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Having a baby in the NICU after birth can be a stressful and scary experience, we are here to help you navigate this unexpected chapter. It’s natural for parents to have strong feelings of disappointment and fear about leaving the hospital without their baby. Though your baby might be in the NICU and in the care of medical professionals, there are still some things you can do to ease your mind.
You’ve probably heard that providing breast milk to your baby is important and may be lifesaving. Breast milk has been known to provide your baby with antibodies, immunities, well-balanced nutrition, and gut-friendly bacteria. Breast milk has shown to protect NICU babies from infections, like Necrotizing Enterocolitis (NEC). NEC is a very serious intestinal disease that is prone to premature infants and can be fatal.
It is important to note that pumping and attempting to breastfeed a medically fragile baby can be exhausting. You may feel a lot of pressure to do it perfectly. You may even feel you have failed in some way if you skip pumping sessions or can’t produce a lot of milk.
Have patience with yourself. You are doing everything you can do, and this is hard.
All moms are different, but most will need to pump at least 8 times in 24 hours to bring in a full milk supply. That means pumping about every 3 hours during the day, and at least once in the middle of the night. You want to start pumping as early after birth as possible, though at first, you might want to combine hand expression with pumping, as that can be more effective before you milk “comes in” (at 3-4 days postpartum).
Hospital-grade pumps are the best choice for any mom who is pumping full-time. If your hospital doesn’t provide a hospital-grade pump for you, you may need to consider renting one. Either way, make sure to use a high-quality, double-electric pump. You might consider having a pump at home and in the hospital for convenience.
Hands-free pumping is a must for NICU moms. This way, you can combine pumping with eating a meal or scrolling through your phone (NICU moms need to unwind too!). You can also pump while looking at your baby, and even stroking their foot or hand if NICU staff allows you to do this.
You will easily run out of pump parts, flanges, and storage materials. Make sure you have extra on-hand. Also, make sure to familiarize yourself early on with the sterilization and labeling requirements of the NICU. This way, you can establish cleaning and storage routines. Of course, you may not have anticipated that you would need to know NICU guidelines. If this is the case, here is a document to learn more about pumping in the NICU in a sterile way.
When you are exclusively pumping and separated from your baby frequently, it can be difficult to keep your supply up and let-down easily for the pump. To assist with this, adding in breast massage, breast compression, and hand expression to your pumping routine may help relax you and improve your milk output.
Galactagogues are substances that may help increase milk supply. There are many common herbal galactagogues that have been used to help breastfeeding women for centuries, such as moringa, fenugreek, blessed thistle, and so much more.
Yes, you are the only one with the breasts, but your partner and loved ones can help you in your pumping efforts. Your loved ones can help clean your pump parts (which will be very often!), help prepare your milk for freezer storage, and help with anything else you need. Don’t be afraid to ask and accept help.
Every baby is different, and although there are guidelines about when preemies and NICU babies are “ready” to move to breast, many babies follow their own timetables. It’s also important to understand that preemies and medically fragile babies might not be strong enough to nurse on the breast for quite some time. If this is the case, patience is of the utmost importance.
Even before your baby is permitted to try nursing at the breast, you can do skin-to-skin and kangaroo care. These practices will familiarize your baby with your smell and voice. Most importantly, it will teach them that you are a place of comfort — which will help immensely when your baby tries to latch for the first time. These practices also help maximize your milk supply by increasing both your prolactin and oxytocin levels.
At first, your baby will likely just lick and explore your breasts. Your baby may also start suckling but not yet be able to take in full meals. Let your baby “snack” and comfortably suck. These are the first steps toward full breastfeeding and they are wonderful lessons for you and your baby to share. You will need to keep supplementing with pumped milk until your baby can take complete meals at the breast. Again, try to be patient.
You know your baby best. If you don’t feel that you are getting enough opportunities to do kangaroo care or attempt breastfeeding, advocate for yourself. Ask for a second opinion! Don’t be afraid to ask questions and voice your concerns. This is your baby — your feelings and opinions matter.
Pumping and breastfeeding in the NICU is a journey. Sometimes it can be a long one.
As you move through pumping for your baby, transitioning to breastfeeding, and hopefully breastfeeding full time, be gentle with yourself.
Your journey may not look like another mother’s, and that’s okay.
Every drop of breast milk you are able to provide to your baby counts. Just by putting in the effort means that you are an amazing mother. Don’t forget that.