I'm not very familiar with ounces, but if my google gadget converts right 10ounce is about 300mililiters. Pumping this x 8/24 wil give her about 2.360 liter a day. This is not a very big oversupply for twins. It is my understandig that pumping for premies should yield what the baby will be needing when reaching term and beyond. Twins would be needing 1,6-2 liters of milk per day.
I'd try putting her on a regimen of pumping 8x9ounces a day. So stop pumping if that amount is reached. If that doesn't settle production mom might consider using sage tea to downregulate a bit more. Stretching time between pumping sessions will probably increase het masttis incidence and does not mimic the probable feeding needs of het twins once they start at breast feeding.
Warmly, Gonneke, IBCLC, LLLL in southern Netherlands
--- On Thu, 12/11/08, Cassandra Leahy <[log in to unmask]> wrote:
From: Cassandra Leahy <[log in to unmask]>
Subject: [LACTNET] Hyperlaction Twins in NICU
To: [log in to unmask]
Date: Thursday, December 11, 2008, 5:49 PM
I could really use some good suggestions for the following situation (I
do have permission from mother to post):
Mother with premature twins in NICU
Exclusively pumping (plan to initiate feeding directly at breast asap)
When contacted me she had been pumping approximately 8-10x/24
hours, obtaining approximately 10 oz/30 minute pump session
Taking second round of antibiotics for Mastitis
Reporting continued "lumpy-hard spots in breasts" bilaterally with
discomfort
Currently we are working on "Reduction of milk synthesis" by
increasing
length of time between pumping session and decreased pumping
duration, along with ice packs/cabbage leaves for comfort, Motrin as
needed, and gentle light tissue massage in areas that require
attention. Mom will pump to relieve pressure when needed.
We are being ultra conservative due to the fact that she has twins and
they are not feeding at the breast yet.
We have had little reduction in supply or comfort in 1 weeks time; mom
still c/o same symptoms.
Am I being too conservative? Should we be more active in the reduction
of milk synthesis; if so what would pumping recommendation be at this
time? I usually do not recommend supplements or medications unless
needed---do we need to introduce?
Other than peppermint tea or sage, are there any other
herbs/supplements that you have found to be effective? I am also
interested in learning if anyone has every recommended Sudafed and
the results you experienced.
Usually I can help mom manage with one breast feedings/block
feedings/and positioning techniques, but in this situation, I am hesitant
due to NICU issues and exclusive pumping.
Mom is looking for new suggestions and I would appreciate any help you
can offer us.
If you would like to email me privately, my email address is
[log in to unmask]
Thanking you in advance,
Casi Leahy
BA, RN, MSN, LCCE, IBCLC
[log in to unmask]
www.thelactationlady.com
Fax: 888.225.2855
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