Baby in the NICU

Giving your baby breast milk is one thing you can do to make sure your baby has the best start possible.

NICU baby with tubes holding parent's finger.

For babies in the NICU, breast milk is more than just a food – it’s a proven medicine. Feeding breast milk to a premature baby reduces the incidence and/or severity of many prematurity-related illnesses. Did you know that three major illnesses can also be reduced or prevented by giving your baby breast milk?

Breast milk helps reduce:

NEC
By up to 3.5 times
compared to infants fed any formula1
Late onset sepsis
By up to 19%
for every additional 10ml/kg/day2
BPD
By up to 9%
for every additional 10% increase in OMM3
Click to find out more about these illnesses.

NEC
Necrotizing Enterocolitis is a serious illness that mostly affects premature newborns.  The intestine or colon in the baby becomes inflamed and it damages the tissue in your baby’s digestive tract.  It can cause tissue death and/or even a hole in the intestine. For some infants the NEC is mild but for others it is severe or even life threatening. 

Late Onset Sepsis
This is a blood infection that occurs after about 3 days of life.  The infection causes different complications like temperature instability, low heart rate and breathing rates, apnea, increased oxygen requirements, feeding intolerance and lethargy.

BPD
Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that affects mostly premature babies and may require ventilator assistance. This disease damages lung tissue, which can cause chronic respiratory issues or may get better over time.

Proven Breast Milk Benefits

The benefits of breast milk last much longer than your baby’s hospital stay – in fact, these benefits last a lifetime.  What are some the things breast milk does for baby:

  • Improved Neurological Development³

  • Increased Life Expectancy⁴

  • Lower Lifetime Healthcare Costs⁵

Improved Neurological Development³

Increased Life Expectancy⁴

Lower Lifetime Healthcare Costs⁵

Providing Breast Milk Has a Learning Curve – Help is Available!

The first hours and days after birth are critical for ample breast milk supply throughout a parent’s breastfeeding journey. In fact, the milk production process can be described as a continuum of 4 distinct stages. 

Click on the titles for more information. 

The first hours and days after birth are critical for ample breast milk supply throughout a parent’s breastfeeding journey. In fact, the milk production process can be described as a continuum of 4 distinct stages. 

Click on the titles for more information. 

The development of breast tissue in preparation for breastfeeding, which occurs primarily during pregnancy when milk-producing cells begin to form.⁶

After birth, the nipple is stimulated by the newborn sucking and the cells developed during pregnancy are gradually “switched on”. This, along with hormonal changes in the mother after delivery, leads to secretory activation (i.e. milk “coming in”) about 2 – 4 days later.⁶

Post-secretory activation (after the milk starts to “come in”) is when milk production starts to increase. Frequent breastfeeding over the first month builds strong milk supply to meet the infant’s ongoing and long-term needs.⁷

By the end of the first month, a full milk supply is usually established, with term infants removing the same volume over 24 hours as they will do at 6 months.⁸,

The development of breast tissue in preparation for breastfeeding, which occurs primarily during pregnancy when milk-producing cells begin to form.⁶

After birth, the nipple is stimulated by the newborn sucking and the cells developed during pregnancy are gradually “switched on”. This, along with hormonal changes in the mother after delivery, leads to secretory activation (i.e. milk “coming in”) about 2 – 4 days later.⁶

Post-secretory activation (after the milk starts to “come in”) is when milk production starts to increase. Frequent breastfeeding over the first month builds strong milk supply to meet the infant’s ongoing and long-term needs.⁷

By the end of the first month, a full milk supply is usually established, with term infants removing the same volume over 24 hours as they will do at 6 months.⁸,

The “Initiate…Build…Maintain” stages are all interrelated, so it’s important to have a strong start. The Initiate stage between birth and milk coming in is most critical for future milk production because that is where you are charging your breast milk ducts for future use.

When you can’t put baby to breast or if breastfeeding is interrupted, stimulating the breast by pumping within the first hour after birth can lead to significantly increased milk production later.¹¹

Pumping replaces or supplements breastfeeding if the baby cannot remove milk effectively and/or is unable to nurse during the Build and Maintain phases.

