Many preemie mums have issues with their milk supply. Expressing is very different to breastfeeding your baby. I expressed while my first son was on the neonatal unit and continued when he came home. He was on so much medication that bottle feeding him expressed milk felt like the best option. Now I have a second son who was born at term but has a tongue tie making breast feeding difficult as he struggles to latch on. I made the decision to express again and bottle feed, only this time I am struggling to keep up so I have had to top up feeds with formula.

Expressing with a preemie

With my first son expressing was easier. I didn’t have any distractions and I could keep to a strict timetable while he was in the NICU. I was advised to express every 4 hours to mimic a feeding timetable that baby would have. The NICU was really regimented with my son’s feeds. To start with they tried 1ml every hour but for the first 4 weeks he couldn’t tolerate any milk. Something called TPN (Total Parent Nutrition) was keeping him alive along with a cocktail of other medications.

On day 27 my preemie was transferred to a more specialist hospital. Within hours they had assessed his medication and adjusted it. A few hours after that his heart condition was under control. On day 28 they decided to introduce feeds again and this time he could tolerate them! Over the 4 weeks I had built up a huge supply. The hospital freezer was well stocked and so was the bottom drawer of my freezer at home.

When he came home I struggled to stick to my expressing routine especially after resuscitating him on our kitchen table and rushing him back to hospital. The built up frozen supply meant that I was able to provide breastmilk for 6 months which I’m very proud of. Once the frozen supply was starting to dwindle I started to slowly introduce formula. My milk had completely dried up.

Baby being held. Photography credit: Jordan Whitt
Baby being held. Photography credit: Jordan Whitt

Expressing with a term baby (and a toddler)

My second son was born at term. I was soon asked if I was breastfeeding and when I answered yes I was told to put him on. He latched on briefly but then lost interest. I was told not to worry as babies only have little tummies. I put him on the breast several times through the night but he wasn’t really interested, mostly he slept!

The next morning I asked the midwife for some advise. She was happy to help and spent some time with me going through where to hold him and some techniques to try. The doctor later assessed him for discharge and noted that my son had a tongue tie. I was asked if there was an issue feeding him. I mentioned that he didn’t latch on for long but seemed OK. That afternoon we went home.

My baby boy just did not want to latch on! I was getting really stressed that he wasn’t getting enough so we did a bottle of formula to see if he was hungry. The bottle went down really quickly. So I decided to start expressing. Having a 3 year old around means that I don’t always get to express when I want to. As a result my supply was decreasing. After speaking to some mummy friends I had a few starting places to do some research on increasing my supply again.

Baby smiling. Photography credit: Filip Mroz
Baby smiling. Photography credit: Filip Mroz

Researching increasing your milk supply

Putting baby on the breast when you can – even if it isn’t for long it will help. Your babies saliva tells your body what need. Also with the practice they might be able to do a little bit longer each time. the other thing I was repeatedly told was that baby will get far more milk than any form of expressing will get.

Try to mimic a cluster feed. This is where your baby wants their feeds really close together. When most cluster feed they seem to want hourly feeds. This can be a really tough few days for mums! Expressing every hour for a day can mimic a cluster feeding baby and tell your body that it needs to produce more milk.

Drink more water. This is one I am really guilty of. I do try and have well placed drinks around the house to remind me to drink all through the day. Remember breastfeeding is thirsty  work for mums as well as babies!

Feed on demand. Don’t stick to a strict routine if you don’t have to. I did with my first due to medication he was on. My second son however is not on any medication therefore can be fed whenever he demands it.

Don’t skip expressing at night. During the night your body produces prolactin which is a hormone that helps you to build up your milk supply. This can be hard if you don’t have a baby to wake you up or if you have a baby that sleeps through.

Avoid stress and anxiety. This is easier said than done! Having a premature baby is really stressful and anxiety provoking so it may cause lots of issues with your milk supply. Having photos and something that smells of your baby can help.

Food that can potentially increase your milk supply

  • Oatmeal
  • Fennel seeds
  • Spinach
  • Garlic
  • Black sesame seeds
  • Carrots
  • Water or juice
  • Brown rice
  • Dried apricots
  • Sweet potato
  • Almonds

Helpful links

NHS breastfeeding in the first few days

NHS is baby getting enough milk

The breastfeeding network

National Breastfeeding Helpline – 0300 100 0212 (9.30am to 9.30pm, daily)

A fed baby is best so trust your instincts and if you need to use formula to help you out then don’t be afraid to.

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