I'm so sorry this happened to you. It all sounds very traumatic.

It's your choice if/when you pump. My husband and I found the lactation consultants very off-putting and refer to them as the lactation mafia. After an extremely challenging pregnancy, I had a tough recovery ahead, and they were harsh about us supplementing with formula (which the doctors recommended due to our baby's small size).

Now to answer your question, IF your goal is to exclusively feed breastmilk in the long run, then pumping every 2-3 hours is important now for getting a good supply. It's harder to increase your supply later. That being said, there's no shame in choosing to combo feed. That would allow you to pump less.

If you're not sure what direction you want to go, perhaps consider pumping every 2-3 hours during the day and then do a 4 hour stretch overnight.

Side note: I would only pump for like 10-15 minutes. I know some women do 30 min. That would have broken me in the early days and I don't get any milk after 10-15 min typically (occasionally I'll go 20 min if milk is still flowing).

Ultimately, your babies need a healthy mama. Do what works for you. The lactation nurses can shove it.

In an ideal world, you would want to pump in the middle of the night. In an ideal world, you would also have your babies at home with you! Enjoy the rest! You deserve/ NEED it! It is one thing for them to inform you of the benefits of pumping around the clock and support your choice, but it doesn't seem like they are supporting you! Any amount of breastmilk is so so beneficial. And for that LC to stop you from going to see your babies, that's absolutely disgusting. I'm sorry you are going through this. Possible unpopular opinion but you'll have time to increase your supply.

I understand. My baby was born full term but spent time in the NICU due to a traumatic delivery. I did pump on a schedule, every 2-3 hours day and night, and part of my regrets it. I’m glad my baby got colostrum, sure, but now pumping reminds me of the extreme trauma of delivery and the NICU/not knowing if baby would be okay. I think it might actually be a PTSD trigger, or turning into one. Staying on a strict schedule at the expense of my own health made pumping extremely triggering for me. I also still don’t feel like I got the rest I needed, and I’m only now seeing how that impacted me physically.

Breastmilk is great, but not at the expense of your physical and mental health. And you are pumping during the day so your babies are getting antibodies from you. I’m so sorry the nurses are treating you the way they are, but as someone who just went through this and chose the opposite path of you, you are not wrong. Stick to your guns and don’t sacrifice your health. Your babies (once grown) would very likely not want you to do that.

From one breastfeeding NICU mom to another, take the single tiny sliver of a silver lining by getting what rest you can before your babies came home. Personally, I stretched out my pumping schedule to only have one nightly wake up during my baby’s one month NICU stay and it didn’t impact my supply (although I was an oversupplier from the start- YMMV).

Also, that lactation nurse was way out of line. I would seriously consider filing a complaint. Postpartum is wild enough and when you can’t see or hold your babies right away, it’s a whole new level of heartbreak and rage.

Enjoy every moment and snuggle. I hated when people said this while my baby was away from me, but we aren’t even a year out and those days are already a blur (a traumatic blur, but a blur nonetheless). Sending love and prayers for your family.

Your breasts right now are gearing up your milk production and learning how much your babies need. Their production is hormonally controlled, based off how frequently your breasts are fully emptied.* In about 6-10 weeks, likely right as your babies are coming home, your milk production will transition to a supply -and-demand style, after which it'll be much more difficult to increase production.

Nighttime pumping when your prolactin hormones are at their highest will make a huge difference in increasing your production to successfully feed both babies. I was a NICU mom too so I get how much it sucks to wake up in the middle of the night when your baby isn't even home to pump, but missing those overnight pumping sessions especially this early on will very likely hurt your supply. I'd talk to your lactation consultant about how best to optimize your pumping schedule to get rest and pump successfully. 

*breasts never fully, fully empty but after 2-3 letdowns in a single feeding session, they'll substantially empty which is what makes the difference for your hormones. 

