This seems to be a common problem with women who have to cuddle up to an
electric pump rather than a nice warm baby. Besides the suggestions already
made (i.e. warm packs to breast before pumping, massage and compression
before and each 5 minutes during, nipple stim., increased numbers of pumping
sessions, Fenugreek, Reglan, oxytocin nasal spray, kangaroo care) , I have
noticed several other things which have made a difference:
The most important organ in breastfeeding may be the mother's brain. SO>
Relaxation techniques such as are taught in childbirth ed. classes ....or
anything the mother finds relaxing, like soft music, breathing techniques,
back rub, etc.
Using imagery - i.e. imagine she is breastfeeding twins instead of using an
electric pump.
Pump where there is a picture of her baby, or even better, pump at the
baby's bedside.
If the baby can be held, put the baby against one breast and pump the other.
This may require help, but can be done quite easily.
Pump immediately following kangaroo care.
Begin kangaroo care when the baby reaches 750 gms unless the baby is
unstable or on a high frequency ventilator or vasopressors.
Suggest to the mother that over production may be a problem and that we will
"cut back later". Amazingly, the expectation of producing lots of milk
seems to make a difference. It is a confidence game.
Unfortunately when a baby is in the NICU, the mother may also be
experiencing serious health problems, which increase the risk of low milk
supply. When the mother does NOT have complications, pumping begins
earlier, the mother comes to the bedside sooner to connect with her baby,
and milk production comes up much faster (usually 500 cc per day by day 7)
I believe maternal health factors, and stress make an enormous difference in
milk supply.
Deanne, R.N. IBCLC
NICU
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