Most new parents-to-be create a Birth Plan at some point during the 9 months of pregnancy, which covers the various contingencies, expectations and preferences that they have in mind for the occasion of the child’s birth. A Birth Plan can be helpful in thinking ahead, making sure you include all necessary supplies, and making sure you can communicate effectively with medical staff and be a strong advocate for your comfort throughout the labour and childbirth process.
One challenge for parents of premature babies is that they often have not expected to have this happen – so very few parents have included “premature birth” or what they want to happen in the “NICU” in their Birth Plans. This is probably one of the most important sections in a Birth Plan to complete.
Fortunately, it’s never too late to make a plan. Whether you’re on bed rest (expecting a possible high-risk pregnancy or premature delivery) or your baby has been born preterm and is now in the NICU, take some time with your partner to discuss your preferences and goals for breastfeeding and pumping breastmilk in the NICU. For example:
Tell the NICU Staff You Want to Breastfeed
Even though it may not be possible, if the baby is on a ventilator and unable to suck, make it clear that if or when there is any possibility at all, you would like to feed your preemie directly from your breast. If the baby’s medical caregivers know that you really have a strong desire to breastfeed, they have a clear directive to follow. Don’t assume that the NICU staff will recommend breastfeeding – make it clear that this is what you want to do, and ask to have it included in the daily plans to care for the baby.
Start Pumping As Soon as Possible
The NICU will likely be outfitted with a hospital-grade breastpump like the Medela Symphony double pump. Request a conversation with a lactation consultant or ask to meet other breastfeeding NICU mothers. Get your support network in place early to ensure a more comfortable and successful experience with pumping breastmilk. This is one time that you need to be very firm about your desire to get a breastpumping schedule in place because every single drop of breastmilk you pump with help your baby get stronger. Being a breastpump dependent mom is hard as this article highlights, but there are things you can do to make the process more comfortable.
Get into a Breastmilk Pumping Routine
Try to pump every two to three hours throughout the day and night to establish your milk supply. Give yourself time to get comfortable and relax before pumping – this will help your breasts achieve “let down” to express good quantities of milk. Create a space, as best you can, where you will be able to relax. Take a teddy or blanket or something that you can hold along with a picture of your baby. This will help you to relax and have the best success with your milk flow.
Don’t Forget the Last Drops
Always keep pumping for an extra minute or two, even after the flow of breastmilk has stopped. Why is this important? It ensures that your breasts will be well “drained” and since the cream content of your milk steadily increases, you will capture those last drops of milk, which have the highest concentration of fat calories that are essential for your baby’s developing brain. Human breastmilk is a powerful source of nutrients that a premature baby needs as this article outlines. Being informed is a great asset when you are in this situation.
Stay Calm, Be Patient, and Keep Trying
Pumping breastmilk can be frustrating or uncomfortable at first for new moms, especially when those moms have been dealing with the stress and health challenges of carrying and giving birth to a preterm baby. But don’t give up! Be good to yourself with plenty of rest, a healthy diet, plenty of water, and a comfortable routine. And keep using breastfeeding accessories like lanolin and nipple shields to prevent sore nipples.
Be Ready to Adapt and Improvise
Figure out what works best for you and your baby. Not every mom has the same breastfeeding experience, and this is especially true for mothers of preterm infants. So be prepared to adapt and improvise. If your baby is big enough to latch on to the breast, but has trouble attaching to the nipple, try to use the breastpump in tandem with suckling at the nipple. Or if your breastmilk flow is particularly heavy at the beginning of each feeding time, pump first to reduce the pressure and make it easier for your baby to keep up. Or you can try using bottle-feeding along with breastfeeding. Whatever you do, just be prepared to keep trying new things until you find the right arrangement that works for you and your baby. And don’t feel frustrated or disappointed – this is all part of the journey of breastfeeding, and you’ll probably soon get to a point where things are easier and more comfortable. And remember, you are not alone, the team of healthcare professionals looking after your baby will have lots of tips and tricks for you, and be sure to reach out to a lactation specialist to get the support and information that you need.
Caring for preterm infants presents some special challenges, but with the right planning, focus and diligence, breastfeeding in the NICU is possible. Remember that even though you have a preterm baby, even if you cannot yet put the child to your breast, you are still doing wonderful things for your baby by giving him your breastmilk. Look to the resources around you. Ask for help. Be good to yourself and get plenty of rest and self-care. Other mothers and their families have gone through this same journey and have come out of it stronger, healthier and happier than ever.
Do you have any stories to share of breastfeeding in the NICU? What worked for you and your baby? Leave a comment and let us know, or join us at the Medela Singapore Facebook page.