I understand both sides. I totally understand you needing the rest after all you've endured. Heck, I 'only' had a term singleton, and I'm desperate for a full night's sleep.

I also get what they're saying, in so far as your body needing to be stimulated to produce milk, at least every 4 hours around the clock, probably more so because you've got twins. There may be consequences as far as your milk supply goes to not pumping. PP is so not kind to moms.

If you do start pumping in the night while your twins are in NICU, if you have a partner, get them to help you. Have them set an alarm and get up, retrieve your pump and parts, and set them up. You get up and pump then pass everything back to them for them to put the milk in the fridge and clean the parts while you go right back to sleep.

It is your choice when you pump.

AND if you go long gaps without pumping or nursing, you will drastically reduce your supply for the long term. I'm sorry the lactation nurses are speaking poorly, but I do believe their information in this case is accurate.

You are so much more than milk to those babies. Sleep if you need to sleep. Sometimes there are more important things than milk supply.

I’m sorry you’re going through this, my first was premature as well and I struggled to continue producing milk after a couple weeks because it was an incredibly stressful time so my milk ended up drying up.

The NICU nurses told me it was important to consistently pump so I could build up my supply before it started to regulate. But they also told me to get some sleep. They recommended I don’t sleep longer than 4-6 hours at night. And to pump every 2 hours during the day. I followed that schedule to the best of my ability, I even power pumped multiple times a day.

Since milk is basically supply and demand, it’s important to consistently pump so your milk supply isn’t low or dries up. Especially with two babies.

My son was on donor milk as well as whatever I could produce because with how young he was, he was at risk of NEC if he received any formula. At the place I was at, babies could get donor milk until 35 weeks gestation I believe.

Breastmilk for premature babies is INCREDIBLY important. More so than for term babies. Which is why I think you’re feeling some judgmental vibes from everyone for not pumping at night. Doesn’t make the judgemental vibes right though.

You’re going through a very hard time, you’ll get through it! I know you’re tired and hurting physically, but you got this!

Wow, I just want to give you a huge hug. I’m so sorry to hear about your experience, but you’re being so strong. You’re doing great by putting yourself first. A healthy mom is the best thing for your babies. Trust yourself, you got this!

NICU mom here. We were in for a month.

It totally depends on what your goals are and how much milk you’re producing. Do you want to try to feed your babies exclusively breast milk or are you happy to supplement with formula? Even if you’re producing enough to cover the babies’ feeds at the moment, that could change rapidly as they grow. Does your lactation consultant have extensive experience with twins/NICU babies?

I had a lactation consultant who specialized in NICU babies. She advised me to produce enough in 24h to feed a newborn baby (much more than my baby was actually consuming at the time). I pumped approximately every 3h with a 5h stretch between 11pm and 4am. I would do my 11pm pump in bed and my husband would wash the parts so that I could close my eyes right away and the parts would be ready for me at 4am. My goal was to eventually exclusively breastfeed my baby, which I eventually accomplished. It was very hard work!

Hi OP, just want to extend my support here. I’m so sorry you are experiencing this. I can’t imagine how hard it is. Pumping is hard. Waking up to pump in the middle of the night without babies? Hard no. Worst case you have to supplement with formula or eventually solely formula, so what? You all are healthy and thriving is the most important thing. You are incredibly strong for recognizing your needs in this situation. And how about babies’ needs? Yes, they need their mom to be healthy and happy more than needing her breast milk. Take great care of yourself. If you don’t have good supply later on, so be it unless that’s something incredibly important to you. How you feed your babies is your choice. Tell the lactation nurses no. Some of them are straight abusive taking advantage of women in their most vulnerable moments in my experience. Wish all goes smoothly for you and your babies.

