1. Will I need to express my milk?
Yes, you will need to express your milk. Your body begins to make drops of breast milk in mid-pregnancy, around week 16. Your milk production will increase a few days after delivery. When a baby is born prematurely, his mother produces milk adapted to meet his nutritional needs. Even though the baby, born term or prematurely, will not be able to breastfeed right away, stimulating your milk supply cannot wait. By expressing drops of breast milk frequently and effectively starting in the first few hours after giving birth, you will have better milk supply in the long term. You can express your milk very well with your hands for the first few days. Ask your nurse to help you with the technique. The use of a breast pump, combined with the hands, will quickly become necessary as the volume of milk increases after a few days.
2. Will I have access to a breast pump in the hospital?
Yes, you can ask your postpartum nurse to bring you a breast pump to your room after giving birth. Remember to ask for help with the manual expression technique (with the hands) as soon as possible.
The nurse taking care of your baby in neonatal intensive care unit will be provide you with a kit for manual expression that includes syringes, medicine cups, labels and instructions. You will also have access to an electric breast pump at all times in your newborn’s room. You will be given a double breast pump kit to use with the pump. It is given to you free of charge and can be used long term (for the duration of your breastfeeding).
3. Will I need a breast pump at home? And what sort?
Yes, you will need a breast pump at home. To establish good milk production, the breasts need to be emptied often and effectively, day and night. This should start very soon after childbirth, ideally within an hour, if not, as soon as possible.
An electric breast pump is preferable to a manual breast pump. It is recognized as being much more effective in starting and maintaining long-term breast milk production. There are two options available to you in getting an electric breast pump: purchase or rent. In terms of efficiency, the rental of a hospital grade electric breast pump is usually your best bet.
You could also consider renting for the first month, to efficiently establish milk supply and consider purchasing a breast pump after if necessary.
4. Where can I get an electric breast pump and at what price?
To rent or buy a breast pump, you can call pharmacies or stores that sell breastfeeding supplies near you (eg WalMart, Melon and Clémentine). You can also buy a new electric breast pump online. There are also community and provincial organizations that can help you (eg. Entre Mamans et Papas, Préma-Québec).
We do not recommend the purchase of a used breast pump. Since most breast pumps are intended for single mother use, they should be considered a personal accessory (like a toothbrush, for example). Boiling a used breast pump set does not guarantee its safety. Even if the risk of contamination is reduced, it is not zero, and the motor of these breast-pumps can be unreliable and cannot be repaired.
Costs of a Rental or Purchase: The cost of a monthly rental is typically $ 90 / month. And a credit card deposit is requested and refundable upon return of the breast pump.
For purchase, prices vary depending on whether you choose a single breast pump (one breast at a time) or a double breast pump (pumps both breasts at the same time). Allow $ 200-300 for a single and $ 350-450 for a double.
5. How often should I express my milk?
You want to simulate a pattern of an on demand newborn nursing baby, which is about 8 to 12 times a day. Therefore, it is recommended to express your milk 8 times / 24 hrs (approximately every 3 hours’ day and night). If you need to sleep longer at night, know that it is still important to do it at least once during the night (between 12 a.m. and 5 a.m.) to produce a sufficient quantity of milk.
6. How long do I have to pump?
Before the milk comes in, pump each breast for 15 minutes (you can pump both breasts at the same time or one at a time). As soon as the milk comes in, pump until the breasts are "empty" (i.e. very slow flow of milk). Do not forget to compress and massage your breast while the pump is working to effectively empty all the milk. (see the video "Maximizing milk production")
7. If I have had breast surgery (reduction or augmentation) in the past, will I still be able to get milk?
You can still produce milk by following the same recommendations listed in this document. Your maximum milk supply will mostly depend on where the incision was made, the breast mass removed, and the time between your surgery and now.
Breastfeeding consultants will work closely with you to achieve the best possible milk production. If, however, supplemental milk is necessary for your baby during his hospitalization, donor milk or commercial milk preparation (formula) will be offered to you depending on the situation.
8. Where and how will my milk be stored?
You will have access to bottles and sticker labels provided by the hospital. We will ask you to put a label with your baby's name, date and time the milk was expressed on each bottle of milk. Breast milk should be placed in the refrigerator in front of the milk laboratory in the NICU. Place it in the bin with your baby's name.
At home, you will keep your milk in the refrigerator. To bring your milk from home to the hospital, you will use an insulated lunch bag or cooler with an ice pack to keep it cold. Know that fresh milk, kept in the refrigerator, is good for 48 hours. However, we only freeze milk that has been pumped in the last 24 hours to keep as much as nutrients as possible. So if you don’t plan on bringing your milk every day, keep it in the freezer at home instead. Milk frozen at home should remain frozen during transport to hospital. Once on the unit, quickly give it to the nursing assistant in the milk laboratory so that they can place it in the freezer. In the event that you bring frozen milk, quickly place it in the refrigerator in front of the milk laboratory and request the help of the staff to put it into one of our freezers.
Because space in our freezers is limited, you will need to plan space at home to store your frozen breast milk.
9. Will my baby be able to breastfeed?
The priority in the beginning will be establishing your breast milk supply and as much skin-to-skin care as possible. This will not only support your baby’s development, but when your baby will be ready to feed by mouth, you will have plenty of milk available and your baby will already be comfortable lying on you in the Kangaroo and breastfeeding positions. Our team of nurses and breastfeeding consultants will help you get your baby to the breast by teaching you positioning and attachment techniques.
10. Why breastfeed my baby?
Your milk is perfectly made for your baby whether he is born at term or prematurely. It contains antibodies, enzymes, hormones, and growth factors that have lots of benefits not found in commercial formulas. For the first few weeks, the breast milk of mothers with premature babies is extra high in fat, calories and protein to meet their unique needs.
The World Health Organization (WHO) recommends exclusive breastfeeding for everyone up to the age of 6 months (no food and fluids other than breast milk). It also recommends continuing to breastfeed until the age of 2 and beyond while giving other foods and fluids. Your breast milk protects your baby against many diseases, it helps him grow and develop well, which can help you and your family get home faster. Your milk adapts to your baby's changing needs. Babies who are not breastfed have a greater risk of developing diseases in childhood and even later in adulthood.
Moms also benefit from breastfeeding. Breastfeeding hormones can help you cope with the stress of having a sick baby in the hospital. It allows you to participate more quickly in the care of your baby. It promotes the health of mothers by facilitating weight loss, reducing the risk of developing breast or ovarian cancer, and in addition to protecting bones (preventing hip fractures in later age). It helps to develop an attachment bond more easily and quickly with her baby. It is also more cost saving and environmentally friendly than feeding with commercial infant formula (formulas).
11. Are there any contraindications to breastfeeding?
Breastfeeding contraindications are rare. Even if you have a cold, gastroenteritis, or covid-19, your baby still needs your milk. It will provide him with the necessary antibodies. The medicines you take are transferred in small amounts to your milk. It is usually not necessary to change anything about your breastfeeding or how you express your breast milk. If you have concerns about any medications, breastfeeding consultants and pharmacists will be able to answer your questions.
12. Will I be able to meet with a breastfeeding consultant?
Yes, you can meet with us as needed throughout your baby's hospitalization. We know that your baby's condition could bring you daily challenges and many questions. We would like to give you any help you need and work with you to achieve your personal breastfeeding goals. You can ask your nurse to contact us to have a meeting.
From the entire team of breastfeeding consultants, McGill University Health Center
514 412-4400 ext. 23159