Breastfeeding Nicu Babies

We all know that preemies are the most delicate of our babies. They require extra special care, attention and if at all possible, the best milk on earth. When at all possible, nursing and pumping, just pumping or even the use of donated milk will help get preemies out of the NICUs faster and with good results.

This thread is designed strickly to focus on breastfeeding NICU babies and the challenges and issues this particular situation creates. We hope this encourages you and gives you both the comfort and support you need during this challenging time.

Topics:
The Benefits of Breastmilk to Preemies
Nursing *in* the NICU; the joys of the public.
Be your childrens advocate
Be Informed

This thread will be maintained as a sticky in the BF'ing forum and will be edited and modified by TS moderators for organization, so if your response/post to it gets edited/moved, etc. that's why. But please do add and share your thoughts!

 

The benefits of breastmilk to preemies

The following is an article on the Benefits of breastfeeding preemies. It covers getting start -- "pump early, pump often", the benefits themselves, the logistics, and a story about preemie twins from a mom that knows!

One quote that I found really important:
"With early deliveries, Mother Nature also miraculously alters the properties of premature breastmilk to fortify a baby with more demanding nutritional needs. “Mom's body produces colostrum and milk with different nutritional content than the milk of a mother who carries full term,” Buerger says. “It is higher in protein, sodium, iron and chloride and pre-term milk also has more antibodies than mothers of full term babies."

 

Nursing *in* the NICU; the joys of the public
The same article as above... Benefits to preemies... has info on the logistics of nursing in a NICU.

A few notes from an experienced mom...

• You can go as often as you like unless 1) they are changing shifts or doing rounds 2) they have an emergency that must be tended to and you will be in the way. The babies ALWAYS get priority from the staff, even if you don't.
• The NICU schedule works for them, but not always for the babies. My one twin was *fine* on a 3 hour then 4 hour schedule; my other one thrived only when fed on demand. I had to specifically request that the NICU feed her on demand due to this reason.
• Preten privacy screens are brick walls. Mentally, just let them be your walls -- especially if you are a very private person or public displays of anything are difficult for you. Know that you are giving your baby everything you've got and by pretending, you'll feel enclosed.
• Ask for more than one screen! We can only pretend so much! I often had 3 screen completely enclosing me.
• Practice nursing. Call it "practice nursing". Preemies often take longer to "get it" and then have to grow in order to even suck effectively. If you think of it as practice, you might not get as down on yourself if it doesn't go well.
• Let the nurses help! They are there to take care of your babies, so let them help! If you need a cup of water; a blanket; a new diaper; help latching; more pillows for support; whatever... ask!
• Since the babies are in the NICU and you are at the hospital, get an LC to come by at LEAST once a day. This was a tremendous reassurance for me. I got to see one nearly every day of a 19 day stay!
• Pump after each feeding. Stimulate your body to produce and bring that milk for nighttime feeds.
• Don't go in the middle of the night. Give yourself a break. It's stressful enough doing back and forth during the day, being kicked out during shift changes, and still healing from delivery. The staff *will* take the best care of your babies and give you time to sleep.
• Do go around 10/11 pm if you can... when the NICU is darkened, the babies are sleeping and the staff isn't as busy. You can get some of the most amazing cuddle time then. Most others won't be there either.

 

Be your children's advocate!

Many NICUs, although they do sometimes know how important BM is to preemies, will hold off on BF until babies are really doing well and are about to go home. Their reasoning is often that the goal is to get the baby feeding and growing and to send him home, and that bf will come later.

Unfortunately, many times mother and baby haven't gotten to practice breastfeeding enough to know if there are any problems, so they get sent home before they get a chance to ask for help. Also, many times bf is delayed because the staff is uninformed as to your wishes or to the real benefits of getting the baby BF, if mom wants to do it. Some things you can do to help the process of bf begin and be successful are as follows:

• You have the right to ask to BF your baby, and you have the right to receive an explanation if the request is refused. If you want a second opinion, you have that right too. Many doctors don't realize how important it is for both baby and mother to begin bf as soon as possible, and will not offer or ask if you are interested, so you may have to be perstistent to be heard.
  
• If you truly believe your baby is ready, many neonatologists will let you at least attempt to BF. They often won't suggest it if you don't ask.
  
• Even if your baby doesn't latch on well and/or take a full nursing, s/he is still getting the benefits of being close to you, smelling your breast and the milk, and learning to associate your smell and touch with comfort and nourishment. It is fine if he can't get milk well or at all, but every time he practices he has a chance to learn and so does mom. Her milk supply may be stimulated too, so it is definitely worth the time and effort.
  
• Many babies don't "get" BF completely until after their due dates, so if your baby struggles with BF it doesn't mean he will never be able to. Try not to get discouraged, and remember, they weren't supposed to know how to nurse yet if they were early, so it will take some patience and time to get it all figured out.
  