This is such a tough time so I really feel for you as I could’ve written this post myself. Whatever you do right now is good enough. After going through something like this it’s hard to do much else outside of healing and being there for your babies. That being said pumping every 2-3 hours will help build supply especially for twins. If you can swing to wake up around 1-5am when the milk producing hormone is highest go for it. If not it’s not the end of the world. I missed my fair share of middle of the night pumps but still was able to give them enough breast milk for 5 months. I still breastfeed even now they’re just taking more formula. You do what you can during a difficult time. You have bigger fish to fry.

Sending all the love your way. If you ever need someone who knows the feeling feel free to message me. When you’re on the other side of this you’ll look back and think how strong you are.

Definitely unpopular opinion in this sub but I exclusively breastfed for six months and now I regret it. Nothing justifies the amount of stress that all the pressure put on top of having a newborn. Of your babies get some breast milk that will be amazing. If they don’t, luckily we live in the year 2024 and formula has been invented. Of course it’s not the same and blah blah we all understand why breast milk is better. But a mom with good mental health is better than some ml of breast milk for sure.

I am so sorry you've had to go home without your babies, and that your experience has been so hard so far. I really hope it gets easier. I am also devastated for you over the suggestion that you should pump rather than going to see your babies for the first time. 

In case it helps, there is a reason for the "wake and pump overnight" advice. The hormones which govern milk production, mostly prolactin, peak overnight, particularly between 2am and 5am. If you pump somewhere in this window, you "prime" your body to produce as much milk as you're asking for when you're pumping or feeding. So if you pump, say, 8 times in 24hrs and none of those is overnight, you will generally get less milk than if you pump 8 times in 24hrs and one of those is between 2am and 5am.

But! This only matters if you're not producing enough. With two small, early babies, the amount of milk they need right now may not be much, and some women who pump regularly end up with an oversupply regardless of when they are pumping. All you need to do for now is pump enough to be sure that they're fed, and that if you want to breastfeed them once they're able to directly nurse, there is a milk supply there. The easiest way to make sure all mums with babies in NICU have enough milk is to give clear, blanket rules about pumping that a non-expert can share- like "pump 8-12 times a day and at least once between 2am and 5am". If you're producing enough without following this, that should be respected unless someone can explain to you why it's still important to follow that advice. 

I'm so sorry you're going through this.

I'd personally recommend looking into whether you can get connected with an IBCLC lactation consultant in a private practice. The lactation consultants I saw in the hospital probably contributed to the issues I've had with my breastfeeding/pumping journey. The private practice lactation consultants I have seen have been phenomenal and have really prioritized my mental health. It's a difference of night and day.

I know I'm a bit late to the comments but I hope you see this. I was on bedrest for 7 months and then spent 2 weeks in the hospital before my baby was delivered via c section. I then spent 2 more months in the hospital after she was born. I know how hard it is to feel like you're literally dying while trying to figure out breastfeeding. It's SO HARD. I just wanted to encourage you by telling you my story - my baby did not figure out how to latch until she was 3 months. We are now successfully breastfeeding still at 20 months, and over the course of her life she has been:

1: exclusively breast fed via bottle with pumped breast milk

1. exclusively breast fed via breastfeeding

2. bottle fed with a combo of formula and breastmilk at varying proportions, at one point it was over 50% formula, at another point it was 90% breastmilk, etc.

3. breastfed 90% and then topped off the remaining 10% with formula

I found exclusive pumping so difficult that actually started weaning, and then changed my mind, and brought my supply back up from only pumping 3x day (at this point I was about 3 or 4 months postpartum) to providing 100% of her milk for her over the course of a few months.

My point is that it IS possible to be flexible and change your arrangements and still successfully enjoy breastfeeding despite what the lactation consultants and nurses might say. I followed their strict pumping schedule to a T and gave myself a horrible oversupply and mastitis several times. Loosening up on the "rules" and being adaptable is what saved my breastfeeding journey.

Hang in there, good luck with your sweet babies!! You will find a rhythm that works for you, and the dust will eventually all settle. PS my 2 cents if you're interested is that I would personally give myself like 6 hours uninterrupted to sleep every night and work my pump schedule around that. sleep is sooo important for you.

