Breastfeeding a NICU baby?

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Joined: 06/24/12
Posts: 252
Breastfeeding a NICU baby?

My daughter Tessa was born at 34w6d and is currently in the NICU. Tomorrow I will be five days post partum and we are attempting our very first actual breastfeeding session. At the moment, I am getting about an ounce a breast at each pumping session. My daughter loves the pacifier and seems to like the elongated nipple. She has played around my nipple and had a few quick on/off latches. My husband had a wonderful idea to pump for five minutes, and get my nipple swollen and thicker/longer before than trying to get my daughter to latch. Does that seem like a good idea? Any other helpful hints to elongate my nipple? I want the nipple shield to be the last option. Do any other mommas have any tips when it comes to breastfeeding a NICU baby, and building up a supply while your child is hospitalized? Thanks so much in advance, ladies!

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6697


I pumped while my daughter was in the NICU then focused on breast feeding once she got home. To me, it was more important that she gained enough weight to get out of the NICU than it was to actually breast feed. All three of my girls are preemies. With my oldest, nursing did not work right away. She was just too small to suck. She lapped from a small cup. She did not gain weight this way though and in order to not have her be re-hospitalized we gave her a bottle and I pumped full time. I did not know at the time that a baby can learn to nurse later on. With my second, she also did not nurse right away and I pumped full time. Then one night at two months old I was too lazy to get up and make a bottle. I offered her my nipple just to buy myself a few minutes. She took right too it. She never looked back and went on to nursing until she was one year old. With my third (Only one who went to the NICU), I did not stress about nursing right away because I knew we could work on it later. She did nurse after awhile, but only with a shield until I got an infection that depleted my supply.

I do not consider myself an expert on nursing by any means. Preemie or not, pumping and nursing are pretty much the same. Go ahead and ask on a more active board like your birth board the breast feeding board. As for nursing in the NICU, go ahead and try, but even if you can't, it does not mean that you will never be able to nurse. Just make sure you keep up your supply buy pumping regularly. They should be able to give the pumped breast milk to your baby in a bottle.

Joined: 10/05/09
Posts: 672

My son was born at 36w3d and was in the NICU for 4 days, then in a room with me for another 3 days. He was really sleepy and would not latch on at all. I usually tried to breastfeed him every 3 hours for about 5-10 minutes (unsuccessfully) and then fed him pumped milk from a bottle, then pumped for 45min for the next feed and to build my supply. By the evening of day 5 my milk came in with a vengeance just from the pumping alone. One nurse had told me to go easy on the pumping (20 min every 3 hrs) so that I don't end up with an oversupply problem. I had a TON of milk for about the first 2 months, so no problems there.

Once my son was about 3 weeks old I made a serious effort to get him on the boob. In our case that involved a nipple shield, as suggested by the lactation consultant. After a few attempts he took to the nipple shield. I made sure to pump for a minute first to get a letdown, then let the shield fill up with milk, then put baby on, and then squeeze the breast as he sucked to make sure enough was coming out. There was not enough stimulation from the sucking alone to keep the milk coming fast enough.

After about a week of nursing with shield, I would let him latch on with the shield and then pull it off after the initial letdown and let him latch right back on. After a few days that worked well and he was fully on the boob. About another week later I worked on letting him latch on without the shield and it worked.

I'm not gonna lie, it was a lot of work and very frustrating, but it was so worth it. My son is now 9 month old and still nursing happily. We never had the perfect breastfeeding relationship - he always preferred the bottle and if I gave him too many, would go on nursing strikes. But it's been alright.

I think your idea of pumping first to get your nipple in a more paci-like shape is good, but I would only pump very briefly so you don't remove too much of the milk from your breast. 5 Minutes seems too long. I would do no more than a minute. Otherwise your baby will suck and nothing/little will come out, and she may lose interest. Also, I would buy bottles that have "breastfeedin friendly" nipples. They have a wide base, and a short, soft nipple to mimick the breast. And I would use the slow flow only. We use Playtex Drop-ins with the NaturaLatch nipples and they work great. I would also switch to a different paci. We use the NUK orthodontic ones because they are soft, unlike the pacis we first got in the hospital which were elongated and quite firm like you are describing.

Another thing I always did was holding baby in a breastfeeding position while giving the bottle, right beside the breast, for every feeding. I would then pull out the bottle nipple and try to quickly slip my nipple in there. Baby would often latch on for a couple seconds and then look for the bottle nipple. But it's a good way to get them used to the breast.

Good luck - it's hard but totally worth the effort!

batbird's picture
Joined: 08/29/06
Posts: 325

We latched a few times in NICU, but like others, I was more focused on him growing instead of getting the breastfeeding down. I was perfectly content to use the pump. When we got home we used the pump. I had an over supply of milk, so I would always pump the opposite breast to help him get let down quicker without having to work as hard, burning crutical callories. We referred to the pump as his electric twin Wink