Jennifer asks in regard to 25 week gestation triplets: "What can I tell her
to expect as far as production with this early a
gestation?  And would  she be better off to hand express early on, or pump,
or both maybe?  Can  she expect a decent milk supply, or does being this
early affect  supply?  I spoke also to the neonatology fellow who was very
glad mom  was planning to pump, but I don't know how much support she'll  get
there.  She will be home from the hospital, obviously, months before  her
babies.
Thanks in advance for your advice!
Jennifer Tieman
Family  Physician
Mom to 4, including nursling Caroline Rose born 5/31/03"

1.  Getting just drops at this phase is entirely normal.
2. Hand expression to start flow followed by simultaneous pumping with
hospital grade pump (nothing else will suffice) for 15-20 minutes 8 times in 24
hr.--every 2-3 hr. in daytime with one 5 hr. break at night.  Massage and  hand
express before starting and stop and massage breasts after 5-7 minutes,  then
resume pumping. Start on low suction setting and increase ONLY to suction
setting that is comfortable.
3. Her milk should come in at the same time as it would have had she
delivered at term. I would hope that she is making between 20-24 oz. by 2 weeks;
supply will gradually increase from there.
4. She will be very tired and stressed. This is a situation where family
members can help--prepare and clean equipment--feed mom, etc.
5. Reassure her that all is going as expected at this point and that
delivering prematurely will not affect lactogenisis 2 or ultimate milk supply.  Of
course other factors can come into play but delivering prematurely is not
necessarily one of them.
6. Her babies will start feedings very slowly so she should be able to keep
up with them for a long time.  I have had mothers of premie triplets supply
all the breast milk the babies needed at least through dishcharge.
7. Finally, she will need all the support she can possibly get on an  ongoing
basis.

Kathy Boggs, RN, IBCLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html