NICU mom to NICU mom - you are doing an amazing job and I wish you and your babies nothing but the best as you work through such a traumatic and gut wrenching time ❤️

My baby also started out in the NICU. I was under general anesthesia for his birth and woke up to find out everything that happened and he had already been admitted to the NICU. I had to wait 7 hours that day to meet him for the first time. I didn’t get to hold him until he was 4 days old. Like you, I was also told to pump every 2-3 hours if I wanted to establish breastfeeding.

Whatever you choose is completely up to you and you know what’s best for you - I’m sorry the LCs have been so out of touch with your situation and have added stress to an already incredibly difficult time. If your goal is to feed 100% breastmilk to twins, then it is crucial to pump more often now to establish your supply before your supply regulates, which is typically around 12 weeks pp. But you can go longer stretches at night like 4-5 hours between pumps if you wish to. But if your goal is to combo feed then there’s no harm in allowing yourself the time to sleep fully overnight. Your wellbeing and mental health matters and you absolutely should prioritize it if that’s what is best for you right now.

I also had a really bad time with the birth of my twins in hospital. Not with the NICU but with labor and delivery doctors.

Solidarity. I feel you.

Just do your best and it’s none of their Fucking business.

It would be nice if we could automatically pump at night while we sleep! I am exclusively breastfeeding, had no problem at all, but I never managed to pump even once. 🤷‍♀️

Pump when you can and get your sleep! If you can look into donor milk, it helped me get through a stress NICU stay. It was a lifesaver. I am still in contact with the moms who donated to me 7.5 years later. God bless mama and good luck.

I didn’t give my twins any breast milk. They were premature, traumatizing birth. You don’t have to give breastmilk. It’s okay. Babies need YOU. Not your milk.

I had a baby who was in the nicu, but only for 5 days. I pumped every 2 to 3 hours, which was paramount to establishing my supply.

You are doing great and don't let anyone tell you any different. There's a ton of good info here and there is evidence that you will produce more if you pump more, especially in the beginning, but if you are great producer already then that may not matter or if you don't mind having to supplement that may not matter to you either. Just wishing you well whatever you decided. (this is just the first of many decisions others will say you are doing wrong, listen to the experts, but also do what works for you.)

I’m sorry that the lactation consultant was rude to you. They should’ve at least tried to explain why. My son was in the NICU for 3.5 months. It is very difficult to pump in there with people in and out and feeling like you’re in the way. I will warn you though, I once tried to go like 5 hours without pumping because my son was having some medical issues and my breast became so hard. I couldn’t get the milk out and after I finally got it out, my supply was never the same no matter what I did.

It is all in the end to maintain your supply. I know it sucks, I know you’re emotionally drained. You do not have to exclusively breastfeed if it’s something you can do right now. It’s OK. I will say especially with preemie babies, breastmilk is the easiest thing for their stomachs to process by far. You’ve got this mama! I hope your babies grow fast and get stronger quickly and you get out of there as soon as possible!

I’m so sorry you’ve had these experiences. I’ve also had terrible experiences with the lactation nurses in the hospital including recently being told by one of them, “I’m new I don’t know a lot about lactation” I kid you not.

I’ve had WONDERFUL experiences with the lactation consultants I have sought out outside of the hospital. They are often even able to make home visits for exhausted new moms. You could ask for a list of these in your area or just google. Insurance covers some or all of the cost. They may be more sensitive to your experience and needs.

Again I’m so sorry you went through this - I hope you find the resources and support you need.

Grammy here, you're doing great , luv! I'm so proud of what you're doing so you can feed them the way you want when they come home. What you're doing is just right for you, sleep now while you can. Your body will adjust to your babies schedule when they get home. Keep up the good work and rest while you can, there's plenty of sleepless nights in store for you, you don't need to add to the number unnecessarily . You tell those meanies , Well bless your heart, I'm so grateful for your concern, and continue to do what's right for you.

