"Improvements for hospital breastfeeding introduction"

I delivered my baby at 29+5 weeks and believe there is more that can be done to support successful breastfeeding. When I was recovering from the birth on the ward, the midwife nurse on duty wheeled in one of the Medela Symphony breast pumps for me to start pumping colostrum for my baby in the NICU.

I was not given any instruction on how to use it, and when I asked for help, it seemed the nurse did not actually know how to set it up or use it! When my spouse arrived back, he was the one who figured it out using YouTube. It was not until the nurse changeover that I was given an idea of how often I needed to pump and for how long. It may have been my isolated experience, but for a new mum with a baby in the NICU where pumping has a huge role to play, I feel as though the introduction could have been delivered in a much clearer way. As a minimum - how to put the pump together (including all attachments), how and how often to clean the pumping equipment, ideal pumping schedule, and a clear overview of the pumping journey ahead for preterm mums who want to breastfeed.

The other major piece of feedback is to do with nipple flanges. I was given a size 24 without the midwife even looking or measuring my nipples (I was told this was the standard size). I had terrible engorgement, was pumping and pumping but the milk was not coming out. When I spoke to one of the consultants at The Breastfeeding Centre (Sharon), she did incredibly well over the phone to determine that the flange size was too big. She gave me the contact details for a private Lactation Consultant who sells a range of pumping accessories from her home.

So, in between pumping every 3 hours and trying to be with my baby, I drove out to this person's house at night after being at the NICU all day to collect some smaller flanges. I ended up being measured up for size 13mm flanges (Spectra brand that were compatible with the Medela Symphony pump) and as soon as I started using them, the milk flowed! I find it bewildering that it seems a size 21mm flange is the smallest offered at the milk room at KEMH when it is the tertiary women and newborn hospital in Western Australia. Surely, there are many more women like myself across WA who are smaller than 21mm (NB. The smallest that was sold was 10mm!).

If Medela can't stock a smaller flange, then in my opinion, some alternatives should be sourced and offered through the KEMH milk room for pumping mothers. And I think all women should absolutely be measured before flanges are issued to prevent unnecessary engorgement, pain and stress.

Lastly, I believe that there needs to be a review of the information being provided by KEMH LCs, midwives from the birthing centre, consultants at The Breastfeeding Centre and nursing staff in the NICU/SCN as I had so much different and sometimes conflicting information during the 54 days my baby was in hospital. I understand that every woman's breastfeeding journey is different, but the volume of different information was overwhelming and confusing at the time.

I would find some online video resources really helpful to watch while pumping on different troubleshooting aspects. I think these could be put together by the LCs as supplementary support to their face-to-face consults. In my experience, video is an easy format to digest and can be accessed and re-watched easily (rather than paper which can be overwhelming when you are receiving heaps of separate pieces and easily misplaced).