Cathy, I agree with your post of how different pumping routines work
differently for all moms. Not all mothers can pump consistenly every three
hours due to demands of home, kids, etc. I must say I do cheerlead to keep
them pumping frequently at least the first few weeks to establish a healthy
supply and then we try to individualize at that point . Many of the mothers
I've worked with feel that getting more sleep at night makes a big difference
in their supply so they don't pump at night. Others are too uncomfortable to
do that and they do pump at night. As with breastfeeding, pumping is as
individual as the mom and we need to listen and make suggestions that we know
will work for HER and still be acceptable for her supply.

We have also inserviced the NICU staff on Kangaroo care and encourage the moms
to kangaroo whenever possible as this does have demonstrated effects on
lactation.

We have one room set aside as a lounge/overnight room for moms who are
breastfeeding their NICU babies, and that is where they usually pump. Our NICU
is cramped for space, but we will be starting construction soon on our new
neonatal/OB unit. I would like to keep a few pumps in the NICU so that these
moms can pump right at the bedside while visiting without having to go to
another room. This will save time and keep them visiting the baby while
stimulationg and emptying their breasts., not to mention enhancing the
letdown.

Anyone out there in NICU land with more suggestions?
How do you all handle the supplements/complements? Does anyone cupfeed or
fingerfeed in NICU as a routine ? I am inservicing the NICU on alternative
feeding methods at the end of this month with the blessing of the
Neonatologist who would like to see our nurses' skills enhanced in this
regard. He has been very supportive of moving towards more breastfeeding
friendly practices and this is an important step for us. We started with the
Kangaroo Care inservice, then I'll inservice on pumping and breastfeeding the
preemie. The last inservice will  center on alternative feeding methods.
Sincerely,
Jane Ciaramella