A NICU stay can feel daunting, stressful, and discouraging. The post-birth experience you’ve likely envisioned for many months has now rapidly changed to one of machines, monitors, and constant activity. Instead of those first few blissful hours of newborn snuggles, quiet times of getting to know your new little one, and attempting breastfeeding, the picture can look a lot different.  

Not only are you now dealing with the feelings of overwhelm of having your baby in the NICU, but now the idea of breastfeeding you’ve envisioned for months, does not seem possible. You might be asking yourself: Will I ever be able to breastfeed my NICU baby?

Many mamas feel guilt over the inability to immediately breastfeed after birth. They feel as though the initial moments of bonding have been taken from them. It seems this sacred act is taken away, or at least the dream of it has been greatly altered.

But, good news! There is still hope! Here are a few ways you can prepare yourself and your baby for eventual breastfeeding.

First things first…

Breastfeeding in the NICU: Ready or Not?

In the womb, babies practice sucking their fingers, swallowing amniotic fluid, and even readying their bodies to begin breathing once they are born. This happens between 34 and 36 weeks in utero. If your baby was born before this mark, then he might need extra time practicing these new skills. Baby might not be quite ready to take any fluids by mouth, and may temporarily have an oral or nasal tube to administer nutrition and medications. That’s ok! 

The Stats

Most NICUs will have certain criteria for when they might allow your baby to start to eat by mouth. Factors such as a baby’s weight, gestational age, stability of vital signs, and presence of certain reflexes all determine a baby’s readiness. Chat more with your team about what these specifically are for your baby.

Remember, whether your baby is ready to eat is NOT a reflection of you, your abilities as a mama, or anything you did wrong during your pregnancy – it’s simply that your baby might be a little too young to start this complex process of learning to eat!

Even if your baby is not quite ready to eat by mouth, there are lots of things you can do to experience that closeness and help him get used to being near you.

Breastfeeding Activates Your Baby’s Senses

When babies are placed at the breast, their sensory systems are activated in the best way. Your baby has many senses, like touch, sound, taste, or movement experiences. You can create positive sensory experiences that will support your breastfeeding journey, even before they are able to try it.

Skin-to-Skin Holding

Often referred to as “Kangaroo Care,” simply practicing skin-to-skin contact provides a variety of benefits. Oxytocin, also known as the “cuddle hormone,” is released in both baby and mama to promote trust and relaxation, not to mention milk production in mama! Other amazing benefits of skin-to-skin include regulation of heart rate, breathing, temperature, and oxygen levels – all of which need to be stable to attempt breastfeeding.

<<Read also Must-Have Tips for a Smoother Kangaroo Care Experience in the NICU.

Nuzzling at the Breast

Go ahead and have your baby explore your breast!

After you have pumped and emptied your breasts, place your baby’s hands on your breast, allow her to nuzzle close, and smell or taste any milk that might be present. You may notice her searching for your nipple and even starting to suckle. This is a great opportunity to “practice” breastfeeding, without the goal of consuming milk for nutritive purposes.  

Pro Tip: place Baby to your breast at the same time those tube feeds are going. She will experience what it’s like to be positioned at the breast while associating those sensations with a full, satisfied tummy. Even if she’s not consuming your milk, this is a super beneficial sensory opportunity for her.

Remember, the idea is not to necessarily work on breastfeeding technique or “get your baby to eat”– simply to let Baby explore your breast with her hands and mouth, to become familiar with your scent and experience feelings of comfort when being placed close to you.

What Smells So Good?

Place a scented cloth or breast pad that you have previously worn in a safe place in your baby’s crib. This will allow your baby to experience your natural scent and be familiar with the smell of your milk when it comes time to breastfeed. 

Colostrum – That Liquid Gold

Colostrum is the pre-milk substance that is present at birth (and sometimes even before birth). Full of nutrients and antibodies, this fluid provides nourishment to your baby before your milk fully comes in.

Your colostrum can be saved and used for Baby’s first introduction to oral feeds – whether it is a drop on his lips during a procedure to provide comfort, or a drop on your nipple while he is nuzzling. When he is learning to suckle, dipping his pacifier in the colostrum can actually help your baby prepare for a positive breastfeeding experience.

You can find more information about using breast milk drops to comfort your baby in Blooming Littles’ signature NICU course for parents, Born to Bloom.

Preparing You for Breastfeeding Your NICU Baby

Generally, a baby’s assessment or “touch times” occur at the bedside every 3 hours. This is when the nursing staff will perform their assessments, change diapers, and start feedings.

Keeping your own body primed and on your little one’s schedule by pumping every three hours, will help your body be ready to engage in a breastfeeding session when the time arises. If you’re in a season where you’re not feeding her directly, you can start to build up a nice freezer stash of pumped milk for when she comes home or is ready for it.

Struggling with the mental burden of pumping? Here are some must-have tips that will help ease the stress, support improved milk volumes and calm your mind.

Water, water, water!

Staying hydrated throughout the day will ensure you keep up your supply. Some nutritionists recommend consuming upwards of 100 ounces of water per day. While that may be daunting to keep track of, a good rule of thumb is to drink a large glass of water with each pumping session. Or, treat yourself to a cute new tumbler or water bottle that will inspire you to sip from all day long. At the same time, keep plenty of yummy snacks on throughout the day to keep your nutrition needs up for yourself and baby.

Speak Up!

If this sounds easier said than done, you’re right! Most NICU medical professionals agree that “fed is best,” and therefore may not readily offer the opportunity for Mamas to breastfeed. But letting the doctors and nurses know of your desire to eventually breastfeed is important, and most are extremely willing to help you towards this goal when it is appropriate for your child.

Alternatively, ask for a consultation from the lactation consultant and occupational therapist – both of these professionals support you in your goals, and can also advocate for your wishes.

Other NICU Breastfeeding Tips and Tricks

Hooray! Baby is officially ready to breastfeed!

Enlist The Help Of Other Staff 

When Baby is ready for breastfeeding, special members of the NICU team can help coordinate your schedule with those touch times for optimal feeding opportunities. They will offer various ways to position, support, and feed your baby, so both you and baby can comfortably ensure success! It’s also common to need support once your baby is home. Lactation consultants are also available (and many lactation services are covered by insurance) to further support your breastfeeding journey outside of the hospital setting.

Four Hands Are Better Than Two!

Your partner is likely itching for ways to be helpful in your unique situation. Involving your partner is a great way to help you feel like a team when it feels like so much falls on you. Have that person bring you snacks, refill your water, and help position Baby for snuggling and breastfeeding.

Final Thoughts

The NICU team is here to support you and your breastfeeding journey. While it may not be exactly how you pictured it, knowing the specific needs of NICU babies and how they develop is key to keeping an open mind about the process.  Breastfeeding is complex, challenging, and beautiful. Chances are with the right support, patience, and practice, you’ll be able to breastfeed your NICU baby!

References

Jozsa, F. & Thistle, J. (2023). Anatomy, colostrum. National Library of Medicine. Link

Gordon, B. (2022). Nursing your baby: what you eat and drink matters. American Academy of Nutrition and Dietetics. Link

Taylor, K. & Hamilton-Spence, E. (2022). Out of focus: using your neonatal therapy lens to empower breastfeeding. National Association of Neonatal Therapists. Link

Gatlin, R. (2015). Intervention in the NICU: a neurodevelopmental approach. Education Resources, Inc.

McClure, V. (2005). Manual for infant massage instructors. International Association of Infant Massage.