Breastfeeding Your Baby in the NICU

If your baby has been placed in the NICU, the separation between mom and baby can sometimes cause a challenge with breastfeeding. How can a mom maximize her breastfeeding success when in this situation? What are your options when it comes to supplementation? And how do you maintain a good milk supply when separated from your baby?

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The Boob Group
Breastfeeding Your Baby in the NICU
Episode 30, November 30th, 2012

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

Wendy Colson : When a new baby is placed in the NICU, the separation between mother and baby sometimes cause a challenge with breastfeeding. How can a mom maximize her breastfeeding success when her baby is in the NICU? I am Wendy Colson, an RN an Internationally Board Certified Lactation Consultant and owner of Latching with Love. Today we are discussing when your baby is in the NICU, this is the Boob Group, Episode 30.

[Theme Music/Intro]

Robin Kaplan : Welcome to the Boob Group, broadcasting from the Birth Education Center of San Diego. I am your host, Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Center. At the Boob Group we have your online support group for all things related to breastfeeding, have you checked out our paneled experts on our website you can call our hotline at any time to ask them a question and we will feature it on our upcoming episodes. Our hotline number is 619-866-4775 and all you have to do is leave us a message, you can also email us at http://www.theboobgroup.com and leave one of your, I just started to improvise and you know, like I am the worst improviser, never, never improvise, just never improvise. Okay, here we go so today, I am joined by three lovely panelists in the studio would you please introduce yourself ladies.

Norene Ybarra : Good afternoon, I am Norene Ybarra, I am 36 years, I am a stay at home to Rex Edward who is 19 months old.

Lori Shomphe : Hi, I am Lori Shomphe, I am 34 years old, I am also a stay at home. I have three children Jack is 7 years, Abigail is 4 years and Zoe is almost 2 years.

Jamie Romero : I am Jamie Romero, I am 28 years old, I am a stay at home. I have 2, 3 children they are just 5 months, 2 years and 4 years.

Robin Kaplan : Fantastic ladies, welcome to the show.

[Theme Music]
[Featured Segments: Overcoming Societal Booby Traps]

Robin Kaplan : Before we get started with today’s topic here is Lara Adelo talking about ways to overcome societal booby traps.

Lara Adelo : Hi, Boob Group listeners I am Lara Adelo a Certified Lactation Educator, Retail Marketing Manager of “Best for Babes” and owner of “Mamma Care Designs.” I am here to answer some of your common questions about how you can achieve your personal breastfeeding goals by helping on domains like cultural and institutional booby traps. Such as why do we have only at hospitals help moms initiates breastfeeding in the first hour after birth? Let’s start with our baby’s very first feeding, research from as far back as the 1970’s has shown that the timing of the initiation of breastfeeding is important possibly in the first hour. It’s such a special time that some have dubbed it the “magical hour” the evidence is strong enough that the initiation of breastfeeding in the first hour was made one of the ten steps to successful breastfeeding. In CVC surveys by hospitals for 2009, only 51% reported that greater than 90% of healthy full term breastfed intense initiate breastfeeding within one hour for complicated vaginal birth. This is up by 44% in 2011, as the current percentage only half shows that we have a long, long way to go but the highest numbers are in the Southeast and Southwest regions of the country with the rates of 39% and 43% respectively. In the West the best rate is 59% wondering with the ten steps say about the finding of the initiation of the breastfeeding after a cesarean birth. What to comply with the cesarean birth babies are to be placed skin to skin in the mother’s arms within half an hour of the mother’s ability to respond to them. The rate of compliance with this practice isn’t measured by the CVC surveys, if you are planning a hospital birth don’t let this “magical hour” get lostinclude your wishes in the birth plan and also details about breastfeeding. And make sure to discuss your plan with your labor and delivery care person, a special thank you to Tanya Lieberman, IBCOC providing the booby trap series for “Best for Babes.” Visit http://www.bestforbabes.org for more great information about how to meet your personal breastfeeding goals and my business http://www.mammacaredesigns.com for breastfeeding supportive whereabouts. And be sure to listen to the Boob Group for fantastic conversations about breastfeeding and breastfeeding support.

