By Rebekah Scroggy, RN, BSN, IBCLC
Photo from Aeroflow Breast Pumps
Pumping parents have always been told that they should be removing milk every 2-3 hours (or 8-12 times in a 24 hour period) to maintain their milk supply while they're away from their baby.
For NICU moms, it's incredibly important that their milk supply comes in strong so that they can give their baby the healing benefits of breastmilk AND be able to continue to feed them once they're out of the NICU.
Most babies in the Neonatal Intensive Care Unit (NICU) are there due to health problems, preterm labor or a traumatic birth. Parents of NICU babies are likely also recovering from that birthing experience, in addition to being concerned and anxious about their baby and producing milk for them.
Then they get told that they need to start pumping as soon as possible, and that they need to pump every 2-3 hours. Imagine how exhausting and overwhelming that is combined with the stress and uncertainty that they're already facing.
As a lactation professional, it is so hard to stress the importance of removing milk often while also being supportive and trying to take the pressure off of parents during one of the most traumatic and stressful times of their lives.
But things are changing.
I recently had the pleasure of attending the Emory Breastfeeding Conference, where Dr. Aloka Patel from RUSH presented new research on pumping frequency for NICU moms.
Her research shows that if NICU moms are pumping at least 5 times in a 24-hour period for at least the first 5 days with at least one pump session between the hours of 1 am – 5am, they are statistically more likely to meet the volume of milk we expect for a full milk supply by 2 weeks.
Left to right: Rose L. Horton, MSM, RNC-OB, NEA-BC, FAAN, Rebekah Scroggy, RN IBCLC, Dr. Aloka Patel MD-Neonatologist
This was fascinating information for everyone in attendance! It's such great news for NICU moms, who could use all the extra sleep and less stress.
Dr. Patel's NICU had obtained this information using SMART pumps to make the data more accurate, as opposed to a self-reported pumping output. The Georgia Perinatal Quality Collaborative also shared that they will also be using this information to inform NICU moms on pumping frequency.
Slide obtained from the presentation by Ravi Patel, MD MSc Neonatal Co-Chair, GaPQC Professor of Pediatrics and Allison Rose, MD Assistant Professor of Pediatrics
As a NICU mom, it is so important for you to rest and recover. Setting an alarm on your phone is an easy way to ensure that you don't miss your pump session without keeping a close eye on the clock.
While I used to advise NICU moms to set an alarm every 2 hours, the new guidance suggests that you can actually set an alarm for every 3-4 hours. This three hour mark gives you a buffer just in case you aren’t able to pump right when your alarm goes off!
A few other things to consider for a successful pumping journey:
- Get flange sized (and know that it can change in the next few weeks!)
- Keep the suction strength at a comfortable level. Pumping should not hurt
- In the early days, do hand expression and use your electric breast pump. Hand expression can be easier to get those precious (but thick and sticky) drops of colostrum out.
- Work with a lactation professional who is comfortable with pumping!
NICU moms, you got this! You and your baby are warriors.
Resources
Short-term rate of milk synthesis and expression interval of preterm mothers
Measures of Secretory Activation for Research and Practice: An Integrative Review
Early pumping frequency and coming to volume for mother's own milk feeding in hospitalized infants