Breastfeeding and the NICU

by Valorie Delp | More from this Blogger

23 Jul 2006 09:00 AM

The NICU (Neo-Natal Intensive Care Unit), is a scary place. There are the tiniest of babies, machines and wires everywhere, and dark lights. The atmosphere is quiet, while nurses and doctors go about the very important business of monitoring little lives.

The NICU is also scary because if you have seen it, it means your baby is inside, likely hooked up to something, perhaps clinging to life. For the most part, babies are in the NICU because they were born prematurely. While there are other reasons babies may land themselves an incubator in the NICU, being premature is the most common.

Interestingly, your body is designed to give your baby milk, even if your baby was born premature. Studies have shown that milk from a mother who gave birth too early is higher in fat content and antibodies. . .providing invaluable calories to promote baby's growth and super immune powers to ward off illness. NICU nurses frequently refer to breast milk as "liquid gold" because of the good it does the baby.

However, breastfeeding a premature infant is difficult and requires a lot of dedication and adjustment of your expectations. If you were not at all aware that you were at risk for preterm labor, you may still be in shock from the delivery not to mention, recovering from a c-section. Regardless, it is important for you to spend as much time as possible talking with your baby, holding your baby (if it's allowed), and caring for your baby. These are all important beginning steps on the road to breastfeeding.

Advice about Pacifiers While in the womb, babies practice sucking. Many mothers (this one included) have seen their infant sucking their thumb on a sonogram screen. It makes sense then, that premature infants need to practice sucking. While the use of pacifiers is commonly discouraged during breastfeeding, the opposite is true for premature infants. They need the practice sucking and so it is acceptable, even preferred to allow them to use a pacifier. Strengthening the preemie's suck, will eventually help the baby to nurse at the breast.

Making Enough Milk Unless you are one of those well endowed women--and by well endowed I mean with milk, not breast size--you will likely not make enough milk toe exclusively breastfeed for awhile, if ever. Don't get discouraged. Any amount of breast milk you are able to give your preemie is far better than none at all.

Your body is designed to produce milk in response to your baby--not a pump. You will produce enough milk when your breasts are efficiently emptied. . .and nature has designed this too. Babies empty breasts much better than pumps do. Many mothers will talk about how they pumped and how they were eventually not able to make enough milk for their baby. Your body also is designed to respond hormonally to your baby. Many mothers of NICU babies note how much more milk they were able to get at the hospital when they were near their baby.

It is important to accept this, try your best and relax. Again, your baby is better off with some of your breast milk than none at all.

Energizer Bunny Pumping Knowing that you will likely not produce enough milk, and that your baby will need some formula, you can establish a decent supply with a hospital grade pump, before your baby comes home.

In order to pump enough milk you must rent or buy a hospital grade pump. Usually, your hospital will have information on where to go to rent one. A store bought pump will not do in the situation, so don't waste your money.

You will also need to pump every 2 hours around the clock. Pumping is more exhausting, because you cannot fall asleep and pump at the same time. If you are absolutely exhausted, plan your pumping so that you are pumping more in the morning and taking a break for 4-5 hours at night. Although this is not likely your baby's pattern, an exhausted mother will produce even less milk so take the rest. Pumping on a schedule like this will help you work with your body's natural rhythms. Most mothers have more milk in the morning (even if the baby thought it was all night buffet) and less milk in the evening.

Get Help If you know you are at risk for pre-term delivery, get the help of an IBCLC. Find a lactation consultant who is experienced in dealing with preemies. When the baby does finally come home, she may be able to help you wean the baby from the bottle completely to the breast.

Even if you are never able to exclusively breastfeed your baby, you are still providing important nutrients, antibodies, and fats for your baby in some quantity. Whatever you are able to do is amazing given the roller coaster ride of the NICU. You should be proud of yourself!

Learn more about Valorie Delp

Hello everybody! My name is Valorie and I am one busy lady! When I'm not writing or editing for families, I am busy trying to get my brood of 5 in line.

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AmyMCGS (834) 25 Jul 2006 10:37 AM

I've gone through this with both of my kids- I had two premature babies- one who was just born in June. The combination of having a sick baby in the hospital, making daily trips to the NICU, and hooking yourself up to a pump (feeling like a cow being milked!) is very stressful. I wasn't ever able to fully breastfeed either of my kids, but I know the breastmilk I gave them in the beginning was very important. Thanks for an article that supports that.

Valorie Delp (49340) 25 Jul 2006 11:37 AM

None of my kids were premature but my last 3 children had to stay in the hospital because of jaundice. (For some reason, the NICU was where they treated jaundice although my kids were HUGE compared to the babies in there.)ONLY because they were not my first children was I able to breastfeed. I think any milk you can give your baby is great and studies show too that it has HUGE benefits that are often long term. So good for you for hanging in there.

lavatea (3371) 17 Aug 2007 10:09 PM

Why wouldn't you be able to produce enough milk once the baby comes home? I thought that your body would respond in response to the baby's demands.

Valorie Delp (49340) 18 Aug 2007 03:55 AM

Preemies are different. Often women are not able to feed them fully once they get home or if they can, they work on it for months and months on end. That's not to say someone shouldn't try. It can work but for a lot of women it's just too much to do on top of caring for a preemie who often has special needs and requirements for care when he gets home. Women that do do it, often have a lot of help.

But there are several key issues. One is that a preemie has been in the hospital and often mom had to wait to even be able to hold that baby. So at a time that is critical in establishing milk supply--she's just been pumping. Pumping, unless you are super special, will never get you to where you need to be to feed an infant. It's just not as effective.

The second issue is the suck. Preemies generally need bottles and pacifiers to learn to suck properly and strengthen their sucking reflex. They really won't be able to breastfeed properly without that. But it does cause nipple confusion which makes it hard to get the baby to latch properly.

But lets assume that the baby doesn't have the latching issues that most do and let's assume that mom has lots of help and the preemie really doesn't have extra special needs. . .it can be done. . .eat lots of food, drink lots of water, nurse on demand, use an SNS. ;-)

Valorie Delp (49340) 18 Aug 2007 03:55 AM

BTW, you're always welcome to PM me or list a question in the forums if I didn't quite answer it here. ;-)

lavatea (3371) 18 Aug 2007 07:39 AM

Ok, thanks. :)