I teach moms how to hand express into a SMALL sterile container for the
first 3 days  It is amazing how 2cc of colostrum looks like so much in a
test tube as opposed to barely wetting the bottom of a regular bottle!
You know when to start using the pump when the milk squirts across the
room instead of dripping into the container.
 I recommend Paula Meier's method of numbering the first 30 expressions
and giving them in chronological order. If the baby is NPO for any
reason, the colostrum is frozen and you start from where you left off in
order to reestablish normal gut flora.
  Many moms who deliver preemies are unable to get to the pumps in the
first day or so because of CS or other reasons, and this solves the
problem of getting to the pump every 3 hours.  BTW. I do not tell them
to pump every 3 hours.  I suggest that they pump 8 times a day: when
they wake up in the morning, before they go to sleep at night, and at
least 6 times during the day.
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel

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