[Theme Music]

Robin Kaplan : So, today on the Boob Group we are discussing breastfeeding when the baby is in the NICU, our expert Wendy Colson is an experienced NICU nurse, an International Board Certified Lactation Consultant and owner of Latching with Love at San Diego, California. Thanks so much for joining us Wendy, welcome to the show.

Wendy Colson : Thank you, thank you for having me.

Robin Kaplan : Sure, well Wendy what are some reasons, why a baby would be taken to the NICU after birth?

Wendy Colson : Well, there are multiple reasons why a baby goes to the NICU but I think the, the most obvious one is prematurity that can vary from a very young baby like a 24 weeker that’s just over viability age to one that is at the cut off at the near term just more of a 36 weeker. The other reason would be obviously infection, this can happen in utero or after birth that can make a baby go into the NICU, a difficult delivery causing baby respiratory distress that can be something as simple as a few hours while the baby is transitioning back to the mother baby unit or it can be something more serious like a Meconium Aspiration and then the most common reason why a baby, whose term goes to the NICU is usually Jaundice.

Robin Kaplan : Okay and how significant the Jaundice have to be for them to be actually removed from the mother’s labor, Oh! I guess they are postpartum?

Wendy Colson : Well, it’s monitored the first level usually is taken at 24 hours of age and that’s right there gonna be flagged and if it’s a kind of moderately high or even high another repeat number will be taken after. If it continues to be heightened that’s when the admission so, it really does depend on the number but not just the number but as well as the hours the baby is.

Robin Kaplan : Sure. Ladies, why did your babies have to spend some time in the NICU and how long were your babies there?Norene?

Norene Ybarra : Rex was in the NICU because he aspirated Meconium and he was there for 7 days there is, because he was on antibiotics and was nothing wrong with him. He ate his own feeding tuba within minutes of him being born so, it was just precautionary.

Robin Kaplan : And he was full term?

Norene Ybarra : Yes.

Robin Kaplan : Okay, how about you Lori?

Lori Shomphe : Zoe was in the NICU for multiple reasons, Zoe was born in 32 weeks 4 days, she also had an eventful delivery so, she has been watched for those reasons as well and she was in the NICU for 30 days.

Robin Kaplan : For 30 days, okay how about you Jamie?

Jamie Romero : My first baby was born at 33 weeks and he was there because he had some breathing difficulties and obviously insulting feeding challenges and then my second baby was born at 32 weeks. And had issues with breathing and also feeding and some Jaundice and other things.

Robin Kaplan : Okay, how long were your babies in the NICU?

Jamie Romero : My first baby was in the NICU for 15 days and then my second was in there for 30 days.

Robin Kaplan : Okay, it’s a little bit longer the second time around. Wendy when the baby is in the NICU, will she be able to breastfeed or just dependent on gestational age or even full term babies have challenges in breastfeeding?

Wendy Colson : Absolutely yes, once baby has an actual feeding order then a baby will be allowed to go to breasts but there is a lot’s of variations with that depending on the diagnosis of the baby and especially the age of the baby.

Robin Kaplan : At what age can a mom kind of predict or kind of understand that,

Wendy Colson : When it’s gonna happen?

Robin Kaplan : Yeah.

Wendy Colson : It would be between 31 and 33 weeks because developmentally that’s when a baby learns how to suck, swallow, breath.

Robin Kaplan : Okay, so even the young ones at 32 weeks or 33 weeks could actually be breastfeeding at that time?

Wendy Colson : Yes and it varies sometimes we get babies who, I always say “don’t read the preemie book” and go on and sure enough that, that 32 weeker is actually transferring her breasts. But other times it’s more typical while the baby will just fall asleep at breasts at 32 weeks.

