Pumping for Your Preemie

A mere 3 hours after enduring the most terrifying night of my life, when my daughter was delivered at 27 weeks gestation, I pulled the Ameda hospital pump over to my bedside and pumped for the first time. It was a ritual I would continue every 3 hours for the next 79 days. Over 600 pumping sessions yielding over 3,500 ounces of milk.

Luckily, I was experienced at breastfeeding and pumping. My oldest nursed for 15 months and my second child for 19 months. I cringe to think of what pumping after giving birth to a preemie would have been like had it been my first child. I remembered the pump settings that worked best for me, how much hand expression helped, and other practical aspects that made it easy to get started. Most of all, I knew that the sooner I pumped after giving birth, the sooner my milk would come in.

The act of pumping was easy for me. The emotions that came along with pumping for a baby born much too soon were difficult. It is said that NICU moms leave the hospital with empty arms and aching breasts. Instead of a warm baby to snuggle and feed at night, a NICU mom gets a cold, hard piece of machinery. Far too often in the middle of the night, I would swear that the rhythmic sounds of the pump were speaking to me. And they were saying, "You suck! You suck! You suck!"

I remember visiting the NICU for the first time in the middle of the night, just hours after my daughter was born. After speaking with the neonatologist, I realized that one of my most important roles would be to provide my daughter with her mama's milk. The doctor told me that there was nothing better for her; nothing could be created in a lab to replicate what my body could give her. And that is when my Type A personality kicked in. I needed to feel like I had a part in her recovery. NICU parents often feel helpless as they peer through an incubator at a baby covered in wires and tubes, cared for by doctors and nurses.

I began to mother her by doing something no one else in the world could. Before I held her at 5 days old, she was already receiving my milk. She only needed a tiny amount. A day's worth for her was one feeding for a term baby. Still, I brought in syringe after syringe at first, then bottle after bottle, until my freezer space at the hospital was full. Don't bring any more milk for a while, they said. I smiled, and my heart swelled with pride.

I no longer looked at my pump with dread and disappointment. It was a tool that was helping me do my part to heal and nourish my daughter. We were a team. I passed the time while pumping by reading every article I could about premature birth. Many touted the benefits of breast milk. Instead of always feeling sad and angry, I channeled my feelings into the one thing I could control. Plus, pumping was not my end goal.

When my daughter was 54 days old, I was able to put her to the breast for the first time. And it happened. One of the best moments of my life. She latched on. I pretended for a second that we were transported back in time to the night she was born. I imagined that she had just been handed to me, all slimy and new, to nurse right away. That vision lasted only a moment, yet it made me so thankful that I had been able to pump so that the milk would be there when she was strong enough. And it was.

Fast forward and my daughter is now 7 months old. With lots of patience and work, she is now exclusively breastfed and thriving. I know that pumping is hard, sometimes painful, and just plain not fair for NICU moms. But I can say that it was very healing, at least for me. With a birth where so much went wrong, at least there was something I could do right. Pumping allowed me to keep my milk flowing until I got my daughter to the breast.

It's hard. Sometimes it hurt. I did it. Now, as I nurse my daughter to sleep, it is all a memory...the pumping for preemie.


What worked for me:

1. Pump soon after giving birth, ideally within 3 hours. Nothing will come out at first. Totally normal. Do it anyway.

2. Pump often, at least every three hours. Do NOT skip pumping sessions.

3. Rent a hospital grade pump. I used an Ameda. Even though our insurance provided me with a pump, I still recommend using a hospital grade, especially if you are separated from baby.

4. Learn how to do breast compression by reading articles and watching video clips. I got colostrum doing this a few hours after giving birth and was able to take it down to the NICU. Nothing was coming out with the pump yet.

5. Let your baby's nurses know that you will always need a pump when you are visiting, and pump by your baby's bedside.

6. After a few weeks, I spaced pumpings during the day a little closer together to give myself a somewhat longer stretch of sleep at night. Getting a 5 hour block of sleep when my baby was in the NICU actually helped my supply. I always made sure to still get in 8 pumps per day.

7. Do kangaroo care as often as possible. As soon as my baby was able, I let her nuzzle at the breast. I would always pump first. If my daughter did latch, I did not want her to choke!