This is a fairly common event in our NICU. We are a regional Level lll NICU
in a children's hospital. We encourage mom's to kangaroo as often and as long
as possible once infant is stable. We are able to get most of our
Neonatologists to allow this to happen even on a vent as long as the baby is
stable. Encourage double pumping with a hospital grade electric pump soon and
often. We tell Moms a minimum of 8 times/24 hours with a 6 hour break at
night for sleep.  She should pump for a minimum of 15 minutes until her milk
comes in then to pump for 2 minutes after her milk stops dripping. Our moms
store their EBM in volufeeds with sterile lids. They are made of a hard
plastic that is compatible with EBM and HMBA guidelines. Our policy states
that it is good for 48 hours in refrig and 3 months in freezer that we keep
at a temp of 0 degrees F. It is very common for milk supply to go up and down
as the condition of the baby improves and deteriorates. If Mom has a problem
with her milk supply, encourage pumping at bedside for the visual stimulation
of baby.  Also, use all the usual relaxation techniques, i.e. warm
compresses, massage, deep breathing, visualization, etc. As soon as infant is
off mechanical ventilation, we encourage them to start doing non nutritive
sucking at breast. Our moms that do kangaroo and NNS are most likely to take
their infants home at least partially directly breastfeeding. Some still need
supplementation for calories and nutrients for a period of time after
discharge.  Good luck and email me privately if you need more information.
Chris Smith, RN, IBCLC
Columbus Children's Hospital

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