Shirley
I don't think anyone knows the answer to this. Very good research
question(s).

I think most of us would agree that early, regular milk expression from
the start will help to ensure a good supply. I think this is a standard
of care at this point. Start sooner, not later. But I don't know if we
know WHEN to go to cluster pumping/expression with the longer sleep
interval, if at all.

For clients pumping long term for babies in nicu and when there is
plenty of milk stored, I have counseled moms re lengthening the pumping
interval (say from q2 to q3.5 hrs) if the moms are indicating that they
are getting very weary. Advice is to closely watch supply and increase
again if need be or when baby begins taking in more and/or breastfeeding
at breast.

It is difficult to balance the need to express the milk regularly and
their need for sleep and meeting other family/personal needs. Many
families travel back and forth to hosp and home. I think some of the
decreased supply issues would not even be there if nicu practices were
more favorable re getting baby to breast/kangaroo care etc. Lots of
these moms really could be bf alot sooner, IMHO. And some of them could
be rooming-in with their feeders/growers as we used to call them when I
was an nicu nurse.




Laurie Wheeler, RN, MN, IBCLC
Louisiana Breastfeeding MediaWatch Campaign
Violet Louisiana, USA
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