Breastfeeding a baby in the NICU? Need help from someone who has successfully nursed a preemie!?
I have my heart set on breastfeeding – I have bought my nursing pads, support pillows, nursing covers (hooter hider – baby au lait), books from la leche league, talked to lactation consultants, etc. and now I’m having to prepare for the fact that my baby may be born 3 months premature. I know you can nurse in the NICU, but will they let you nurse a baby born that early? Will a baby that early even know how to nurse or have the sucking reflex yet? I heard babies get the sucking reflex after 36 weeks usually. If you have a preemie & pump until your baby makes it to when his/her due date would have been, is it possible to get them to nurse after months of feeding tubes and/or bottles?
I haven’t had the baby yet, I’m on bedrest, but I’d like to be prepared so I’ll have my facts together & know what to tell the NICU nurses if I do indeed go into labor within next 2 weeks like they’re preparing me for.
I had twins at 30 weeks. I can tell you the policies at my hospital…. At first they will not let you nurse, but will ask that you pump. They will feed your baby via a gavage tube, on a continuous feed (pumped through an IV-like machine) until sometime between 32-34 weeks, when the sucking reflex kicks in. The bottle will be introduced first, so the nurse can watch the monitors and make sure the baby isn’t having apnic spells or bradycardia. Around this time they will start doing more feeding on-demand, usually with 10-20 ml in a bottle, followed by the rest of the meal in a gavage tube. They have predetermined amounts that they will give a baby at each feed, based on weight and age and tolerance. If the baby tolerates the feeds, they will gradually up the amount fed to the baby, and increase the amt given by bottle. Usually within a few days of the bottles being started, if all goes well, they will let you attempt nursing once a shift (so twice a day). The sucking required on the breast is entirely different than on a bottle, so it’ll take some getting used to. If the baby isn’t tolerating feeds well, this will take more time. They will then gradually increase the number of times you can nurse, until you are allowed to nurse each feed. If you aren’t there at feed time, they will use the bottle. Also, the NICU had a dedicated LC with knowledge geared towards preemies (it’s not the same as nursing a full-termer), so she helped out a lot. Ask if your NICU has a dedicated LC with preemie experience.
My hospital lent out a hospital-grade electric double pump while my kids were in the NICU, and it made life much easier. After both kids were discharged, I used the Ameda Purely Yours, which worked great and I thought was quieter than the Medela Pump-In-Style. You’ll most likely still have to pump after the baby is discharged (depending on age anyways) because you’ll have to fortify the milk with extra calories, and probably add in a multi-vitamin with iron once a day. A good pump is essential.
Of my twins, one had a hard time adapting to the breast, and the other did great on his first try. And of course the one that did really well on the breast actually had serious trouble tolerating food due to reflux, so we didn’t start breastfeeding until closer to 37 weeks.
Hope this info helps!
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