Robin Kaplan : Okay and Wendy what are some reasons why baby may not be able to breastfeed while in the NICU?

Wendy Colson : Usually it’s related to prematurity obviously and just illness, when you don’t feel good you don’t feel like eating that goes you know, just the same for us. That’s really the main reason, that’s why you can have that term infant who just doesn’t wanna eat.

Robin Kaplan : Okay, ladies where you able to breastfeed your babies while they were in the NICU?

Norene Ybarra : Yes, I was.

Robin Kaplan : Yeah, initially or like right away?

Norene Ybarra : Immediately.

Robin Kaplan : Okay.

Norene Ybarra : Well, actually you know, because they put him in like 10 to 12 hours but as soon as I woke up we, we out him to breasts and he took.

Robin Kaplan : Okay and were you able to be there for all of his feedings?

Norene Ybarra : Yes, yes.

Robin Kaplan : Okay, so did you sleep there then?

Norene Ybarra : The first two nights the nurses are, were amazing and how they kind of gaged what kind of, what your ideas are about breastfeeding and kind of but not pushing it and kind of respecting what you want. Because initially I was like “okay, well I have to stay here overnight I am gonna sleep here, do whatever it takes” and they were really amazing about like asking me questions like “do you believe in you know, nipple confusion” and I was like “I don’t know, do I, because we don’t” and I was like “Okay, okay, okay.” So, and then telling, they told me to pump and on the pumps and so, I did they were like “go run it, go do it, this is your schedule” when you go they told me exactly what to do when I went home. So, I did exactly what they told me and that first week so, the first two nights in the hospital I stayed there and then they said “We will call you if we need you” they didn’t call but figured it out. And then I came in the morning and then we started the schedule were I was there during the day I go home at nights in the first week he was born, I went home every night but I stayed during the day and breastfed him and was just I would eat during shift change but otherwise I was there with him so, that was my plan.

Robin Kaplan : Okay.

Norene Ybarra : Well, that was never my plan but that’s how it worked out and it was really amazing.

Robin Kaplan : Okay, cool. How about you Lori?

Lori Shomphe : In a lot of ways we were really blessed with Zoe’s birth, I hemorrhaged unfortunately but we had a tandem nurser at home so, I had a three and a half-year-old at that time I was still nursing. So, I never, I always had milk for her which is a huge blessing and because I had hemorrhaged I didn’t get to see her for until she was about 12 hours old but upon seeing her there was like two admissions happening so, there were busy nurses. And because when I had babies I just put them to breast that’s what I did so, about 32 weeks she went to breast, yeah 32 weeks 4 days she went to breast, she was always transferred we were really, really blessed with Zoe’s ability to transfer. And I, I agree that part why we were so successful in getting her out of there as quickly as we did.

Robin Kaplan : Yeah, absolutely. How about you Jamie?

Jamie Romero : Well with my first preemie, the 33 weeker the doctors in for me doesn’t allow to breastfeed him because he wasn’t able to and he proving them wrong which was fabulous. And once I was able to hold him and do skin to skin and it ended up taking a nipple shield for the first few months then he was able to nurse successfully. And I had to fight having to breastfeed him and to put him to breasts and stir and then bottle feeding him and then with my second preemie since I was an experienced mother I went in there and told them like maybe he is not going to do anything other than get breasts milk. And my second baby they again told me “Oh! He is not well enough to breastfeed so, you cannot so, well do skin to skin” and he self-latched at 32 weeks, 3 days after his birth like we were doing skin to skin. And I was not you know, attempting to nurse him and he self-latched which is fabulous and he was able to breastfeed and still breastfeeding.

Robin Kaplan : Wow! That’s amazing. Wendy, what would be a reason why baby would need supplementation while in the NICU and does it always has to be formula if mom’s milk isn’t in yet?

