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  • "spider smiles" started this thread

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Reg: Feb 20th 2008

Location: Dubai

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1

Monday, September 29th 2008, 3:26am

Expressing for preemie

Hiya girls- as you can see I'm joining you a bit sooner than expected. My beauty is ten weeks early and obviously in SBCU. Si for seven days I have been expressing. Still getting collustrum by the look of it- about 30 ml from well over half an hour pumping. The nurses are increasing his feed day by day and say that I have to try to start doing more each bottle. Does anyone have any tips at all? Last night I spent well over an hour, swapping from boob to boob every few mins, but still the amount was pathetic! Oh and the photo thing doesn't help at all! When will my milk 'come in' do we think? I had a c sec.
Also- bad planing- I have an Avent Microwave steriliser and a Medela electric pump which says the parts are non microwavable- anybody been brave enough to try them anyway without them melting??? I am boiling the pump parts in a pan for 3 mins and then I let them air dry on a piece of kitchen towel on a surface that's been Miltones- then I transfer to a tupperware box that's been Miltoned, but I do open it a few times between each Milton wipe! Is this all ok so far? xxxx
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

Rene

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Monday, September 29th 2008, 6:09am

Hi, Emma
Firstly - congrats on your little man
Unfortunately I have no experience with expressing for premies but I have to ask a question here
How often are you expressing? You would need to be epressing at least every 3 hours day and night to encourage your milk to come in cos that is how often a baby would be suckling

Make sure that you are drinking at least 2.5 to 3 litres of fluid per day - your body needs fluid to produce milk and that you are eating well.

Beyond that, if the nurses are saying you need to produce more milk ask them if they can give you some medicinal help. There are tablets that help boost the milk supply.

Will they let you express when you visit?


PCOS, hypothyroid - on thyroxine, aspirin and Met
Lap/Ovarian Drilling Oct 2005
DIUI X5 + 2 abandoned cycles (total 7 cycles)
:BFP: 22 March 2006 - Connor Born 24 November 2006 - unplanned c-section
At 3 and a half C finally gave up the boob!

  • "spider smiles" started this thread

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Monday, September 29th 2008, 6:42am

Thanks Rene- yes I'm doing it every 2-3 hours or so but have just read that I should be getting up in the night to do it- whoops! I do my last one of the day around midnight and then get up at 5am for the next one- maybe I should try for a 3 o clocker too. I can express when I go to the hospital- but it's hard as I'm in Dubai so sat amoungst Arabic ladies and we all have to cover up and its really hard to chill out and just get the job done when you're trying to keep your boobs hidden in a boiling hot room with temperamental equipment!!! Grrrr!
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

Bells

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Monday, September 29th 2008, 9:44am

Hi and congratulations on the rather hurried arrival of your baby!

Brilliant job managing to express at all, well done and do take a moment to pat yourself on the back. You're doing great :)

Here's a bit of info on the mechanical side of breastfeeding and why it matters about your environment when you're expressing Expressing

As you can see, it's not just a case of sticking the pump on and milking your breast like a cow, there's a psychological aspect that comes into it also. Fighting with modesty and temperemental equipment isn't going to help you....is there anywhere you can use your breastpump where you 'can' totally relax? Can you set yourself up and then sit back, close your eyes and switch your mind off from the hustle and bustle around you?

Your milk may well be delayed in coming through but it's important that you continue to spend time every 2-3 hours pumping, even if you don't think you're getting much out as it's the physical stimulation that makes your body produce milk. It 'would' be a good idea to pump during the night as this is when prolactin levels are highest, it's the premium time to express or feed for milk production.

It's hard for you because you haven't breastfed and you have no frame of reference when it comes to how fast/slow/ hard/soft to pump. When a newborn baby breastfeeds from you the suck is VERY strong and at the beginning of each feed it sucks rapidly. This is something you need to replicate when you pump. For the first minute of pumping the rate needs to be rapid and quite strong, after a minute less so, after two minutes slower and less strong. You can do this with your pump and this 'may' encourage your let down reflex which will then hopefully trip your body into producing more milk.