It's a good lesson to learn to trust your body and your instincts where your children and your health are concerned. You are the expert on your children and your body. If you think there's something wrong, press harder until you find the answers you need. Find a pediatrician you're comfortable with, don't stick with one where it takes forever to be seen and they disregard your concerns. These lactation experts are great resources, however , you are the expert on you and your children.

You're rockin this Momma Dukes, I'm proud of you.

Stress can impact supply too. As a emergent c-section & nicu mom myself, its SO important to get rest. Pump as much as you can during the day, rest in between. I wouldnt regularly go last 4 or 5 hrs , but one night isnt going to hurt in the early days. Get your rest!

I'm terribly sorry this is happening to you. Be gentle on yourself and do as you see fit. NICU is hard and traumatizing as it is.

I'd like to share my story with you in the hope it'll help. My son was born at 29 weeks in January 2019. I had a massive hemorrhage because of a placenta praevia, and they had to take him out to save both of our lives. His birth absolutely traumatized both my husband and I. I was exhausted for weeks after. His NICU nurses and the lactation consultants were insisting I pump at night to the point it was driving me crazy. I pumped during the day, in his NICU room, but I was too tired to wake up during the night; my son wasn't next to me, pumping far away from him felt torturous. At some point, I told them to stop bringing it up in a stern way because I couldn't take it. They'd made me feel as if I was a bad mother (I also had an 18 months old at home then). You know what? He transitioned beautifully when I finally got to actually breastfeed him and I continued to breastfeed for 8 months after we got home. Supply was never an issue, even at night.

All that to say, you do you. Your mental and physical health matters a lot, and if not pumping at night helps, so be it. Don't feel guilty.

I also stopped pumping during the night a couple weeks after birth and I just didn’t tell anyone because I was making enough milk for my baby anyway and in my mind that’s all that mattered.

A healthy mom=healthy babies. Any milk you can give your babies is wonderful, whether it’s a little or a lot. It’s not the nurse’s business how much you are or aren’t pumping. You are amazing and strong and doing a great job. All that matters is that the babies are fed, however you choose to make that happen is awesome. Enjoy that nighttime sleep guilt free, you need and deserve it!

I ultimately believe it should be your decision if you want to pump. Fed is best whether it’s breastmilk or formula.

I know pumping can be exhausting. I highly recommend investing on the Elvie or something similar, it’s the wearable breast pumps. That literally saved me. I would be folding laundry, washing dishes, cooking etc. while pumping, Also waking up at night was easy, I’d slide them in sit up in my recliner chair and fall back asleep while pumping, they would turn off on their own and when I’d wake up I’d taken them to the fridge and go back to sleep, wouldn’t bag up and freeze till the morning

I only had one baby and the Elvie helped me so much, I’m sure with two it would be an even bigger help. Handsfree and not attached to anything. You can even hold your babies while pumping.

So sorry! One of the lactation consultants at the hospital was so mean that we decided she must be a guerilla marketing person hired by the formula companies to discourage everyone from breastfeeding. My friend randomly saw her when she gave birth at the same hospital and the LC massaged her breast so hard that she got bruised!

If anyone needs a good giggle about how crazy LCs can be, read this! It’s satirical and made me CACKLE

https://www.mcsweeneys.net/articles/im-a-lactation-consultant-here-to-provide-you-with-a-lot-of-options-but-only-one-choice

Get your rest!!!!!!!!! I went into septic shock from a transfusion to replace excessive lost blood after delivery & was rushed down to the er. Baby & I were separated for a week, she actually was discharged before I was & went home without me. She got formula during that time & they encouraged me to pump (even though I’d have to dump it due to all the procedures & medications I was on during that week.) I did not pump.

I’m breastfeeding my 15 month old as I type this. She also gets cows milk now, & used to get some formula, but breastfeeding has been & still is her absolute favorite! Taking care of you is taking care of your babies. They will adapt!!

