Breastfeeding in NICU


PREPARING TO BREASTFEED - HOLDING YOUR BABY SKIN TO SKIN

Holding your baby against your skin helps your baby to feel secure and stimulates your milk supply.

This will prepare you and your baby for breastfeeding.

When your baby is held skin-to-skin you will likely notice them do the following:

»» become more alert
»» suck their lips or fingers
»» move towards your breast.

These are signs that your baby is feeling comfortable and ready to feed. When you think your baby is ready, a nurse can help you to begin.

Offer your baby breastfeeds every time you think your baby is ready.

On some days this may be quite frequent or your baby might cluster feed, where they have lots of small feeds over several hours. This is normal for most babies.

The staff will help you make sure your baby has at least eight feeds every 24 hours.

As your baby starts to breastfeed you will notice them progress through the following stages:

1. nuzzling and licking your nipple

2.moving towards your breast and then falling asleep

3.taking one or two small sucks, then a few sucks and a swallow

4.sucking and swallowing for a couple of minutes and then for longer periods of times

5.looking for breastfeeds at every feed.

Your baby may not feed as well if they have just hada medical examination or blood test. Holding your baby skin-to-skin will help to settle them and make them feel secure. You can offer them a breastfeed when they are ready.

 

What if my baby seems to be more interested in sleeping?

If your baby is still asleep three hours after their last feed:

  • »»  Hold your baby skin-to-skin.

  • »»  Gently stroke their back and head to help wake them.

  • »»  Put some expressed breast milk near your baby’s nose and mouth so they can smell and taste it.

  • »»  If your baby is not awake the nurse will help to tube feed your baby while you continue skin-to-skin contact.


My baby is too sick to feed

When babies are sick or premature it often takes them longer to breastfeed well. It may take weeks. This is very normal. Spend time with your baby and try to go
at their pace. Look for and take pleasure in the small achievements. Feeding should be pleasurable for both you and baby, enjoy the time holding your baby skin-to-skin. Over time your baby will start to feed better.

 

Expressing before feeds

If your breasts are very full, the nurse may advise you to express some milk before you start breastfeeding. See the Unimom Forte Double Hospital Grade Electric Breast pump.

This will help your baby to start feeding without too much milk flowing into their mouth. Over time, as your baby feeds more, the need to express will lessen.

Sometimes your baby will signal to you that they don’t want to feed or they want to stop feeding. If you notice any of these signs from your baby, stop feeding and hold your baby in an upright position on your chest. Signs include:

  • »»  their colour changes or their skin becomes mottled

  • »»  coughing, spluttering or gagging

  • »»  arching or stiffening of their body or spreading their fingers widely apart

  • »»  fussing or crying more than normal.

    Try resting skin-to-skin, and when baby is calm again you can try continuing with the feed. Or you can feed by tube for this feed and try again later. Whatever feels best.

 

Maintaining your milk supply while your baby is learning to breastfeed

The more you feed or express milk, the more milk you have. So if your baby is still learning how to feed, you will need to express milk to keep up your supply.

Continue to express after every feed. Or express at least eight times in 24 hours while your baby is learning to breastfeed.

This will change over time but you may still need to be feeding and then expressing for days, even weeks after you go home.

When your baby has breastfeeds that do not require top ups and that satisfy them for at least one to three hours, you can stop expressing after those feeds.

Support when you go home:

Follow-up breastfeeding support may be helpful for you and your baby. Discuss your options with the NICU staff.

Home consultation information can be found here