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Monday, September 29th 2008, 10:16am

Hi Spider

Firstly congrats and hope yr little man is doing well. I had the twins at 33 weeks and both were in SCBU for 2 weeks. I couldnt breastfeed for the first week or so as the sucking reflex doesnt kick in till 34 weeks so I was expressing.

At first I was using the big hospital breast pump and like you was only getting small drops of colostrum, then about the 4th day, my milk came in. Till then the girls would get topped up with formula but every little bit I expressed got put in their feeding tube and it all helps. I had no problem with my milk flow and was filling a 9oz bottle off one breast but some of the other girls were maybe only getting 3 oz of both. I think my 2 started off on 30ml of milk every 3 hrs in their tubes then the feeds were upped and they went to every 4 hours. I used to be like a headless chicken, making sure I had enough for every feed. I breastfed the girls till they were 6 weeks old.

I pumped first thing on a morning, then about every 3 hours during the day until they were ok to go on the breast. I never got up during the night whilst they were in SCBU but found I was fit to burst on a morning and couldnt wait to get the milk out. I used the Avent Electric breast pump at home which I bought from Mothercare and used to put the parts in my Avent Steam Steriliser but at the hospital, I just used to pop the parts and bottles in the cold water steriliser with the milton fluid in. As long as you change the tablets/solution every 24 hours you'll be fine. Even now I use a tub with a milton tablet in for the teethers, dummies etc instead of steaming them, 10x easier.

I know its difficult but I think your environment doesnt help with Dubai being a very cover up country where ladies are concerned. I went there last May for my honeymoon and I went to the gold souk with my shorts and a vest top on one evening and the looks I got were unbelievable, I just wanted the ground to swallow me up so it cant be easy for you to reLax. Its a no win situation as I found that if I didnt relax and was anxious my milk flow was crap and I also found the photo thing didnt work.

Keep going, you sound as if ure doing a grand job, I know its not easy having a baby in SCBU, its mentally and physically exhausting as well as the worry of everything else but you'll get there.

Lots of love to you and your little man.
Me 34,DH, 32. DD15 from prev relationship. Scan 9/07 showed 2 [zx076] [zx076] My perfect little ladies arrived healthy 7 weeks early on 18/3/08 weighing 4lb 8 and 3lb13...Love my three pinkies

:girl: :girl: :girl:


Torisen

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Monday, September 29th 2008, 10:24am

DS was not premature but I did a lot of expressing to donate to other premmies.
For me it was all about the mental state.
I started off twiddling the nipples and then hand expressing (where you squeeze in a motion from outside the areola towards the areola. I would send this down the pump and then eventually I would get the let down reflex and could just sit with my eyes closed pumping.
It was lots of self hypnosis but it worked for me.

I can imagine that there is a lot of pressure for you now but if you really are struggling then ask your doctors if it is possible to get an oxytocin nasal spray that will help you with the let down reflex.

:hugs:
ICSI Jan 2006 - BFP
MC one twin at 6 weeks
DS born in Oct 2006
BF DS 10 months 3 weeks and 5 days
FET 11/07, ICSI 12/07 (ABANDONED), ICSI 2/08, IUI 5/08 - BFN
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Pootle

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Monday, September 29th 2008, 12:26pm

Hi Emma, congrats on the arrival of your little boy.

My DD was 8 weeks early and I expressed - not the easiest thing in the world after an emergency c section eh!?

I think it sounds like you're doing great. I used a medala too and found that was the best pump for me. I expressed every 2-3 hours too, like you. And I did it on a really strong setting otherwise I didn't get very much.

The thing that really worked for me was using the pump but also my hand at the same time - not very glamourous but it seemed to do the trick!

I have vague recollections of being offered domperidone to encourage milk production but I could well be wrong - it all seems a bit of a while ago now.

Having a baby in SCBU is a challenging time so sending lots of love to you, your DH and your DS and I hope he's home in no time.

x






My family is complete...I am grateful every day

DD1, natural miracle, 2005
DD2, IVF miracle, 2008


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Monday, September 29th 2008, 1:09pm

Congratulations SpiderSmiles on his birth.