Wendy Colson : Well, the reason why, the main reason why a baby needs to be supplemented because the mother is not there you know, I know some of you were there because you lived 5 minutes from the hospital we were discussing and you had the privilege of going to every feeding. It’s not always typical, you had stated that you stayed all during the day but at night so, your baby is going to be supplemented but we try not to use formula if we don’t have to because we want to use mother’s express breast milk or if we can’t and it’s a premature baby at my facility will actually use donor milk from a milk bank.

Robin Kaplan : And then obviously the mom is creating her milk supply so that way the baby can be transitioned half either donor milk or formula?

Wendy Colson : Absolutely, that is the main priority when a mother and baby are separated is establishing the milk supply so, that when that baby and mother are reunited again that there will be milk on board.

Robin Kaplan : Cool, ladies did your babies need supplementation in the NICU and if yes for how long, Norene? No, straight to the tap?

Norene Ybarra : That’s what I was mentioning, I was pointing out I was never supplemented they were like pump, pump and so, when I would go home at night I would take the pump, pump. I maintained the every couple hours,

Robin Kaplan : Every couple hours, okay.

Norene Ybarra : Every couple of hours of boob pump, boob pump, boob pump for however long it took you know, and became this thing you know, because it started out with the NICU like create this supply. So, that it was there for your baby I mean, at some point they were like “you should stay home for long, go home earlier because we have so much milk and you are gonna go home with gallons of milk.” And I was like “No, no, no I was obsessed with” you know, my milk supply was so bountiful and then when they mentioned that I was like “Oh! That’s great because I am gonna go home and has all this milk.” And then he never took a bottle but so, it was nice that he didn’t have to, they trained me the women, the nurse that was there they trained me how to get this done and did it so amazing and my boobs were godsend. And so, he never got supplementation because it came in right away and I was filling up the fridge there.

Robin Kaplan : Yeah, how about you Lori?
Lori Shomphe : In terms of formulas, I never had formula and I had complications as a result of Zoe’s birth and that included a significant open surgical wound that lasted for nearly eight and a half months. So, there were tons I simply needed had my own medical care needs met. So, on the times when I wasn’t there for feeds they were feeding her through her NG Tube which was the choice that we made, that we prefer her to use her energy on latching at breasts and latching on a bottle at in the hospital. So, until the last 24, 48 hours in the hospital her feeds that she had when I wasn’t there, the feeds that all were done by NG Tube and those were probably two feeds a day.

Robin Kaplan : Okay, how about you Jamie?

Jamie Romero : Both of my preemies had NG Tube initially, the first preemie I believe he got may be 5cc’s of formula that were mix of my initial colostrum because with the first baby no one told me to start pumping right away. And so, I didn’t start pumping until probably 8 hours after he was born and he didn’t, he wasn’t allowed to eat until I think day 3 or 4 so, by then my milk was coming in and they you know, I had a little bit of colostrum that they had. So, I believe he got may be 5cc’s of formula and after that it was completely breast milk through an NG Tube, we did a few bottles with him but mostly at breast once we figured out the nipple shield. With my second baby I went in there and I knew better and I was already lactating because I was still nursing my second son was full term and so, there was endless supply in breast milk which was fabulous. And so, my second preemie got completely breast milk, we did alternate feedings at breast and NG Tube and he did have few bottles.

Robin Kaplan : Okay, Wow! This is really a great way to promote breastfeeding through pregnancy, holy cow! Because I mean, both of you had said your babies had so much milk because you were actually still nursing that’s, that’s incredible. Well, when we come back we will be discussing how mom can establish a breastfeeding plan while her baby is in the NICU and will be right back.