That’s why, for pump-dependent mothers, a hospital-grade (multi-user) breast pump with Initiation Technology™ is recommended to Initiate, Build, and Maintain your milk supply. Ask any of your baby’s healthcare team how to access a hospital-grade (multi-user) breast pump with Initiation Technology in your area. 

The “Initiate…Build…Maintain” stages are all interrelated, so it’s important to have a strong start. The Initiate stage between birth and milk coming in is most critical for future milk production because that is where you are charging your breast milk ducts for future use.

When you can’t put baby to breast or if breastfeeding is interrupted, stimulating the breast by pumping within the first hour after birth can lead to significantly increased milk production later.¹¹

Pumping replaces or supplements breastfeeding if the baby cannot remove milk effectively and/or is unable to nurse during the Build and Maintain phases.

That’s why, for pump-dependent mothers, a hospital-grade (multi-user) breast pump with Initiation Technology™ is recommended to Initiate, Build, and Maintain your milk supply. Ask any of your baby’s healthcare team how to access a hospital-grade (multi-user) breast pump with Initiation Technology in your area. 

Getting Started – Pumping

It’s important to understand how to use your pump. Visit Symphony PLUS® Breast Pump Support | Medela for helpful videos on how to use the Symphony PLUS Breast Pump. 

Don’t expect to get a full container of milk the first few times you pump. It can take several days before your milk comes in completely. Be patient and keep to the number of pumping sessions your healthcare team has recommended. Use this helpful and printable pumping log to keep your healthcare team up-to-date on your progress. Keep in mind that stress, discomfort, and fatigue can cause a slow start to milk production.

Additional Pumping Tips:
  • Start pumping as soon as possible after giving birth.
  • During your first pumping sessions, you will only see a few drops of milk.
    • This is called colostrum.
  • Use your breast pump at least 8 to 10 times per day.
    • This will build a long-lasting milk supply.
  • Pump for at least 15 minutes per session.
  • Over the next several days, the amount of milk will increase over time.
  • Pumping while your baby is in the NICU takes dedication. Don’t give up.
  • Contact your Lactation Consultant, or talk to your baby’s healthcare team at the first signs of problems or concerns.
Helpful Breast Milk Feeding Questions to Ask Your Healthcare Provider
Additional Helpful Questions to Ask Your Healthcare Provider
  • Why is my baby in the NICU?
  • What are your procedures for taking care of my baby?
  • Who can visit my baby?
  • What are the visiting hours?
  • Who will be taking care of my baby?
  • What tests are being performed on my baby?
  • What is the diagnosis and please explain in words that
    • I can understand?
  • What type of support is there for my family?
  • Is there housing available so that I can be close
    • to my baby?
  • What can I do to help take care of my baby?
  • When will I be able to hold or touch my baby?
  • When will my baby be ready to go home?
  • What type of financial assistance is available?
Additional Resources

 ►  March of Dimes | Healthy Moms. Strong Babies.
 ►  PROVIDE - LactaHub
 ►  Let's Talk about Breastfeeding - Video

 ►  March of Dimes | Healthy Moms. Strong Babies.
 ►  PROVIDE - LactaHub
 ►  Let's Talk about Breastfeeding - Video


References
  1. Johnson TJ et al. Neonatology. 2015; 107(4):271-276.
  2. Patel AL et al. J Perinatol. 2013; 33(7):514–519
  3. Patel AL et al. Arch Dis Child Fetal Neonatol Ed. 2017; 102 (3):F256-F261.
  4. Vohr BR et al. Pediatrics. 2006; 118(1):e115-e123.
  5. Mahon J et al. Health Econ Rev. 2016; 6(1):54.
  6. Rollins NC et al. The Lancet. 2016; 387:491–504. 1
  7. Pang WW, Hartmann PE. J Mammary Gland Biol Neoplasia. 2007; 12(4):211–221.
  8. Kent JC et al. J Obstet Gynecol Neonatal Nurs. 2012; 41(1):114–121.
  9. Kent JC et al. Pediatrics. 2006; 117(3):e387-95.
  10. Kent JC et al. Breastfeed Med. 2013; 8(4):401–407
  11. Parker LA et al. J Perinatol. 2012; 32(3):205–209