I expressed with DD for 11 weeks although she wasn't prem. I was expressing every 3-4 hours and was advised that 20 minutes was enough, any longer and I was unlikely to get get any more milk, just more pain! I was using a double medela pump that I borrowed from the midwives and I found it a lot easier once I'd altered one of my old bras so that I could 'wear' the pump and have my hands free. It meant I could stroke my baby, read, rock the moses basket, and it eased the pain in my shoulders from hunching over holding the pumps to my breasts.
You can take various herbal supplements to increase milk supply. I took the following: Bach rescue remedy before expressing which helped me to relax, fennel both as a tea and a vegetable which is supposed tohelp increase milk supply. I also took fenugreek suplements which are also supposed to help increase supply but I found they repeated on me in a not very pleasant way!

Massaging your breasts prior to pumping can help too. Use the flat of your hand and stroke down from the base of your breasts to the nipple for a few minutes before pumping.

Teach someone else how to wash and sterilise the equipment so that you can rest and be with your boy as much as possible. I did it all myselff because I was the only person pigheaded enough to insist she got breastmilk, and I was bloody knackered.

Try and get as much contact with your baby as possible, he really needs skin to skin contact so make sure you can stroke him and talk to him.

Be nice to yourself. You have been through a bit of a shock to say the least and you need to get as much rest as you can. And give yourself a huge pat on the back for all your hard work. When I look back on those early weeks of expressing with DD, it was so tough. Well done on getting this far.

Hope he is home soon.





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Monday, September 29th 2008, 4:46pm

Hiya - I'm in the middle east now as well!!

Can you ask for a private room for yourself? does your insurance cover that? my BUPA when I was in Asia with my premmie (didnt see him for 3 days at first!) covered a private room for me to stay in - I had an em-c as well but even though I could be discharged they let me stay an extra week in the room

I got an Avent Isis duo - much more comes out if you do both boobs at once - get your hubby to go to the mothercare in dubai and buy that, and also buy an avent electric steam steriliser - it's only money - hahahaha! ;)

and sorry to say but you have to pump for 20 minutes or so (no need for more!) every 3 hours all day and all night - so at least 8 times a day

if you cant get a private room, then just throw on an abaya and go braless underneath :snigger:

drink lots and lots of water - Ramadhan is almost over - hoorah!!!!

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Monday, September 29th 2008, 4:52pm

Quoted

Originally posted by Bells
It 'would' be a good idea to pump during the night as this is when prolactin levels are highest, it's the premium time to express or feed for milk production.



I was told this was between 10pm and 6 am. Proof, if you ask me that God is a man!





  • "spider smiles" started this thread

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Monday, September 29th 2008, 5:57pm

Thanks everyone- you've been really helpful. Sunshine- he's in a government hospital as my lovely private hospital sent me there- none of the private ones have the facilities for babies under 34 weeks!
Anyhow- tell me about double pumping girls. I actually have a Medela double pump but thus far have just done one boob at a time! I realise that this would make life easier as I could do two bottles of the eight he requires at once- but I only get about 20ml in one bottle- does this mean I will get just 10ml in each bottle in a session? I was doing one at a time to give nipples a break and because after one boob has had a break whilst I'm doing the other one, I tend to get a decent spurt from it when I go back to it! Sorry for being so ignorant about all this! Also, I have a limited number of bottles as the hospital will only accept their own but have a limited supply! Which means if I double pump, I'm using all 8 of my daily bottles in four sittings- meaning I'm out of bottles for the last 4 sittings of the day. What would I do then? Use the plastic ones that came with the pump and throw the milk away? (Been told that's a sin!)
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

Torisen

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Monday, September 29th 2008, 6:13pm

The South African milk bank used sterilized jam jars and the UK milk bank had their own sterilized plastic bottles.
They took my "normal" presterilized bags though (Lanisoh milk bags).
Could you express and then put it in the same bottle?
Does the bottles go straight on the pump or do you use the pumps bottles?
ICSI Jan 2006 - BFP
MC one twin at 6 weeks
DS born in Oct 2006
BF DS 10 months 3 weeks and 5 days
FET 11/07, ICSI 12/07 (ABANDONED), ICSI 2/08, IUI 5/08 - BFN
Clomid IUI 7/08 BFP MC a twin... again :(


  • "spider smiles" started this thread

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Monday, September 29th 2008, 8:10pm

I'm not ever so sure if I can use a bottle twice- can I refridgerate it and then open it again to pour another load in? I have to use the glass hospital bottles apparently. I have some plastic ones that came with the pump but they won't accept them!
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

Bells

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Monday, September 29th 2008, 8:23pm

Can you store the milk in your own bottles and then decant it into the glass bottles as and when you need to take it to the hospital?