[Theme Music]

Robin Kaplan : Alright, we are back and we are discussing breastfeeding when your baby is in the NICU and our expert today is Wendy Colson an experienced NICU nurse and a Board Certified Lactation Consultant and owner of Latching with Love in San Diego, California. So, Wendy what can a mom expect when her baby is in the NICU? I mean, obviously the women here in our panel two of them were tantrum nursing you know, one of them had gallons of milk exploding out of her breasts, Norene and but that’s definitely not the case wouldn’t you say for most moms or babies?

Wendy Colson : For most moms no, it’s not we have definitely I, I panelists that had just the best case scenario while their babies are in the NICU but typically there is mother baby separation and mothers go home, the baby stays sometimes it’s long term such as the premature baby, sometimes it’s the 7 to 10 days of antibiotics that have to run its course. But the mother can’t come in may be she’s got other children with no child care, may be she has transportation issues the best case scenario is when a mother can come every feeds which we schedule in the NICU so, that the babies don’t tire up to every 3 hours but that’s, that’s usually not typical. So, usually what we usually get and that’s okay to is from mother to just come in once a day, may be twice a day, once in the morning and then once when the father gets off at work, they will come together.

Robin Kaplan : Okay and so then the babies will be either they will be fed by NG Tube you know, based on I guess their age as well as given bottles and so,

Wendy Colson : Right, so basically if mother is away obviously breastfeeding won’t even be in the picture but otherwise it will be a combination of may be just NG Tube for the baby who is not gaining well because they need to rest and reserve their clerk reserves. And then there is the combination of what we call nipple collage so there will be a combination of tube feedings with nippling, meaning bottles if mothers are not present even if mother does come in these babies tier very quickly on the breasts. And so, they may choose some breastfeeding but you will see that a bottle will be offered right after the breasts or will actually hook up the feeding tube and the rest of the feeding will go by feeding tube.

Robin Kaplan : Okay and sometimes I know some of my clients have had I guess kind of dry nursing in the hospital so baby is being fed by and NG Tube at their breast but the mom is already pumped?

Wendy Colson : Alright, absolutely so this is, this is the case were when a baby is premature and may be a little unstable, we mean by unstable for that clientele is that they hold their breath and they, they go Apnec on us, the heart rate goes down also. And so, that baby we know that if it gets on the breasts the Neonatologists will be freed when the mother’s milk gets released, the milk ejection reflex that the baby will basically be essentially choking and then she is afraid of the Apnec episode. So, it’s essential to ask the mother that has that plentiful supply to pump prior to coming in and then the baby will go to the breasts and then we will decrease the chance of that episode happening.

Robin Kaplan : Okay and would you, I mean, I know what’s hard to say because you work in only one facility but do you find, do most moms have an opportunity to meet with an international board certified lactation consultant in the NICU?

Wendy Colson : Yes they do, I know at the facilities that I have worked with that, that it’s a priority if a mother and baby are separated it’s an automatic referral to a lactation consultant. However in my private practice I did have a client tell me that she never was able to meet with the lactation nurse and she said “it was because whenever she happened to be visiting the NICU, the lactation nurse was no long available.”

Robin Kaplan : Okay, so the timing was may be off?

Wendy Colson : The timing was off but again we usually see these women in the postpartum in their rooms because our biggest goal is to getsupply initiated and to establish supply. So before we even walk into the NICU and meet a mother and baby, we usually as the lactation nurse said we are in the postpartum room setting up breast pumps.

Robin Kaplan : Okay, ladies did you meet with the lactation consultant when your babies were in the NICU and if so what does she discuss with you? Norene, you were actually kind of looted with this plan that they came up with for you?

Norene Ybarra : My baby was delivered at 4, he was you know, tented right away I saw him at 8 but I believe a lactation consultant came to my room, must have been after I saw the baby. So, within like 6 hours of having the baby and so she was talking about like go ahead, get on the pump and she put together the pump and that’s when the colostrum started coming in. And so, and then she, she personally delivered that colostrum down to NICU so at some point you know, in the middle of the night he was still in the tent I couldn’t breastfeed. So, in the middle of the night they gave him the colostrum and when I woke up in the morning I breastfed for the first time so, he was you know, I went in there at 7 am after shift change and then he was less than 12 hours old when I breastfed him.

