breastfeeding unwell baby
Louise Broadbridge
Louise Broadbridge

Breastfeeding when your baby is in NICU

If your baby is born early or has a health issue which means they need additional care, they may need to spend time in the neonatal intensive care unit (NICU).

Your baby will need the right kind of nutrition to develop and grow and the team caring for your newborn will do what they can to support you if you want to breastfeed. Make sure the midwifery team caring for you in hospital know your wishes about breastfeeding so they can support you too.

Depending on the reasons your baby is in NICU, they may not be able to breastfeed themselves straight away. However, you can still express your milk and it can then be given to your newborn so they are still benefitting from the nutrients and antibodies in your milk.

How can babies in NICU be given breast milk?

If your baby is not well enough to breastfeed or they are too premature to suckle, there are other ways they can be given your milk. The medical team will be able to advise you on what the best option is for your baby based on what help they need and their health.

Drip feeding

Some babies in NICU will be fed through an intravenous (IV) line, often inserted into their umbilical cord, where their tummy button will be. A thin tube will take nutrition and fluids directly into your baby’s vein so it goes straight into their blood supply.

This method, known as parenteral nutrition, is often used for very premature babies or newborns who need to have surgery. Drip feeding may also be used for babies who are considered to be too ill to have milk or who are having milk but not gaining enough weight. 

Parenteral nutrition is a temporary way of feeding your baby until they are well enough to be given milk. The liquid which will go into your baby’s vein is a special solution containing a careful balance of vitamins, minerals, proteins, fats and carbohydrates.

At first, this is likely to be their only nutrition but if you want to breastfeed your baby, it is still important to express your milk while your baby is being drip fed to build up and maintain your milk supply. Speak to your midwife to get advice on expressing and storing your milk until it is able to be given to your baby.

Tube feeding

If your baby is able to digest milk but cannot yet breastfeed, they may be tube fed. Breastfeeding requires babies to be able to suck, swallow and breathe and it can take time for newborns to learn to co-ordinate these actions with each other.

If your baby is tube fed, your expressed breast milk will be put into a thin soft tube which goes through your baby’s nose or mouth and takes the milk directly to their stomach. This allows them to benefit from your breast milk before they are able to feed themselves.

When will I be able to breastfeed my baby in NICU?

The team looking after your baby will help you to identify when your baby is ready to start breastfeeding. This is likely to be something you do alongside feeding expressed milk at first, while you both get the hang of feeding. 

Staff in the neonatal unit will be able to support you with starting to feed your baby. Don’t be afraid to ask for help and get someone to observe your feeds so they can check technique and position.

Is breast milk the best choice for a baby in NICU?

Whether you breastfeed your baby is a personal choice and no one will pressure you into making a decision you are not comfortable with. However, there are major benefits to giving breast milk to preterm and sick babies even if you do not plan on breastfeeding once they leave NICU.

The first milk your produce, known as colostrum, is packed with nutrients and antibodies which will help your baby fight off infections and build their immunity. Even expressing small amounts of your milk will have enormous benefits for your baby.

Breast milk is easier for babies to digest than formula milk and it will help their guts and digestion system to mature. It also reduces the risk of your baby getting necrotising enterocolitis – a serious condition which can affect newborns and sees tissue in their bowels become inflamed.

When should I start expressing?

Ideally, you should start expressing your milk as soon as you can after your baby is born even if they are not yet able to be given your milk. The hospital should be able to arrange for you to use a hospital-grade breast pump so you can start collecting your milk and building up your supply.

Talk to your midwife or the breastfeeding support team about getting started and aim to express as often as you can – at least eight to 10 times in a 24-hour period. If you are able to express near your baby, you may find it is easier to get the milk to start flowing.

If this isn’t possible, you may find looking at photographs of your baby while expressing helps. At first, you will only produce very small quantities, this is completely normal.

The more you express, the more you will produce. You will find your milk starts to change in colour and consistency after a couple of days and it will become paler and more liquid.

Each hospital will have its own policy on storing expressed milk so speak to the staff there about how you can make sure it is kept safely ready to be given to your baby. If you have been discharged from hospital, you may want to buy, borrow or hire a breast pump you can use at home. You can then bring the milk into the hospital in a cool bag.

What is donor breast milk?

If you are unable to produce breast milk or your supply is very low, the NICU team might suggest using donor breast milk. This is milk which has been donated by breastfeeding mothers to be used by babies who need it.

In the UK, the NHS runs non-profit milk banks and the milk is carefully screened to make sure it is safe. If you want to use donor breast milk, use an official milk bank rather than sourcing it online.

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