Lactation Services

Information for breastfeeding families

717-531 3754

Increasing Breastmilk Supply

For a Baby in the NICU
Frequent stimulation of the breasts, by
breastfeeding or by using a breast pump, during
the first few days and weeks, are essential to
establish an abundant breastmilk supply.

Get off to a good start

Begin to pumping 1-4 hours after birth with a
daily goal of 8 or more times per day
including once at night. Never go more than 5
hours between pumping even at night. The
pump takes the place of your baby if he were
able to breastfeed. He would be feeding 8 or
more times each day. Using a bi-lateral pump kit
stimulates your milk supply better than pumping
each breast individually.
Pump for at least 15 minutes each time.
When milk stops flowing do some hand
massage to remove the remaining milk. Rotate
your hands around the breast to empty all
areas.

Pump regularly and keep a log

Daily goal should be to pump 8-10 times per
day or every 2-3 hours while you are awake. If
you miss a session, pump more often later in
the day. If you can, pump more often: 10-12
times per day especially in the first 1-2 weeks.
When you visit your baby, use breast pumps in
the NICU so you wont miss a session. Just
bring your own kit with you.

Benefits of breastmilk

Promotes your babys growth and development

Breastmilk is easier to digest
Special breastmilk fat helps your babys eyes and
provides better brain growth and development
Breastmilk is your babys first immunization
Protects against many medical conditions of the
preterm baby
Only you can do this for your baby!

Which type of pump should I use?

It is recommended that you use a hospital grade or
double electric breast pump. It is the only type that is
designed to start your milk supply when you are not
breastfeeding yet. These may be placed at your infants
bedside to use during your visit or are available in the
NICU Mothers lounge.

If staying at the Ronald McDonald house, a

hospital grade breast pump is located in the Quiet
Room

Discuss what type of pump to rent or buy with the

bedside nurse or a Lactation Consultant. Most insurance
plans will not pay for rental of a hospital grade breast
pump but will pay for a personal use double electric
breast pump. Contact your insurance plan for details.
Borrowed or Hand-me-down breast pumps are not
recommended due to risk of contamination or ineffective
suction.

Preparing to Provide Breastmilk for Your

Preterm or Hospitalized Newborn

Avoid these things that are known to

How Do I Pump?
reduce breastmilk supply
Wash hands
Assemble breast pump kit
Smoking
Gently massage breasts to help milk to flow more easily
Caffeine
Center nipple in the breast shield
Birth
or injections
Turn on the breast pump and use the Preemie Plus Program which
runscontrol
for 15pills
minutes
Decongestants, antihistamines
Pump Like a Baby Feeds
Severe weight loss diets
Start your pump at low suction and fast cycles. This will mimic how a baby starts sucking fast and light. Gradually t
Herbal supplements
Once your milk starts to flow easily that means the let-down reflex has started. This is the time your baby would be
Stress can be a major problem for your let-down reflex,
especially
mothers
Make
Sure That for
YourNICU
Flange
Fits
Suggestions to help:
Hold your baby skin to skin
You will know if it fits if:
Look at pictures of your baby or smell baby smells
Your nipple stretches easily in the flange
Relax your shoulders and do neck rolls
your
Onlybaby
the nipple is pulled into the flange,
Listen to music, relaxing sounds of the ocean or recorded sounds of
none of the areola
Drink plenty of fluids and eat a snack when pumping

Your breast empties all over with no lumps

Dont pump during a stressful event and dont watch the collection bottles
or unemptied pockets of milk
There is gentle motion of your breast
Massage Your Breasts While Pumping
tissue outside the flange during each
Massage can make a tremendous difference in how much milk you obtain while pumping. Detailed instructions on h
suction cycle
There is no pain, only a tugging sensation.
There is no compression ring or blanched
skin around the areola
Watch what happens during a pumping session.
Your nipple size may change during a pumping
session, or over the weeks that you use a breast
pump. There are larger flange sizes available if
you find that yours in too tight.

