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Pumping for my premie - Kashiefa

My second child, my son, was born on 2 September 2021 after an emergency C-section. He arrived unexpectedly at 32 weeks, weighing 2.1kgs. For the first 24 hours he was in the NICU on oxygen, and I couldn’t see him, but I was advised that breast milk is the best for his development and I should start expressing immediately.

The first attempt at expressing my milk involved a nurse hand expressing and catching the milk in a 5ml

syringe. I think I got around 2ml of colostrum and the nurse thought it was amazing. At 32 weeks my son

needed very little, and every drop helped.

They also requested donor breast milk, as they didn’t want to top him up with formula if I wasn’t going

to produce the volumes needed. I loved that, as I was always an advocate for breastmilk. For that first

day after my son was born, I couldn’t see him or hold him, but my body was doing what it needed, and

with the guidance of the nurse I was hand expressing every 2 hours. Expressing every 2 hours was very

stimulating to my breasts and I could notice that my milk production was increasing.

By the time I was discharged 4 days later, I was using an electric pump, and I was getting about 60ml at

each pumping session. I was now able to hold my baby, but he was still only being fed my breastmilk via

a feeding tube. My body was doing what my baby needed even without the stimulation of baby’s mouth

on the breast. When I was discharged, I stuck to a 2.5 hourly pump routine. I would do my last pump around 11pm and then wake up at 4am to start my daily routine of pumping.

In the beginning I would combine milk from 2 pumping sessions into one bag/container. I would take

about 4 full bags of breastmilk to the hospital. At about week 2 I was told that my baby had enough milk

at the hospital, and I shouldn’t stop expressing but should start freezing my expressed milk.

Two weeks after the baby’s birth we started trying to get him to latch. That was a challenging process;

being premature his sucking skills weren’t fully developed. Because of Covid protocols and NICU

protocols I was only allowed to be with my baby for part of each day. I would come at 8am, try to get

him to feed, leave at 9am, come back at 11am, leave again at 12pm, come back at 2pm and leave at

3pm. I would then go home to my 4-year-old at that point who also needed my love and attention.

When I wasn’t at the hospital, the nurses would try to give him a bottle with my breastmilk. This was a

concern to me, as I was worried that he would prefer the bottle and maybe reject my breasts, but that

wasn’t the case.

The doctor was happy with my son’s development but indicated that baby would only be discharged

when he could drink a full feed from bottle or breast and maintain his weight. After 3 weeks in the

hospital my baby was latching and feeding successfully from breast with some top-ups by bottle and

then he was discharged.

When I got home, I followed the hospital routine of feeding every 2 hours. At this point my breasts were

producing more than my baby was drinking so I would pump for 10mins after feeds if there was time. I

managed to fill a 5 litre container with bags of 180ml breastmilk. I was super proud of the quantity of

breastmilk I had in storage as I knew I would be going back to work when my baby was 5 months old,

and I wanted to continue with exclusive breastmilk feeding for 6 months. But pumping and breastfeeding was time-consuming and exhausting and I gradually stopped pumping and was just

breastfeeding. Even though my baby took a bottle in hospital I never gave him breastmilk from the

bottle after that, as we were never apart, and I still feared that he might prefer the bottle.

When I first went back to work after maternity leave, I didn’t go directly to the office. I was on a work-from-home basis and that allowed me to continue to breastfeed my baby on demand. I did however

start introducing the bottle again. I would take milk from my freezer supply, give it to him in a bottle and

then pump to replace that milk.

When my baby was 7 months old, I started going into the office for 50% of the month. He would then go

to my mother-in-law for every 2nd week. Here he was on solids and on breastmilk. He would drink about 3 x 120ml breastmilk from the bottle and would breastfeed when we were together.

Around 8 months I noticed a drop in my milk supply. I was at the office every 2nd week where I would

pump for 2 x 30mins sessions with 3/3.5 hours between sessions. I contacted La Leche League as I was

concerned because I was no longer able to pump the same quantity as before. I was advised that the

breastmilk baby was receiving was sufficient as he was also on solids. I wondered if he needed to be

topped up with formula milk, but La Leche League assured me that wasn’t necessary. I followed their

guidance and continued to pump and give baby whatever I could while apart and breastfeed him when I

picked him up. That system worked well for us.

Even during the Ramadan (month of refraining from food and water from dusk to dawn) I would have

thought my milk supply would drop, or I would feel super drained breastfeeding while fasting but that

didn’t happen. God created us to feed our babies, thus breastfeeding fits into every situation life throws

our way. I attended an online workshop presented by La Leche League on breastfeeding while fasting in

the Ramadan. They suggested foods that help with milk supply and how to manage the demands of


When my baby reached 1 year old, we still had a good breastfeeding system but I noticed my son was

drinking a lot, and I wondered if my breastmilk was insufficient. I reached out to La Leche League again.

They reassured me that as long as my big boy is drinking, he is extracting the milk he needs, and my

body will replenish the milk. At this point it became a struggle to keep up with pumping at work. When

my boy was about 15 months I decided to stop pumping at work as by then breastmilk wasn’t his main

source of nutrients. At the suggestion of La Leche League I began to offer him more water and solid


Breastfeeding was also challenging at times. Baby would usually sleep in my bed and drink 2-5 times

during the night. I felt like a pacifier at times, as I thought he was sucking to soothe himself, not because

he was thirsty.

I also got an infection in one breast; doctor said some bacteria from baby’s mouth must have gone into

my breast. It was extremely painful. My breast was full and red, and the doctor suggested I should pump

out the milk and not let my baby drink from that breast. (LLLSA comment: Mastitis or breast inflammation is not a contagious condition and frequent breastfeeding helps to reduce inflammation in

the breast.)

Around 17 months I no longer had any stored breastmilk and was no longer expressing. I started baby

on a growth milk, but that didn’t work well. I don’t think he liked the breastmilk replacement and soon

he was completely off the bottle, but still feeding on demand from the breast.

Around this time, I had started a new job that was extremely demanding. At this point I felt I needed to

start weaning baby off night feeds so I could get a better night’s rest. We started with removing the

middle of the night comfort feeding. He would fall asleep on the breast, and then when he woke up my

husband would try to get him back to sleep. If he woke up any time after 4am, I would give him the

breast but not before that. By day 3 that routine was working well. I tried my best to do a gradual wean.

I then dropped the falling asleep on the breast and eventually we were only on day feeds. That was

when my breast started getting painful and full and very uncomfortable. I started with expressing in the

morning to relieve the buildup during the night, as I was always leaking during the night. I then decided

to remove him completely to start drying up my milk. I again looked to La Leche League for guidance. I

note that they encouraged me to continue to breastfeed. It was rather sad and emotional to end my

breastfeeding journey, but I believed it was the right time. At first, I needed to pump briefly to relieve

my breast, as it was full and sore. By week two I didn’t need to pump but I did still have milk. My breast

would leak, especially when pressure was applied like picking up baby or laying on my breast. By week

three my breasts were a lot softer and there was no more leaking. I think it was around that point my

milk dried up.

I loved my breastfeeding experience with my son. I am super proud of my commitment. I always

encourage other moms to breastfeed; it’s easier than having to pump, it’s easier than having to wash

bottles all the time and it’s cheaper than buying formula milk. But mostly it’s healthier for baby, and it’s

a wonderfully bonding experience.

Moms, you can do this!!!

Kashiefa Kalam (Dec 2023)


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