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Subject:
From:
"Jessica L. Callahan" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 2 Nov 2013 11:22:46 -0400
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I see other comments about 'regular' pumping and I agree. 
Usually a mother who has a baby in the NICU pumps are scheduled during the babies feeding sessions. Most babies in the NICU are put on a every 3 or 4 hour feeding session. If the baby is being feed every 3 hours and mother is pumping at this time this is actually only 8 pumping sessions in a 24 hour period. 0000, 0300, 0600, 0900, 1200, 1500, 1800, 2100. If we compare this to a baby who is nursing at the breast they normally nurse between 10-12x in a 24 hour period. 
I explain to mothers that their pumping schedule should not line up with babies feeding schedule mother should try pumping more than baby feeds. Have mother aim for 10 pumping sessions per day at least. Other suggestions I would make:
have her prolactin levels drawn,
do a breast exam to rule out hypoplasia
try power pumping sessions, 
hold baby skin to skin when she is pumping 
wrap a blanket around her face of his so she can smell him (one that baby has used)
record him crying,
look at pictures, 
prior to pumping massage the breast and areola for a few minutes, 
about 10 minutes into pumping take the pump off the breast and massage breast again and then go through the stimulation phase on the pump,
After she is done pumping hand express as much as possible,
Place 10 pieces of mothers favorite candy in a dish near the pump and every time she pumps she can have one piece of candy,
Place candles in the room that mother uses to pump in. When it is time to pump turn off the lights and light the  scented candle ( a smell she finds relaxing - lavender,  sandalwood, or chamomile oils). Not only will this help to relax her but it will also make it harder for mother to see the milk dripping into the bottles - too many times mothers stare at the bottle and wonder how come she isn't making more milk which does not help with the effect of oxytocin. 
It is important to have mother chart her output because once she starts to pump more frequently she will get less milk out and this will make her think that she isn't making more but by charting each pumping session then adding it up at the end of the day she will see the her daily total has increased. 

Jessica Callahan RN, IBCLC
NC, USA

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