A NICU RN asked me to help a mom who is on dialysis and having trouble pumping milk. Babe was born at 29 wks gestation, now at 31 wks. Babe gets 11 cc every 3 hrs by NG tube of mom's milk or 24 cal formula when no EBM available. Every 12 hours feeds are increased by 1 cc. Mom's last delivery of milk was 12 cc total. Babe is also on TPN and lipids and nasal cannula O2 support. No info on actual frequency / duration / technique for mom's pumping.

I did set up her Symphony pump during the postpartum period and directed her to her WIC office to borrow a Lactina for home use. At that time, I was not informed of mother's need for dialysis. She had kidney issues, but the dialysis is a new thing. It is my broken record to teach pumping in the manner of the Jane Morton / Stanford videos. Getting mom to follow through is often problematic. We do help & urge moms to pump during their NICU visits with babe, either at bedside with privacy screens, or in a private room when available. The NICU RNs know that at least 8x a day is recommended.

I have checked Riordan 4th Ed, Making More Milk, Textbook of Human Lactation, Lawrence 7th edition (book, not online yet), & Clinical Therapy in BrFdg Patients. Didn't find anything related to a lactating woman undergoing dialysis. No, I have not yet checked Lactnet Archives.

I have learned onine that a dialysis patient must be on a regimented diet and restricted or controlled fluid intake. Might this affect her prolactin levels?

What else do I need to know to best advise this mom who is pumping for her non-nursing preemie? And thank you all in advance for your wisdom.

Phyllis

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Phyllis Adamson, BA, IBCLC
Glendale, AZ.
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