Breast pumping for a preemie in the NICU can provide babies some amazing benefits that no formula could ever give them even if he or she is too young to use a body ot breastfeed directly.
If your baby was born prematurely and is unable to breastfeed or latch onto a bottle, don’t assume that something has gone wrong with his care. Many premature babies are unable to feed from a nipple due to immature lungs, lack of coordination between sucking and swallowing, or a variety of medical issues that are deemed more important to the health of your baby than learning to feed properly.
Your baby’s inability to feed naturally isn’t your fault. It doesn’t mean that your newborn will never gain the ability to breastfeed. It also doesn’t mean that you can’t give your baby the gift of your nourishing, protecting breast milk. You will just need to depend on a breast pump to make that happen.
The Importance of Breast Milk for Preemies
Premature babies are at high risk for learning disabilities and other limitations that can make their lives more challenging when they get older. A research study released by the University of Edinburgh in 2018 provided scientific proof that preemies nourished with breast milk in the early days of life are more likely to overcome learning and thinking limitations than formula-fed preemies.
The study was based on brain scans of 47 babies born earlier than 33 weeks gestation. Researchers followed the babies until they reached an age equivalent to about 40 weeks. The results showed that feeding the preemies breast milk at least three-quarters of their hospitalized days resulted in the greatest brain connectivity in scans.
- Easy, Comfortable Digestion – Breast milk is made just for your baby’s needs and is easier for your baby to digest than any formula. That means less risk of stomach upset and colic, which can make your baby’s experience in the NICU even more uncomfortable.
- Precise Nourishment – Your breast milk will naturally change as your baby ages. Your body will intuitively offer what your little one needs to grow and develop fully.
- Protection from Illness – Your breast milk includes natural antibodies that protect your baby’s system from many illnesses. That’s invaluable for a preemie who lacks a fully developed immune system and is more likely to get sick than full-term babies.
Mother’s Milk Is Always Best
In a 2013 issue of the journal Pediatric Clinics of North America, a discussion of the benefits of feeding human milk to premature infants noted some differences in milk produced by the mothers of premature babies compared to the milk of mothers delivering at full term:
- Higher concentration of protein
- More bioactive molecules
These differences reveal an advantage of giving preemies not just any breast milk, but preferably milk produced by their own mothers. That milk is perfectly formulated for the needs of a premature baby and will deliver the right concentration of nutrients for your preemie to grow.
Even though there is clear evidence that breast milk gives premature babies an advantage, many doctors and nurses working with preemies prefer to feed formula in the NICU. That’s because babies fed formula tend to gain weight faster than babies receiving breast milk. When breast milk is used, it’s fortified with additional nutrients that can help speed up growth. Formula-fed babies are still often faster when it comes to picking up weight.
The problem here is sacrificing the long-term view for immediate gains. Research has shown that premature babies receiving breast milk in early life have clear neurodevelopmental benefits later in life. One study showed that babies receiving breast milk scored significantly higher on neurodevelopmental tests than babies who received formula in early life. The testing in that study was completed at two and five years of age, and breast milk-fed babies came out ahead at both ages.
The good news is that technology makes it rather easy to deliver breast milk to your baby even if he isn’t ready to breastfeed or latch onto a bottle right away. If your medical team prefers formula, you can discuss the long-term advantages of breast milk in order to advocate for your baby’s best interests.
The final decision should support your baby’s unique needs, so don’t feel like you’re depriving your baby if you end up feeding formula at least for a short period of time. You can still pump your breast milk and create a freezer stash at home if you believe that breastfeeding or delivering your milk to your baby may become an option in the near future. Donating to a breast milk bank is another option if you want to make sure your milk benefits a baby, even if it can’t be your own.
If you’re unable to pump and provide breast milk for your baby, talk to your medical team about donor milk from a breast milk bank. Mothers with an abundance of breast milk often donate to these banks to benefit babies in your situation. While it may not have the special formulation that your breast milk would provide, any breast milk is more valuable to your baby than formula.
Breast Pumping for a Preemie with Feeding Tubes
Many preemies receive their nourishment through a feeding tube at least in the early days of life. Some will receive nourishment through an IV, and others may have an IV and a feeding tube. If your baby needs a feeding tube, you will likely pump your breast milk and then deliver it to the hospital. The milk is reserved for your baby and delivered directly into your baby’s stomach through the tube.
That bypasses the mouth entirely, so your baby doesn’t have to waste energy trying to learn how to suck from a nipple and swallow. Your little one can receive the nourishment from your milk while conserving energy and focusing entirely on breathing and other essential skills.