Robin Kaplan : Okay, how about you Lori?

Lori Shomphe : We, we had a kind of rocky situation in lots of ways again we were so lucky, Zoe was nearly delivered home, we actually had been planning a home birth ultimately it was abandoned by our OB in labor. And so my water broke at home, it was just my husband and I and I have a very dear friend who is a hospital based IBCLC so, as we were leaving the house I got in the phone with her because I knew we will be going to the hospital where she works and said “hey, this is what’s happening tell me who is onboard tonight?” So, by the time I was out of the OR I had an IBCLC in my room which I was very, very, very lucky about and yeah, we had again I have several friends at IBCLC so, I always had them available all the times. But while I was in the NICU it was, it was almost a joke it would be like the LC would come in and may be like “what you need? How can I support you?” and I was like “I kind of got it, we kind of have a system down, yeah” So, we were blessed with having lots and lots of resources available.

Robin Kaplan : Yeah, how about you Jamie?

Jamie Romero : Well, my first baby it was, it was quite a challenge I requested an IBCLC because I was in labor in the hospital for like 36 hours before my baby was actually born. So, I requested that one was present you know, right after so that we could get the pumping initiated and everything that never happened. So, my baby was born a little bit after 3 and then I was in the NICU at 4 talking to the doctors he said he can’t eat, he need to start pumping and so, I got the hospital grade pump and I didn’t but it took a long time, the whole thing was a process. So, I don’t think I ended up starting to pump until about 8 hours after birth and then I didn’t actually see an LC until the next day and they came in and showed me how to pump. And just you know, showed me what kind of schedule I would be on to pump but it was very brief and I remember feeling very rushed and I had a lot of questions that weren’t answered. And at that time there was only one LC for the entire hospital and so, she would have to go to the NICU but then also see all the L&D people so, it was I think it was very challenging for her because she was stretched so thin so, I didn’t seem very much of her during the first time. My second preemie, I was extremely blessed that there was more LC’s on staff now but again they were stretched between the L&D and the NICU. But it was good because I knew what to do, I didn’t need their help but I did see a lot of mothers coming in and struggling because no one had even told them “okay, you need to start pumping and you need to pump on a schedule.” I had seen moms come in and say the nurses would ask for them you know, “do you have any breast milk to give us?” and they would say “well, not really getting anything.” The nurse would say “well, you know are you pumping?” and they would say “yes” many of them when they got down to it I found out were pumping twice a day and as we all know now that’s not a great way to establish milk supply. And so, I just felt like the LC’s although they were extremely helpful were stretched very thin and not everybody who went into the NICU whose breasts, I used have, I have been through before had any experience. There was a lot of first time moms who had no idea you know, how to establish milk supply and unfortunate their babies were not able to receive enough breast milk because of this so, it’s very challenging.

Robin Kaplan : Okay, Wendy actually gets into my next question so, how can a mom establish a good milk supply when she is separated from her baby?

Wendy Colson : Starting early, there are facility we start within 6 hours if we are not there are of course births are happening 24 hours then the staff, the postpartum staff all are equipped to set up a breast pump and get you started and then will see you first thing in the morning. But just early initiation and then frequency some mother’s do have misconception that nothing is coming out which is very common that is supposed to come out initially when there is, when you are first time mom and it’s called colostrum which I always call the thickest milk we can compare it to cheese cake, it’s not supposed to come squirting out of a pump. But going over the breastfeeding norms and establishing the frequency how important that is and because what usually happen is will tell them to pump at least every 3 hours and through the night. But then when we come back the next day and we will say “did you pump” and they will say “well, no nothing was coming out”and so we are constantly reinforcing the breastfeeding norms in the early days when they are pumping.