Collecting and storing breastmilk while your

baby is in the Hospital
How Do I Collect My Milk?
Pump all your milk into the breastmilk storage
containers provided by the hospital.
Your breast pump kit contains 2 small (30 ml)
colostrum collection and storage containers and 2
large (80 ml) containers. Your bedside nurse will
provide you with additional containers.

Pump or hand express into the container.

Label each container with name, date, and
time of pumping
Number each container (1, 2, 3, etc.) using
the yellow circle stickers to indicate the
order that you pumped the milk
Number the first 24 containers. Colostrum
will be fed to your infant in the same order
Do not mix milk from different pumping
sessions. Never add freshly pumped milk to
milk that is already in the refrigerator or
freezer

How Much Milk Should I Be Making?

Please refer to the sample breast pump log with
daily target goals. You may feel breast changes by
days 3-5 and begin to collect 5-10 mL each time
By day 10, you should be collecting 500 mL in 24
hours. Using a pump log is useful to track your total
volume of milk.

How Do I Store My Milk At Home?

It is preferred to refrigerate milk immediately. Room
temperature for 1-2 hours is acceptable, if not used,
then refrigerate.
If baby does not take the milk within 4 days (96
hours), then freeze milk.
Transport breastmilk chilled or frozen to the hospital
in an insulated cooler with frozen gel packs (NOT
ICE).

Storage of Breastmilk in the Hospital

There are designated refrigerators and freezers for
breastmilk. An individual storage bin is provided for
each patient.

All milk should be given to the infants nurse

upon arrival in the nursery or hospital room.
Talk with your babys nurse each day to
decide how much milk should be stored in
the hospital.
Space in each bin is limited and you may
need to store some milk at home if the bin in
full.

Helpful Hints for Maintaining Breastmilk

Supply
If your infant is not breastfeeding or breastfeeding
well make sure to

Achieve 8-10 pumping sessions every 24 hours.

Pump before bed, 1 time at night, and first thing in
the morning. You will only need to pump 5 more
times during the rest of the day.
Keep track of your milk production using a log.

As your baby starts to breastfeed better

Continue to pump 3-4 times every 24 hours to

maintain milk supply.
Discuss your breastfeeding plan with the babys
nurse or a Lactation Consultant prior to discharge.

Seek help from a Lactation

Consultant
Knowledgeable nurses or
Lactation Consultants in the
NICU can give you advice
based on any unique
situation.
Lactation Services
717-531-3754

Plan to pump during every visit with your baby

Most mothers express more milk after seeing,

touching, kissing or holding her baby. Always plan to
pump before leaving the nursery so fresh milk is
available for your infant.
Feeling or smelling your babys scent on a cubbie
cloth, using relaxation techniques or listening to
music are ways to make pumping easier.

If your breasts become full and painful (engorged)

Apply cold compresses 10-15 minutes after
pumping to decrease swelling.

Online Resources for Breastfeeding

Kelly Mom: http://kellymom.com/

March of Dimes: http://www.marchofdimes.org/baby/feeding-your-baby-in-the-nicu.aspx
La Leche League international: http://www.llli.org/
National Healthy Mothers, Healthy Babies Coalition: http://www.hmhb.org/

Sample Pumping Log with Daily Target Goals

Date

Day of
life

Time and Amount Pumped Per Session

#1

#2

#3

#4

#5

#6

Target
#7

#8

#9

#10

#11

#12

Day of
delivery

Drops

Drops

Drops

25-75 mL
1-2.5 oz

75-150 ml
2-3.6 oz

150-225 ml
6-7 oz

225-300 ml
7.5-12.5 oz

300-375 ml
10-12.5 oz

375-450 ml
12.5-15 oz

450-525 ml
15-17.5 ml

10

525-600 ml
17.5-20 oz

11

600-650 ml
20-22 oz

12

650-700 ml
22-23.5 oz

13

700-750 ml
23.5-25 oz

14

750 + ml
25 + oz