5 Helpful Tips to Breastfeeding in the NICU

Your birth story is not going as planned but you would like to still breastfeed your newborn. This is definitely a possibility and I would love to help you with this. The NICU comes with its own challenges, but feeding your baby shouldn’t be one. The first thing is to make sure you keep your supply up is by staying hydrated, having a well supported bra, and snacks on hand because pumping is hard work.

Now depending on when your little one made their arrival will change how and when to feed your baby. Always check with your provider and the babies provider before giving breast milk.

A few tips that will help are to:

• Pump at least 5 times per day by day 5

• At least 1 pump between 1am and 5am

• Don’t go more than 5 hours between pumps

• Don’t pump into bags, pump into bottles

When your baby is born earlier in their gestational period, pumping and giving breastmilk is the best way to breastfed. NICU babies don’t usually have the strength to breastfeed on their own yet. When a baby is born between 24 and 28 weeks exclusively pumping is the best way to give breastmilk, but as the gets older (closer to the original due date) a mix of pumping and breastfeeding can be established.

Babies born prematurely do not have the ‘suck, swallow, breathe’ technique that is necessary for breastfeeding affectively, so they have to learn it slowly as breastfeeding gets established. The “suck” is the intake of milk, the “swallow” is the breastmilk going down the esophagus, and the “breathe” is necessary so that the milk does not just stay in the babies mouth and the baby can then take another gulp of milk.

The Le Leche League website has lots of knowledge especially about breastfeeding in the NICU, they have the 5 L’s that have to do with feeding in the different gestational ages that babies are born at. Each L relates to information about how to best provide the needs of the baby. They are as stated:

Love:

• When a baby is born at 26 weeks they need a lot of skin to skin time

• They will try to start sucking, but not ingesting any milk at this time

Lick:

• By the time a baby is at 26-30 weeks of gestation the most a baby will do is lick and snuggle

• They will have short sucking bursts, but mostly sleeping at the breast

• They can/ will have a brief latch, with long rest between sucking bursts

Latch:

• By the time a baby is at 30-34 weeks gestation there will be a brief latch with a few sucks, some swallows

• Mostly sleeping at the breast as this is a lot of energy for these tiny babies

• Often times they will re-latch with short sucking bursts with some swallows

Learn:

• By 34-36 weeks a baby is showing hunger cues and completes short sucking bursts

• They are slowly learning to coordinate the sucking, swallow, breathe cycle

• Still very sleepy at the breast with brief wakeful periods

Leave:

• And finally by 37-weeks and on most babies can stay latched and have coordinated the suck, swallow, breathe cycle

• They are usually mature enough to breastfeed well

Breastfeeding is a journey, and I want you to know that you are not alone, there are many resources I am here to help and if you need more advanced support you can read out to a CLC or an IBCLC.