Robin Kaplan : And just setting up those expectations of when you put a pump on and it’s the colostrum stage that “you are doing this for stimulation but not necessary for accumulation.”
Wendy Colson : Exactly, we often say in our department that we are making up a phone call so, we are pumping to make the phone call and if we get breast milk I always say it’s a bonus but it’s not what expected in the early days.

Robin Kaplan : Yeah and Wendy how important is it for a mother to provide breast milk for her baby when especially when her baby is in the NICU?

Wendy Colson : It’s crucial because breast milk is medicine and these babies are sick whether it’s just prematurity or whether it’s a critically outpatient or a jaundice patient. All research shows that breast milk can clear Meconium faster than formula or of course water so, it’s, it’s crucial it is truly medicine and that’s why we even ask a mother who had no intention of breastfeeding, if she had a baby go to the NICU lactation will be called because it’s mother, baby separation and the baby is outpatient too and will go to their room and ask them “will they consider pumping while their baby is in the NICU?” Don’t always push for breastfeeding but we do push for the breast milk if it’s less than 33 weeks our facility will be used, will use donor milk.

Robin Kaplan : Okay, ladies were you pumping a lot while your baby was in the NICU?

Norene Ybarra : Yes, constantly and I was very spoilt when you mentioned like lactation consultants so, I got those you know, the within 12 within like 6 hour visit in the morning. But also one of my first nurses in NICU was amazing about breastfeeding and she was like one who, who set my schedule for me you know, the one I remember lactation consultant was, you might wanna think about she got me started amazing. She said “you might wanna think about this” but this nurse was like “you are gonna do it every 3 hours” and she told me “you are gonna rent this because whatever you have home is not gonna work, if you wanna set it up you have to do it right now” So, she told me “get whoever is with you to go rent a pump it’s like you are gonna be on this every 3 hours” she was like “when you get in the shower you are gonna you know, you know comb your boobs, it’s gonna hurt but you just gonna do it every time you shower” you know and she was like “you have to shower like twice a day so, that it gets going before you come.” She was like you know, “watch your schedule this and this”and so, she was amazing like about like getting that done so, all of a sudden I was on this 3 hour thing she also brought the pump to our station where the baby was. And so nurses would come around and like move the pump and then she would be like, they would be like “Oh! Are you ready to breastfeed?” and I would just sit there in the chair just waiting for my pone and everything and they look at me like I am like a crazy person. And I would just sit there waiting for my chair and let the pump and so I never went into a room because they were just amazing and so like there was one who wasn’t nice about bringing the pump I was like “No, no I stay here with the baby and I pump here because I” she was like and then “when you after, you feed when you pump or whatever the schedule was.” And so we had it down because I was fortunate to be able to be there for the full 12 hours during the day so, I pumped every 3 hours for 7 days around the clock.

Robin Kaplan : How about you Lori?

Lori Shomphe : Because I had hemorrhaged I was and so, I had a, I had a significant, I was pumping every 2 hours to establish supply because I had a significant tip again I was trying to make what it look like. So, I was pumping every 2 hours around the clock and I had to pump like, sorry quite honestly I felt like everybody in San Diego had seen my boobs, whatever I am just here to pump, okay.

Robin Kaplan : What, I can’t hear you?

Lori Shomphe : Having a pump available was not never an issue we also had an hospital gated home so, when I was at the hospital I pumped there when I was at home I pumped there. The only, the only big impact on us was we closely was with our children so, full of the time I was at the hospital so, I had to sleep somewhere else because I was up every 2 hours waking my big kids. They were like “what the lights are on? What’s happening?” so, during the time we were in the hospital I was interrupting everybody else’s sleep.

Robin Kaplan : Wendy with moms who have babies in the NICU especially for a long time like so many babies were there like for 30 days, these moms are obviously pumping a lot which strategies do you have to make so that pumping is comfortable as well as I mean, the fact that the pumps on they are 8 times and for a period there is lots of plastics on the breasts?

