9 Things You Need When Exclusively Pumping for a Preemie in the NICU
by Kristin Eberhard
Fresh milk and frozen milk and pumping parts, oh my. Image courtesy of the author.
My baby was born at 27 weeks gestation and was in the Neonatal Intensive Care Unit (NICU) for more than two months. Within hours of his surprise birth, the hospital staff brought me a breast pump. If I wanted my milk to come in, I needed to pump 15–20 minutes every three hours. I dutifully started pumping. It was both demoralizing (for days, nothing came out — my body, like me, thought it had three more months to get ready for this) and very physically uncomfortable (I was holding the pumps up to my breast with both hands). There was no way I was going to be able to keep that up for the hundreds of hours of pumping I had ahead of me.
The hospital emphasized that breast-feeding was the best thing I could do for my baby. They even had professional lactation consultant on staff to come by every day to check on how pumping was going for me. Puzzlingly, the lactation consultant never mentioned any of the helpful objects, like a pumping bra, that could make it sustainable for me to continue pumping exclusively for months. Luckily,I remembered seeing on an episode of the Netflix TV show Working Moms someone using a hands-free pumping bra, so I ordered one. (That’s right, I got more helpful tips from a TV show than from a live lactation consultant).
Over the next few weeks, I put together a pumping routine that I was able to sustain, eventually filling an entire 5 cubic foot freezer with frozen milk, in addition to feeding my baby exclusively with my pumped milk during his NICU stay.
If you are in a similar situation, I’ll spare you the weeks of experimentation that I had to do and just tell you right now — go get the things below immediately. Pumping is hard enough. These things will make it a little easier.
1. Pumping bra
If you’re going to be pumping every three hours, you should at least be able to do it hands free. A pumping bra will hold your double electric pump on your chest. You can get a cross-over model like this or a zip-up one like this. I also got this velcro wrap-around one as a spare.
2. Lots of pumps
Your insurance is required to pay for a pump (thanks, Obamacare) and you might think you are done. But to make pumping as easy as possible, you will want more. Pumps, galore.
I had four: one at the NICU, one in my bedroom, one in my office, and one cordless pump. The NICU provided a Medela Symphony there, but I had to buy the tubes. I got a Spectra 2 from my insurance. I got a Spectra 1 for free from a neighbor. The Spectra 2 is more expensive, but the Spectra 1 had a big advantage for me — it has a rechargeable battery inside so you can use it when it’s not plugged in. This gave me a limited amount of mobility when using it, for example I could sit at the table and eat breakfast, and then pick it up and go to the kitchen to wash dishes. With the Spectra 2 I was tethered to my desk.
My big splurge was the cordless Willow Pump. I was super excited about hands-free pumping, and particularly about being able to lie down in bed while I pumped at night. But I ended up not using the Willow as much as I thought I would. My main use was in the morning — I could move around, getting breakfast, getting my son ready for school, driving him there, driving myself to the NICU, all while pumping. I even did a morning meeting wearing the Willow once!
3. Lots of pumping parts
I had four sets of Medela pumping parts, and adapters so I could use the same ones with my Spectra pumps. Each set of Medela parts includes a breast shield, connector, valve, and membrane. If you are pumping eight times per day, then you’ll have to wash all four sets of parts twice each day and sanitize all four once a day. With only one set of parts the washing is never ending.
Image courtesy of the author
4. Wash tub and dry tub
I had a dedicated wash tub (this one) to collect my pumping parts in as I used them. After each pump, I’d toss the parts in the wash tub. When I’d used all four sets, I’d wash them all up and put them in the dry tub (I used the one they gave me at the hospital) to dry. I could carry the whole dry tub into my bedroom at night so I wouldn’t have to go wash or searching for clean parts for night time pumping.
5. Sterilization bags
To keep your NICU baby safe from infection, you’ll want to sterilize your pumping parts every day. Microwavable sterilization bags like these are a life-saver. Instead of boiling a big pot of water and fishing parts out with tongs, you just pop them in the microwave for a few minutes.
Image courtesy of the author
6. Cooler bag
Don’t forget the milk.
You’ll need an insulated bag to carry the milk from home to the NICU. I used this cute little thing. When I got home from the NICU I’d put it in the freezer again. Before going to bed, I’d bring it to my room so I could put my night-pumped milk bottles in the bag and not have to get up and carry them to the refrigerator until the morning.
7. Breast warmers
Warmth can help the milk flow. At first I tried using those bean bags heating pads that you heat in the microwave, but they were awkwardly sized and always seemed to be too hot or too cold. Instead, I treated myself to these amazing warmer/ massagers. (The massage setting is more like a vibrator than a massager). They are just the right size and shape to fit perfectly in your pumping bra, they warm up nicely and can also vibrate to help with clogged ducts. I also found the dim green light helpful for checking to see if I had filled a bottle during night pumpings.
8. Tips for unclogging blocked ducts
DIY way to change your Spectra’s bright blue nightlight to a lovely warm orange. Image courtesy of the author.
I got clogged ducts several times. Most of the time, warming it and hand-massaging the hard spot while pumping did the trick. The warming massagers, above, also helped. But one night I just couldn’t get it unblocked. I was up for hours massaging and warming and pumping and desperately googling, repeat. All the pages I found just said to do what I was doing.
Finally, finally, I found a different bit of advice that miraculously worked! Dangle your breast towards the ground to let gravity help. That’s right, lean yourself over until your nipple is facing as downwards as possible, then pump. I stood up and rested my forehead on the table (nice hamstring stretch, to boot) and at last it started flowing!
9. Orange lights
The Spectra pump includes a nightlight which is a nice touch. However, I found it too bright and too blue for comfortable night use without waking me up too much. I covered part of the light with black electrical tape to dim its brightness and covered the rest with orange tissue paper to tame its blueness. Voila. I also got a dim orange nightlight.
Final words
If your NICU doesn’t provide them for you as mine did, you also want bottles and labels. I was very happy for the bottles, since I used 16 bottles a day (8 pumpings, times 2 breasts). They pre-printed labels with a bar code correlated to my baby, and then I wrote in the space the date and time of the pumping so they could be sure not to let any go bad.
Happy pumping!
Kristin Eberhard is a bike-riding Pdx mom who fills the role of Director, Climate and Democracy at Sightline Institute. This article was originally posted on medium.com. Read her other articles on our blog here and here.