Judy....

Have you done a search for Preemies, premature, etc, in the archives of
Lactnet? That is the first thing to do.  I will send search instructions. It
is always wise to access past notes on Lactnet, because lots of things have
been covered in the past 4 years....and many wise notes have come and gone.
So, first rule is do a *search*.

Second thing would be to look up in Auerbach and Riordan under Premature
infants. There is a detailed chapter on how to manage this.  You will see
that Paula Meier has done much research on this, as have other
practitioners.  LLL has a section on Premature Infants in the BFAB. LLLI
also has webpages with a great deal of information at www.lalecheleague.org.
Ruth Lawrence has information on this in her book as well.  LLLI also has a
LC series devoted to this subject, although that is a bit dated. Sarah C.
Danner has a handout on management of preemies as well. So, you see there is
a lot of information out there that will help you.

The mother should not be using a "used" minielectric. First, the used pump
is not wise, and is a risk. Secondly, a MIni Electric is not appropriate.
Most insurance companies here will cover a rental pump if the mother has a
preemie baby. If the first flunkie says noway at the insurance company, tell
the mother to go up the ladder to the manager, the manager's manager, etc,
and then start quoting studies of how the preemie gets out of the NICU on
average many days earlier if bf. This saves the insurance company BUCKS, and
they need to cough up the bucks for the rental, as this is chicken feed.

Then, pumping in short frequent bursts, like 8-10 times a day for 10-15
minutes, doubly with a hospital grade pump, is the way to increase supply.
Pumping "longer" is not going to do anything for this...except make the mom
sore.  Read the study that says that a mother needs to pump at least 100
minutes per day to maintain and build supply.  This is 10 minutes, 10 times
per day, with a hospital grade pump. Shorter and more often is better than
longer and less frequent.

Then for herbs, etc, and drugs, you might want to investigate Reglan,
Domperidone, Blessed Thistle and Fenugreek. Do  a search for these on
Lactnet. They have been covered. Herbs by themselves will do nothing. She
needs a pump that is appropriate for the job,  and she needs to use it
frequently.  Drugs and herbs may help some.

Do you have some assistance as you are guiding this mother? It sounds like a
very complex case, and one that needs close followup. I hope this
information helps.

Kind regards,

Kathleen


"I have a student who gave birth to a premie a month ago. As of this date
the little one is just barely 3lbs. 6oz. Mom does have a double pump
mini electric that is loaned to her and for two weeks  she is pumping
approx. every 3 hours, maybe 4 hours through the night. Altogether she is
only producing  about 10cc per day. I did suggest she pump more often during
the day , every two hours and pump longer......at least 20-25 minutes at a
time. I also feel she needs to use a Lactena but she cannot afford the
rental.  She has ask about pills to increase her milk supply. I realize
their are natural herbs that may help, but I need help
on this....Could her OB suggest a drug that might help or just go for the
herbs? Please e-mail me private if necessary or send help on the net!!!!
I am a student LC that teaches basic breastfeeding and need info on the
herbs and premies........
Thanks
Paula Livinston, SLC

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet,TLC, Indep. Consultant
Williston, Vermont
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