Wendy Colson : We do, we hope that it’s on there for at least 7 to 8 times a day so, we don’t always skip that but we do always strong correlation that when a mom does pump that much that she will have a nice supply. But we do encourage pumping at bedside it’s, it is mechanical to pump but when you actually can touch your baby perhaps just look at your baby there was more success. So, we will ask a mother to bring their pump kit to the hospital so, that we can assure that she can’t pump plus sometimes they sit there all day and if they don’t bring it they get quite engorged. So, pumping bedside is perfect and at home you are again away from your baby it really is hard to stay connected so we always suggest a picture I also like to take the blanket, people steal them anyway. Why not steal it for this purpose, the blanket that’s actually swallowed in your, in your NICU baby and wrap it around your neck while you are pumping and knowing that, that blanket touched your baby.

Robin Kaplan : It just smells good, the baby just smells good.

Wendy Colson : Yeah, yes. That really, really does help also double pumping show that it is more effective than single pumping.

Robin Kaplan : And massage too, correct?

Wendy Colson : Yeah, yes with massage there are times were single pumping is definitely warranted in the beginning when the milk is first in for engorgement with some edema sets in some swelling but double pumping is definitely beneficial too.

Robin Kaplan : Okay, great and Wendy when should a mom expect to be able to breastfeed her baby in the NICU, I realize this is a very, very large spectrum but what was going on with the baby that makes it so he or she will be able to breastfeed?

Wendy Colson : Stable respiratory wise, once learned in nursing school if they are not breathing nothing else matters but truly is if you have a baby who is stable respiratory wise then feedings will be initiated and then breastfeeding will come into play at that point.

Robin Kaplan : Okay, well thank you so much Wendy for your insight to breastfeeding while your baby is in the NICU and the panelists as well. And for the Boob Group club members we will continue after the end of the show for more information about our Boob Group club please visit our website at http://www.theboobgroup.com.

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Cherry : Hi, Boob Group this is Cherry calling, I am just wondering about giving Vitamin D to our baby who is 3 months old, I have heard so many people talk about giving Vitamin D drops to our babies but my Pediatrician never said anything about it. Is this something I should be doing?

Dr. Tara Zandvliet : This is Dr. Tara Zandvliet, south part doctor, Vitamin D is needed for babies that are exclusively breastfed. If your child regularly gets even 8 hours of the formula daily they are getting plenty of Vitamin D. Vitamin D, it doesn’t seems to get through a significant quantity for the baby with the breast milk we recommend 200 hundred international units a day the most common source over the counter is a supplement called Tri Vi Sol. And the proper dose is half a milliliter to one full a liter a day, we are not sure why baby seems to need this now and not 100 years ago but the fury is the reduced exposure to the sun. We now know that the rays can be harsh for a baby and about the dangers as early sun burn is just too great to put our little ones for an extended period of time. So, we recommend shade up to 6 months old and then the supplement of Vitamin D, why didn’t your Pediatrician tell you about it? Well, since Pediatricians are not used to exclusive breastfeeders would generally just forget to mention it, only 10% of moms continue to exclusively breastfeed for 6 months or more. For most babies come into the office they don’t need Vitamin D supplements.

Robin Kaplan : Thank you so much for our experts, panelists and all of our listeners. If you have any questions about today’s show about the topics we discussed, please call our Boob Group Hotline at 619-866-4775 and we’ll answer your question on an upcoming episode. If you have a breastfeeding topic that you would like to suggest, we would love to hear about it. Simply visit our website at http://www.theboobgroup.com and send us an email through the contact link. Coming up next week we will chat with Annie, Cherry and Jane about their babies 5 months in our series “Breastfeeding Expectations.” Thanks for listening to Boob Group because mothers know breasts.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Suggestions and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. For such information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advice or care and should not be used for diagnosing or treating any health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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