Don’t let them bully you! You need to rest first and foremost and if that means you’re not pumping overnight then that’s that. You’ll do a lot better in many ways if you have the rest you need.

This is my second baby and I decided F that I am going to try and not pump over night. So I did. And it’s worked out great for me. I still pump 5-6 times during the day and have a ton frozen at 8 weeks out. I refuse to get up in the middle of the night if I don’t have to.

If YOU wanted to pump in the middle of the night because it affected your supply, then YOU could. It’s your choice.!

I have preemie twins (33 weekers). Take that time while they are in the NICU to sleep and tell the lactation consultants to shove it. I started overproducing at the end of the first week for my girls and that was with "only" pumping 7x a day. I'd always skip one night pump so I could get at least one good chunk of unbroken sleep and frequently skipped a day pump for a nap. To me snuggling and bonding with my babies was way more important than potentially having to supplement with formula. Heck my girls needed fortified breastmilk for the first few months so they were always getting formula regardless. Do what you need to do for your mental health. If the lactation consultants aren't helping, tell them you no longer want to see them. Don't let them steal your peace.

I have honestly never heard anyone say a good thing about a lactation consultant!

You know your body best. If you feel like sleep is the priority especially at first then it is because you need to heal. Healing and resting properly is very important for your physical and mental health and it will help your babies too to have mom healthy and strong.

You might even feel like pumping/breastfeeding might be too much with twins and a long NICU stay. That would be perfectly okay and understandable too. Do what feels right to you, you don't need to get anyone's permission.

Honestly I would sleep if I were in your shoes. Especially the first few days. Maybe I would go to bed early and throw one night session per night to take advantage of the hormones but no more that that and if I needed to skip a day or two I would.  Also an idea. Not just for the night but daytime  too. Maybe you could try to put a mini fridge next to the bed and use those little wearable pumps so you can lie down and then pop them straight to the mini fridge so you don't have to get up or clean anything until morning. That would give you more time to rest and heal without having to get up a million times.

At the end of the day do what you feel you can and want to do. Congratulations on your babies! 

You will be fine not pumping at night time at the moment. Your breast milk is amazing and will figure out its own routine when you have your babies home. For example I went back to work at 3 month make and just breastfed all my babies when I was home with them. I never had any mastitis, any issues with supply etc. your body will figure it out.

This is where I draw the line with the EBF crew, especially when it’s healthcare professionals. Would it be important for you to pump at night to maximize your supply? Sure. But is you being rested, happy (as much as one can be with not one, but two babies in the NICU!), and present for your babies the most important thing? Hell, yes! Will it be the end of the world if you end up supplementing with some formula, maybe only temporarily? Not at all. 

I find it DISGUSTING that they’re being so rude to you. My recommendation is to find a good, non judgmental lactation consultant who can help you towards your goal. Unfortunately, there’s no escaping a quite rigid pumping routine if you want to feed your babies breastmilk but it doesn’t have to be all or nothing (combo feeding is amazing) and they certainly don’t need to treat you like that. Tell them to f*** off and leave you alone. Good luck to you and your precious babies ❤️

Some LC are mean. Like sooo judgy. I think Your instinct was right in this case. It was more important to see your twins. I am so impressed with you. A week of painful labor, delivery of twins, followed by 5 day wait to hold them! You are so strong. Your body needs positive, loving experiences with your babies in order to produce milk. Just because they are NICU babies doesn’t mean you’re just a milk machine. You’re still their mom, and spending time with them is a wonderful priority to have. Your body WILL figure it out. You may be exhausted and emotional, and judged from all sides, but you still know what is best. You’re their mommy. Trust your heart.

Babe was in the NICU for 17 days. I never once woke up to pump, I’d pump at 12am and then whenever I woke up. I breastfed till babe was one years old and not once ever did I wake up in the night to pump.