I had a call from a mother who was concerned that she no longer had enough
milk.  Baby is 2.5 months old and now taking all feeds at the breast.  She
needed to pump in the beginning as he was unable to nurse, and he has only
been home for 2 weeks.  When she was pumping, she did it on a schedule and
noticed big changes before and after pumping.  Now, baby is at the breast
most of the time and she said 'It's like they've been punctured!'  They are
soft and not tense.  Baby is gaining well, as shown at his twice weekly
weigh-ins.  But mother wondered whether she ought to continue pumping now.
I asked her if she had any milk stored and she laughed. 'I could feed a
regiment from my freezer!'

What makes this a really nice story is that the baby NOW weighs 2 kg (about
4 lb 6 oz) and that means he has more than doubled his birth weight of 950 g
(2 lb 2 oz).  He is small; her due date was yesterday.  I asked about
fortifier, because I was curious.  He got fortifier until he was 1500 g.
Now he gets a multivitamin supplement and iron, which is standard here for
all babies born at less than 36 weeks, throughout the first year, a policy
set by the neonatologists.

My best guess is that this guy is making up for lost time, and he is now
taking his food the way he prefers, in small amounts, frequently, which
means she will not experience the swings between over-full and pumped empty
that she was before.  I advised her to pump if he just tastes the milk and
then falls asleep, or if she feels uncomfortably full and he isn't
interested, but that as long as he seems happy at the breast and is gaining
appropriately, she doesn't need to do anything extra.  If anyone feels I
have forgotten anything, I am grateful for feedback because tiny premies are
definitely not my main area of expertise.

Rachel Myr
Kristiansand, Norway

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