also may raise the prolactin level in your blood. Prolactin is the hormone that tells your body to make milk. You can increase the amount of milk you make by massaging and hand expressing more milk after a pumping session.

5. Relax.

   Relaxing can help trigger your let-down reflex. Sit in a comfortable position and relax your entire body. Practice the relaxation exercises taught in childbirth classes. Think about your baby, look at your baby's picture, play soft background music, or read a good book or magazine. If milk flow does not start after 5 minutes of pumping, stop. Focus on getting relaxed and then start pumping again in 5 to 10 minutes.

6. Massage your breasts.

   Gentle massage of your breasts can help start milk flow. Start at the chest wall and gradually move toward the nipple. Use a circular motion about the size of a quarter.

7. Warm your breasts.

   Taking a warm bath or shower before pumping can improve the flow of milk. Placing warm washcloths on your breasts can also help trigger the let-down reflex.

8. Drink a lot of fluids.

   A good rule of thumb is to drink an 8- to 12-ounce glass of water each time you sit down to pump.

9. Eat a balanced diet.

   Try to eat fewer processed snacks such as cookies, cake, and candy. Instead, eat more fresh fruits and vegetables, whole-grain breads and cereals, non-fat dairy products, and other sources of protein. Continue to take your prenatal vitamins.

10. Keep a diary of the amount of milk you pump each time.

    You may get different amounts of milk each time you pump, depending on the time of day and how long it has been since you last pumped. However, the total amount of milk you pump in 24 hours should steadily increase during the first 2 to 3 weeks of pumping.

    By 2 weeks after delivery, a generous milk supply for a single baby is about 24 ounces every 24 hours. (Mothers of twins or triplets need to produce more milk.) You should aim for producing at least 20 ounces every 24 hours by 7 to 10 days after the birth, even if your baby takes little milk now. It is easier to keep producing a generous supply of milk from the start than to increase your milk supply later when your baby begins taking more.

    Even if your pumped volumes are lower than desired, don't give up. Often a mother's milk production climbs when she is able to start breast-feeding her baby.

    Check your diary to make sure you are pumping at least 7 times each 24 hours and that the longest time between pumping sessions is 4 to 5 hours once at night.

11. Start breast-feeding your baby as soon as possible.

    Spend skin-to-skin time with your baby while in the hospital. Even if the baby is not able to nurse, this helps the baby to link comfort and warmth to nursing.

    It is important to start breast-feeding as soon and as often as your baby's medical condition permits. Offering your breast to your baby whenever possible during your hospital visits will help your baby learn to nurse.

    Always pump after nursing to express any remaining milk. This will make sure that your breasts are emptied well and that you keep producing a generous supply of milk. Once your baby is breast-feeding every time and gaining weight well, you can begin pumping less often.

    You will probably need to keep pumping until your baby weighs at least 7 pounds and is a few weeks past his due date.