Providing breast milk for a preterm baby has significant immediate and long term health benefits. And because of these benefits, the first step is establishing a good milk supply.
BIRTH TO DAY 3
Your preterm baby may breastfeed well from birth. But if not, start pumping. The sooner, the better. If you can, start within the first hour but no later than six hours. Use a multi-user, hospital-grade breast pump. Plan to double pump at least 8 times per day for 10-15 minutes. For more details, see our Q & As, Reaching Full Milk Production with a Breast Pump.
Expect to pump just a little colostrum, the first milk, at first. But even drops are important to your baby. Every pumping you do puts in your order for more milk. This is how you can tell your body to make more milk.
DAYS 4 TO 10
Expect to see a big change by Day 3 or 4. Where there were drops, you’ll likely see ounces. If your baby is not yet breastfeeding, use your pump to try to reach full milk production by Day 10. Your body is primed and ready to do this right after birth. If you wait until later, this can be much harder. When you reach 25 to 35 ounces (750 to 1050 ml) per day, you are there.
When you start to pump more milk on Day 3 or 4, try these tips to boost your supply faster:
- Pump longer—until 2 minutes after the last drop of milk or 20-30 minutes. (Drained breasts make milk faster.)
- Hand-express milk into the pump flange afterwards. By draining your breasts more fully, you’ll make more milk.
- Don’t go longer than 5 hours between pumpings until you reach full production. (Full breasts make milk slower.)
- Pump 8-10 times each 24 hours. You don’t have to pump on a set schedule. You can pump more during the day to fit them all in.
- Massage your breasts during pumping.
- Check your breast flange fit. Flange fit can change as you pump more. See the photos in Getting a Good Flange Fit under Breast Pumping on www.ameda.com.
Once they reach full production, most mothers can pump less—6-7 times per day—to maintain their milk. If you can sleep longer without too much breast fullness, go ahead. Any milk that your baby does not need right away can be frozen for later.
The following extra steps have been found to be of no benefit to you or your baby: cleaning the breasts before pumping, sterilizing pump parts after each use, and throwing away the first milk pumped. Most hospitals no longer recommend these steps.
STORING YOUR MILK
Follow your hospital’s rules for milk collection and storage. Most hospitals suggest that you:
- Use glass or hard plastic containers approved for food storage.
- Use a tight-fitting lid, rather than a bottle nipple.
- Label the milk with the baby’s name and the date and time of the pumping.
Your hospital may give you bottles and lids to use. Milk storage times may differ from those for full-term healthy babies. Ask your hospital for the storage times it recommends at room temperature, refrigerator, and freezer. You can use the Ameda Cool ‘N Carry™ or other insulated tote to keep the milk cool between home and hospital.
BOOSTING MILK PRODUCTION
If your production drops to below 25 ounces (750 mL) per day, try these ideas to bring it up.
- Switch to a hospital/rental pump, if you’re not already using one.
- Hold your baby skin to skin before pumping.
- Massage your breasts before pumping.
- Hand-express milk after pumping.
- Pump longer. (Drained breasts make milk faster.)
- Pump more times each day.
- Ask your lactation consultant to talk to your doctor about prescribed medications and/or medicinal herbs that can boost milk production.
This is general information and does not replace the advice of your healthcare provider. If you have a problem you cannot solve quickly, seek help right away. Every baby is different. If in doubt, contact your physician or healthcare provider.