Once you are at home with your baby discharged from NICU, you and the father have more opportunity to practice kangaroo care. This will calm your baby and be more stable and safe. Consider the following tips to successfully feeding your baby at home:
- Pay attention to your baby’s cues and feed him as soon as you notice them
- Breastfeed your baby in a supportive position and a deep latch. Make sure you support and compress your breast while breastfeeding
- The healthcare team will help you to determine whether you need to add or continue any supplements to your milk to help your baby grow. If your baby latches well and actively breastfeeds with you see or hearing swallowing sound for minimum 10 minutes, you may not need any top up after this feed. Make sure you are available for the next feed whenever baby asks for it, no later than three hours
- Continue to pump your breasts after each breastfeed while your baby is learning to breastfeed. This will help to secure your baby with enough milk and to maintain enough supply until your baby sufficiently establishes the feeds at the breast
- During the first week at home pump for seven to eight times a day after breastfeeding and give it to your baby preferably with small cup. Watch for your baby’s wet and dirty diapers and make sure you chart everything during this week
- You will be seen by the lactation consultant a week after discharge. If your baby gains weight that first week at home, you can decrease to four to five pump sessions after breastfeeding. Continue to gradually decrease pumping sessions every three to four days if your baby is gaining weight and no longer needs to take a supplemental feed after breastfeeding
How to tell if my little baby is getting enough milk?
Once you are at home with your baby discharged from NICU, you have a chance to breastfeed your baby on demand.
However, while your baby is learning to breastfeed; he may not be strong enough to get all he needs at the breast. Here are some tips for you to indicate that your baby is getting enough milk when breastfeeding:
- Your baby wakes up on his or her own and demands at least eight feeds a day. This should be with a gap of two hours and not more than three to four hours. It is normal if the baby feeds more at night than in the day or vice versa
- Your baby will coordinate between sucking, swallowing and breathing. A few minutes after baby starts breastfeeding, he will start to suck deeply and slowly rather than short and fast
- You can see or hear a swallowing sound
- Your breast softens during and after the feeding is over
- When you pump after breastfeeding, you remove less milk from the side you breastfeed than you do if you did not breastfeed from it
- Your baby has six to eight wet nappies and several dirty nappies every day (usually yellow mustard colour)
- Your baby is gaining 170 – 220 mg/week (6–8 oz/week) and growing well
How to tell if my baby is NOT feeding well?
Contact your baby’s healthcare provider if:
- Your baby does not wake up on his or her own to feed for more than two feedings in a row, has a weak suck, and falls asleep after only five minutes at the breast - it is likely that he or she is not drinking enough milk
- You have difficulty waking baby up and feed
- Spitting up more than usual
- Not passing two to three stools and not having five to six wet nappies a day
Can I breastfeed and use formula milk?
Exclusive breastfeeding is typically recommended for the first six months after birth, followed by continued breastfeeding as complementary foods are introduced, for two years or more, as determined by mother and infant. Giving your baby formula may cause him or her to not want as much breast milk. This will decrease your milk supply.
Although exclusive breastfeeding is ideal, some mothers may feed their babies breast milk and formula at the same time. This might be due to some primary reasons such as: mother’s informed choice, shortage of mother’s milk supply, and nutritional support for your baby as per your baby’s doctor evaluation and decision.
In these cases, your baby’s doctor or a lactation consultant will discuss a plan with you that works best for your family. Powdered infant formula is not sterile. It may contain bacteria that can cause illness in infants. Your nurse will also discuss how to sterilise equipment and how to prepare a feed safely.