Torisen

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Monday, September 29th 2008, 9:34pm

Let the two cool down before you put them together though if one is fridge cold and the other one body temp.
ICSI Jan 2006 - BFP
MC one twin at 6 weeks
DS born in Oct 2006
BF DS 10 months 3 weeks and 5 days
FET 11/07, ICSI 12/07 (ABANDONED), ICSI 2/08, IUI 5/08 - BFN
Clomid IUI 7/08 BFP MC a twin... again :(


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Tuesday, September 30th 2008, 8:34am

Quoted

Originally posted by spider smiles
Sorry for being so ignorant about all this!

And what on Earth in your life would have prepared you for it? Don't apologise, you are doing really, really well and he is a very lucky boy to have a mummy who is so determined to feed him the best stuff available.

I would say that double pumping would be better if you can do it because each breast is getting double the stimulation which is going to increase your supply. However, if you then have to go for longer between pumpings that will have a negative effect on supply, so sadly its not going to mean you can pump less often. My instincts tell me that throwing it away is a sin too! Could you donate any of it? Could DH take some home and freeze it? Frequently pumping is best, preferably on both breasts, but definitely on one. Why not try double pumping for 24 hours and see what it does for your supply?





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Tuesday, September 30th 2008, 1:30pm

Emma

You're doing an amazing job out there, I can't begin to tell you how amazing you're doing!

Can I help in anyway - I'm really happy to go out and buy baby milk bags for you or any herbal remedies you might need, anything that might make your life easier whilst you focus on baby - anything to help at all, just PM me and it'll come first class to you.

C
xxxxx
Cathie

Proud mum to Eric after 3 years TCC!!!

  • "spider smiles" started this thread

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Tuesday, September 30th 2008, 4:20pm

AW thanks Cathie! I'm ok thank you but thanks for being so kind. And Mrs J- good idea, I'll start tomorrow and see how it goes. But guess what? Have discovered that I can squueze more out with my hand than the pump! Don't know if i'm doing it right but just kind of massaging downwards the squeezing the nipples gentle and I can have someone's eye out in a flash! I do each for a few mins into the funnel then pump for a while while I do suduko and so far it's going ok. Still not getting enough to feed the five thousand but I'm just about cutting it!
Milk donation isn't an option here- again a cultural issue. Thanks for your tips and tricks girls- keep them coming as I'm finding trial and error an adventure! x
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

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Tuesday, September 30th 2008, 5:05pm

spidersmiles - go up to my link at the top - how much milk does my baby need - of the threads

look at the size of your baby's tummy
look at the 20ml of milk you have produced

looks ok now doesnt it? 88)

i dont know the science behind why double pumping works, it just seems to produce more if you do both together than if you do one after the other?!

re: bottles - pump using your own bottles, store milk in fridge if you can, then decant into hospital containers when they ask for them. if you get 10 or 20ml per boob, then use your plastic bottles to express, and then pour both boob contents into one glass jar for the hospital.

the 8 glass bottles makes sense - remember 3 hourly 8 times a day

i too was in government hospital rather than private for the same reasons - MUCH better facilities :) but... still... they had private rooms even in the government hospital... you just had to pay cash and then claim it back on BUPA afterwards.

  • "spider smiles" started this thread

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Tuesday, September 30th 2008, 5:28pm

Thanks Sunshine- yes I did have a private room as my husband requested one, but never even realised as I was so out of it the day after! :snigger:
I think I'm getting there girls with your help! I shall surely be back if any problems. x
[zx160]Emma

Me 32, DH 28
Ectopic Oct 06- right tube removed
Endometriosis
First IVF cycle began 5th Feb 08
:BFP: 16th March bab11
:cuddle


Baby Gregory born 10 weeks early on September 20th. baby1

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Wednesday, October 1st 2008, 9:41am

by the way - do you have a poncho or an abaya? then no esposure is needed at all! :)




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