Why should I breastfeed at NICU?
Breast milk contributes to the healthy development of all babies. Breast milk is vitally important for preterm or sick babies in NICU. Mother’s own breast milk, and particularly her colostrum, will bring the greatest benefits to her baby. No matter at what gestational age your baby is born, your milk provides the right balance of nutrients and vitamins specially made to fulfill the need of your baby to grow. Mother’s milk with premature babies contain more protein to boost the immune system of the baby and make it easy to digest. This immunity is especially important for premature babies. Your milk also contributes to preventing allergic disorders such as eczema and asthma.
How do I connect with my baby in NICU?
Having a close and loving relationship with your baby is crucial for your baby’s well-being and development both now and in the long term. Remember you and the father are a vital part
of your baby’s care rather than just a visitor. Visit your baby as much as you can and hold your baby as soon as baby is ready to be held. Prolonged and frequent holding of your baby, skin-to-skin or Kangaroo mother care, provides warmth, breast milk and love. The more you hold your baby, the more your baby will be physically and emotionally safe. Our team in NICU welcomes and supports you to achieve it.
How do I protect and maintain my milk supply with my baby in NICU?
One of the best things you can do for your baby at this stage is to provide your breast milk. Your baby may not be ready to feed at the beginning, but you need to protect and maintain your milk supply until your baby is ready. Your breast milk is unique for your child. The earlier you start to express and the more often you express, the more milk you will produce for your baby’s growing needs.
GOOD TO KNOW:
- Start expressing within the first one to two hours after giving birth; our team of midwives will show you the technique of hand expression
- Continue to pump eight to10 times in 24 hours including one to two times during night. During the day pump more often and more frequently, and at night pump every four hours. This will establish and increase your milk supply
- Stay close to your baby when expressing, or have a picture of your baby. Close your eyes and think about cuddling your baby
- Warm up and massage your breast prior to expressing milk
- Drink lots of water, rest well and rela
- Rent a hospital grade pump or use a double pump at home. Make sure you have the bra to hold the double pump because you need your hands to be free to compress your breast to get more milk (ask your nurse how you can make your own bra). See the video on hands-on pumping
Depending on how early your baby is born, you may need to express for many weeks. If you have established a good supply in the first couple of weeks, you can be a little more flexible about when and how much you express.
How do I store my milk with my baby in NICU?
See the chart below for the storage of the milk with pre-term and sick babies. Washing your hands thoroughly and hygiene of containers and pump parts are significantly important with baby in NICU.
| STORAGE OF MOTHER’S MILK FOR PRE-TERM OR SICK BABIES IN NICU | ||||
| Mother’s milk | Room temperature | Time in Fridge | Time in freezer | Time in cooler bag with ice pack |
| Freshly expressed | 2-4 hours | 2-4 days | ≤3- 6 months | Just use to transfer milk from home to hospital or vice versa |
| Frozen milk thawed in fridge | ≤2 hours | ≤24 hours | Do not refreeze | |
NOTE:
Once you go home with your baby follow the chart with term babies for the storage of your milk
(see the storage of milk section).
What about breastfeeding my baby in NICU?
Once your baby is ready to breastfeed, your nurse will support you to breastfeed your baby with proper position and attachment. The first times could be just a trial of breastfeeding for 10-15 minutes to see how the baby is doing on the breast and you will practise and become more confident breastfeeding your baby.
Consider the following tips for a smooth start:
- Remove some milk from your breast in advance to soften your breast to make it easier for baby to attach
- Try to get as comfortable as possible
- Hold your baby skin to skin prior to breastfeeding for 10-15 minutes to make baby alert and ready
- Make sure baby’s nose and toes are facing the same way, so they do not have to twist their head to feed
- Gently support baby’s head, neck and the whole body
- Express a little milk onto your nipple and let baby lick this
- Hold your baby in cross-cradle or football hold as you have more control (see the guide to breastfeeding positions and proper attachment above)
- Make sure you support your breast and compress while baby is breastfeeding to make the flow higher to create less work for baby
- If your baby does not seem comfortable, try changing the way you hold them. Ask the nurses to help you find a position that suits you both
GOOD TO KNOW:
- The journey toward full-time breastfeeding takes time.
Be patient with yourself and your baby. - Further progress on feeding takes time and efforts and your availability plays a great key.
- The NICU team and the lactation consultants will work with you by observing your baby’s feeding progress closely and planning his further needs.
- Pumping is recommended as your baby might not be strong enough to drain the breast and that is mandatory to increase and maintain milk production for the long run.
What do I need to know when going home with my baby from NICU?
Although you have been waiting for this day, it is okay to feel anxious about taking your baby home and looking after him without the support of the nurses and doctors. At this point, your baby can bottle-feed or breastfeed without breathing difficulty. Consider the following tips for preparation to go home:
- Spend more time in NICU and actively participate and help in direct care activities and feeding your baby as much possible
- Make sure you can breastfeed confidently before going home
- Ask as many questions as you need to make yourself aware and clear about your baby’s needs and condition. Make sure you know the difference between a nutritive suck vs. non- nutritive suck
- Before you leave, it will be discussed with you how much your baby needs to feed based on your baby’s needs and the team will discuss ways to tell if your infant is taking enough milk: either while feeding at the breast or by a bottle
- Observe your baby more often to make sure you are familiar with the coordination of sucking, swallowing, and breathing cycle when the baby is feeding. Be aware of the baby’s voiding and stooling pattern
- You will be scheduled to be seen by the lactation consultant in the clinic within a week and informed who to contact if you have any questions or concerns
