Breastfeeding After the NICU

Breastfeeding a premature baby at home, after it has been in the NICU, will often be very similar to how it was in the hospital.  Many parents come home with the expectations that breastfeeding will progress into that of a newborn baby very quickly.  This is not always the case.

It is common in NICUs to send premature babies home a week or two before their original birth date.  A 31-week preterm infant could, in theory, be sent home healthy at around 38 weeks, still 2 weeks early!  Because of this, it is likely that the infant’s breastfeeding habits may not have completely matured to that of a regular newborn baby.

Breastfeeding behaviors for premature babies at home may still include:

  • Falling asleep at the beginning of  a feed.
  • Lack of ability to suck strong enough to draw milk from the nipple for an entire feed.
  • Requiring use of a nipple shield.
  • Waking up hungry at random times, not fitting a set schedule.
  • Longer feeding times, with little or no sucking at random intervals.

Because it will take a few weeks for these behaviors to subside, mothers should expect to breastfeed very similarly to how they did in the NICU.  Eventually, the infant will grow strong enough and progress into more normal newborn breastfeeding routine.

Pumping Breast Milk

Just as mothers pump frequently while their infant is in the NICU, they should continue to pump as well after their baby is home.  This will help keep up, and even increase milk supply as the baby slowly improves his or her feeding behaviors.

Premature babies may lack the energy and strength to completely empty their mother’s breasts of milk, so it is important for mothers to pump and express milk, so as to maintain a strong milk supply.  A good goal for a mother can be completely emptying her breasts three times a day.

In the instance where a mother is producing more milk than her baby is taking…save, store, and freeze that milk!  It will definitely keep the milk supply strong, but also helps a mother build up a reserve of breast milk in case of emergencies.

Moms and dads want a tip on using that extra breast milk stored in the freezer?  When the baby needs a 2 am, 3 am, or 4 am feeding, have dad get up and do a bottle feed with some of that extra milk!  This allows for mom to sleep for an uninterrupted 5 or 6 hours, possibly longer!  Definitely a small sacrifice for dad to make, given the wonderful service mom is doing for the baby by breastfeeding.

Parents who bring home a premature infant from the NICU and plan on breastfeeding at home need to have patience and understanding, much as they did when their baby was in the hospital.  I the baby’s own time, it will grow stronger, and learn to feed as a newborn would.  Enjoy these times, and enjoy caring for a preterm infant that has the gift of going home!

Photo by kwadrat under Creative Commons CC BY 2.0