Women's Center
Childbirth
NICU
BREASTFEEDING an Infant in NICU
The many, fascinating health advantages of providing mother's own
milk to her infant are profound and well-researched, especially
for sick or premature infants. Whether you express milk for a few
weeks or breastfeed for months after discharge, your milk provides
your baby with significant benefits; some of which last into later
infancy and childhood. Any amount of breastmilk is valuable and
an important part of your infant's treatment plan in NICU.
Breastmilk is a complete source of nutrition for infants of all
gestational ages. It's natural content of fats and proteins makes
it easier to digest than soy or cow's milk. It also provides resources
to normalize the environment inside your infant's bowel. It even
lines the bowel with a growth factor that helps to mature the bowel
for better digestion.
But it is more than an excellent source of nutrition. It is a powerhouse
of immunity that provides through a complex system of healthy bacterias,
antibodies and living cells to actively fight infection, especially
in the first milk called "colostrum". For example, milk
produced by the mother of a premature infant is different in content
from milk of a mother who delivers a full term infant. The premature
milk is loaded with higher amounts of several ingredients to protect
them against infection until their own bodies can protect themselves.
Often people have been misinformed about breastfeeding a premature
infant. They may believe delivering a premature infant will limit
the mother's ability to make enough milk, but this is not correct.
Stress of delivery or illness surrounding a premature delivery may
cause a slow start with milk production. Often mothers collect just
drops each time they use the breast pump in the first few days after
delivery. Just remember these drops are like a medicine for your
baby because of it's protection against infection. The slow start
in the beginning usually progresses to an adequate supply by the
5th or 6th day after birth.
What type of breast pump should you use?
To help stimulate milk production, it is important to use a hospital
grade, double-electric pump so both breasts can be emptied at the
same time. This type of pump is the most effective in stimulating
release of the milk making hormone, prolactin, which creates the
greatest amount of milk. If you have received a battery-operated
or plan to manually pump, these pumps can be used later after your
baby is discharged. They simply will not provide enough stimulation
to establish and maintain a good milk supply for a mother pumping
for a premature baby. A rental program is available for your needs
after discharge from the hospital from Expressly For You located
on BAPTIST HEALTH Medical Center - Little Rock campus.
How often should you use the breastpump?
Since breastfeeding is a "supply and demand" process,
it is important to begin pumping within the first 8-12 hour after
delivery if possible. In the first week or two after delivery you
need to pump as often as 8-10 times daily, which is as often as
a full term baby would breastfeed in the immediate days after birth.
This is every 2-3 hours while you are awake and once during the
night after midnight. Again, you may not see the results of your
pumping immediately, but your hard work will pay off at the end
of the first week of pumping.
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How long should you pump each time?
In the beginning when you are producing small amounts at each pump
session, the session lasts for 10-15 minutes. Later after your milk
has "come in" abundantly, you should continue pumping
past when the milk stops to flow for 1-2 minutes. The last droplets
of milk contain the highest levels of fat which provides the greatest
calories for your premature baby. Also, by emptying the breast more
completely, the body will receive an important message to make more
milk for the next pump session. If the breasts do not get emptied
completely or often enough, the body begins to produce less milk.
Some mothers say the milk never stops flowing while they pump. Typically,
you should not pump longer than 30 minutes, even if the milk is
still flowing. Also, if you pump this long, you may not need to
pump as often as a mother who can express her breasts in a shorter
time period.
What amount of milk expressed should I expect?
It is a common concern of mothers, who deliver prematurely, to wonder
if they are producing "enough" milk. There are many factors
that can affect the amount of milk produced particularly in the
first few days after delivery. A slower onset of milk production
does not mean that a mother will not make enough milk for her baby.
It simply means it may take a few more days to catch up with mothers
who have had uncomplicated deliveries. The best scenario is to be
pumping 500ml (2 cups =16ounces) of milk each day by the end of
two weeks. This is generally the amount your baby will need each
day at discharge.
How should I store my milk?
You will be pumping milk into bottles or bags provided by the hospital
or NICU. It is important to label your milk with the name, date
and time it was pumped. You can store all the milk from a single
pump session into 1 container but do not add new milk to a previous
collection. You can bring fresh milk directly to the NICU. However,
if it will be days before you visit, please freeze immediately after
it is collected. It can be frozen in a refrigerator for 48 hours.
Once milk has been thawed, it needs to be used within 24 hours.
When can I start nursing a preterm baby?
Infants develop coordination of their sucking-swallowing-breathing
abilities which is required to eat by mouth, when they reach approximately
32-34 weeks gestation. Things you can do to help the baby breastfeed
when it is appropriate is Kangaroo Care or placing the baby skin-to-skin
with you. Next is "non-nutritive sucking" which means
the baby gets a chance to nuzzle/lick on an empty breast 1-2 times
a day. As your baby develops further, you will be allowed to offer
your baby a breastfeeding session. The frequency of these sessions
will gradually increase as your baby becomes stronger.
In NICU we can provide you with comfortable chairs, footstools
and pillows to aid you in positioning the baby at the breast. Typical
positions to begin with are the football and cross-cradle holds.
The nursing staff of NICU can address most concerns you may have
with breastfeeding. However, if a concern arises that poses a special
need, one of the Lactation Consultants can be called to assist you.
We also provide the Mother's Own Milk Club for NICU families each
Tuesday from 1:30-2:30 pm for education and support.
Tips for taking care of yourself while breastfeeding a NICU
baby:
- Pump consistently every 2-3 hours
- Rest as often as possible
- nlist the help of friends, family and neighbors to help with routine
chores
- Drink six 8 oz. glasses of water, juice and milk each day
- Limit caffeine to no more than four 8-12 oz. servings each day (this
includes coffee, tea, chocolate and soft drinks)
- Eat as healthy as you possibly can. Eat a wide variety of fruits,
vegetables and meats. It is important to follow your thirst and
hunger since
- It is generally driven by hormone levels that produce
milk
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