• If you aren't sure about BF or are feeling discouraged, ask people you trust for help, and read success stories of those who started out in NICU. Instead of deciding you will BF until 1 (or whatever date you had picked to BF until), take it a week, day, (or feeding) at a time. Set small goals so you won't feel so overwhelmed, and ask for help if you need it. We are here if you need us, too!
  
• If you have any issues at all with the babies nursing, and even if you don't, make sure the hospital LC sees you nurse and gives you any help you need before you go home and are more on your own. This is your chance to ask questions, get help, and you can get feedback on how things are going.
  
• Ask lots of questions, and don't feel as if you are bothering busy people. They are there for your baby, and you are your baby's advocate. They do answer to you as the parent, so you have the right to ask questions and report any behavior you think not acting in your baby's best interests.
  
• Remember you are not alone, and it definitely is possible to bf babies born early or sick. They are the ones who need breastmilk the most, and there is help if you need it!

 

My girls were born at 34 1/2 weeks. I asked for a breast pump the minute I got back from my C-Section. They were both in the NICU at that time. One of mine came to my room the next night and she would nurse and then I would double pump for 20 minutes. I would walk my BM down to the NICU proudly whether it was three drops or an ounce. I was lucky in that the nurse who had my girl most nights she was there was a HUGE advocate of breastfeeding. They wouldn't let me BF her (she had an NG tube) because they were concerned that she would burn more calories than she ate (she was 4 pounds). After 7 days with the NG and not taking bottles, they let me BF her ... the nurse said that she talked them into it because she had let me BF her early on (before she had rejected bottles, I tried once to BF her and she latched great) and thought that she would like "Mommy" better than the bottle. Turns out, this was the case. She BFed great and they would weigh her before and after feeds to make sure she ate enough ... within 2 days she was home. She still won't take a bottle ... at 5 1/2 months old. The NICU where we are had curtains you could pull for privacy. For me, breastfeeding/pumping for Meredith was very stress relieving. I hated that she was there and every time I had to leave her I would cry. Giving her breastmilk and love was the ONLY thing I felt I could do for her. When other people are taking care of your newborn baby, it helps to know that there is something you can do.

I think the best advice is to be informed. I took a class on BFing. Also, be proactive ... such as taking a pump with you or getting one to borrow from the hospital. Be prepared to have some bumps in the road with latching (really hard with preemies with teeny mouths) and other issues. Have the phone # of the lactation consultants at your hospital on your fridge when you get home. You never know when problems may arise and they are greatly helpful and very supportive. Know that it does get easier and you will find your rhythm. When I think about weaning my girls it makes me want to cry. I know I did the right thing by breastfeeding ... as hard as it was with one in the hospital and one at home ... and one that didn't get to BF until a week after birth. It is the only thing that ONLY YOU can do for your babies.

 

What are the visitiation hours for everyone else..family friends..do grandparents get the 24 hr visitation or just parents

 

QUOTE(troublewitangels @ Feb 7 2008, 12:43 PM) [snapback]611260[/snapback]
What are the visitiation hours for everyone else..family friends..do grandparents get the 24 hr visitation or just parents


Visitation hours at my NICU were 24 hours a day -- except for 7-7:30 (both am and pm) when it was shift change for the nurses. Other visitors had to be escorted by a parent OR had to have prior parent authorization on file.

 

QUOTE(poppan @ Mar 4 2008, 08:57 PM) [snapback]653075[/snapback]
Visitation hours at my NICU were 24 hours a day -- except for 7-7:30 (both am and pm) when it was shift change for the nurses. Other visitors had to be escorted by a parent OR had to have prior parent authorization on file.



same at the hospital where I was ... and only parents and grandparents could visit alone. Any other visitor had to be with either a parent or grandparent.

 

I bf my premie twins. It made me feel like I was their mom since the nurses were caring for them. I really miss the wonder loving feeling that comes with bf. It was hard work but worth it all.

 

I'm not sure I"m in the right place but here's my question
First off I'm 34 1/2 wks expecting twin frat girls, have successful 15 mos history of nursing my son who is now 4.

My experience with him was that the moment he made it into the nursery they wanted to formula feed him and they did although we asked them not to. I felt they went looking for reasons, that I was on an anti-depressant that i had researched very well and then that he was "really hungry". LUCKILY with a lactation consultant on Staff (my current rural hospital does not have) the next day he latched on and the rest was history.

1) My concerns with what may be pre term babies is that this nursery will pull some of the same BS the other one did. What if they tell me that one of the babies has low blood sugar? Is that reason enough to give that baby formula?


2) If I C-Section but pump immediately afterward (which I've already checked on pumps and know exactly where to go) can the babies wait for the collustrum and for how long?? I know they don't need much but I know there will be arguments about how long they can go without being fed especially if pre term.


I was recommended the Symphony pump for a rental because I was having twins, is this make/model for twins?

Thanks, I know it's alot but I have so many questions and the last thing I want is that argument with a PEDS nurse at 3 am after a 12 hour labor, you know?

 

How did you manage BF one at home and one in NICU?