As your baby gains strength and is able to focus more on feeding, you may have the opportunity to try breastfeeding or feeding through a bottle. That may require a transition period in which you stimulate your baby’s suckling motion without offering actual breast milk. This is known as non-nutritive sucking and involves pumping your breast until it’s empty and then allowing your baby to orally explore your nipple.
The goal of non-nutritive sucking is to help your baby master the sucking and swallowing pattern so that he’s ready to feed when it’s time to make an attempt. Talk to your medical team and handle this according to their recommendations for your baby’s unique needs.
It’s important to have patience with your baby and with hospital staff throughout this process. You may feel saddened that you can’t cuddle your baby at the breast and feed naturally, and that’s normal. Keep in mind that ensuring that your baby’s lungs develop fully and other health problems are resolved is critical to your baby’s health and wellness.
Can You Breastfeed in the NICU?
If your baby is able to breastfeed, then you may have the opportunity to feed your baby at the breast at least some of the time. The majority of premature babies aren’t able to breastfeed, so count yourself among one of the lucky if you’re able to breastfeed in the NICU. You may have rules to follow when positioning your baby at the breast, but this experience gives your baby the skin-to-skin contact that he needs to feel loved and secure in the early days of life.
Many breastfeeding mothers pump and store their milk even if their preemie is able to feed naturally. That ensures that your milk is always available for delivery through a pump if the baby is unable to breastfeed occasionally. You may create your own freezer stash at home or talk to your medical team about keeping some milk available for easy access in the NICU if needed.
How Much Milk Does a Preemie in the NICU Need?
Are you worried that you won’t be able to continuously pump enough breast milk to nourish your developing preemie? That’s a common concern for mothers who are pumping exclusively and delivering their milk to the NICU. Keep in mind that breastfeeding is a supply-and-demand business. As long as you stimulate our breasts enough to send the signals that more milk is needed, your body is likely to continue producing enough milk to satisfy your baby.
The amount of milk needed to sustain your baby each day will be unique, so you should discuss that with your medical team. They should be able to tell you about how many ounces of milk you need to keep your supply of breast milk strong.
In general, premature babies feed about every two to four hours around the clock. A baby weighing 4.5 pounds may need up to 15 ounces of milk each day. The amount of milk delivered to your baby will vary, so talk to your medical team to determine the right amount of milk for your little one. Also keep in mind that your baby may need more milk as he grows.
If your baby isn’t receiving your breast milk at first, you may pump every four or five hours and store it in a freezer. Make sure that you mark each deposit with the date it’s pumped. Once your baby is able to start receiving your milk, you can stimulate the production of more milk by pumping every two or three hours.
If you’re able to breastfeed at times, then you may need to deliver less milk to the NICU. Hopefully, breastfeeding will eventually become the primary feeding method and you will only need a small supply of breast milk at the hospital.
Pumping Tips for Moms of NICU Preemies
It’s time to get down to the fun details. You’re pumping breast milk to ensure your preemie is well-nourished, and it’s challenging at times. Keeping up with an exclusive pumping schedule or even part-time pumping while breastfeeding can take a lot of your time. You’re also caring for a premature baby in the NICU, so you may feel stressed at times. Remember that you’re giving your baby a powerful jumpstart that will pay off for years to come as your baby continues to develop mentally and physically.
Keep the following tips in mind to make your pumping experience less stressful:
- Invest in a good breast pump. It’s tempting to pick up the cheapest one you can find or just order one without much research, but your breasts will thank you for putting in a bit more time to find a good one. The quality of your pump will impact the degree of comfort that you experience, especially if you’re pumping exclusively while your baby is in the NICU.
- Don’t wait to start stimulating our breasts, even if your baby isn’t able to consume our breast milk right away. While your baby receives nourishment through formula or an IV, you can pump and store your milk for later use. Many preemies are eventually able to consume breast milk, especially if it’s fortified to stimulate faster growth. Stimulate your breasts and start expressing milk right after delivery and don’t stop. That will help kickstart a strong supply of milk.
- Don’t neglect self-care while pumping. All new parents are sleep deprived, but that’s often an understatement for parents with babies in the NICU. Getting adequate sleep, feeding yourself properly and managing your stress levels will help you with pumping and breastfeeding. Your body is producing specialized nourishment for a new life during a period of emotional distress. Take care of yourself to keep your supply strong.
The key to breast pumping successfully for a preemie in the NICU is communication. Make sure your medical team knows that you prefer your baby to receive your breast milk as often as possible. That isn’t always possible, but it doesn’t mean that you can’t continue pumping and offering your milk as your baby’s developmental condition changes.
It’s also important to communicate openly with your spouse or partner. They often serve as the biggest advocate and support system for breast pumping mother. Make sure everyone close to you and your baby understands the importance of breast milk for your little one.