Breastfeeding is much, much harder with a premature baby.  This is how you can successfully breastfeed a premature baby during and after NICU.

I am a breastfeeding advocate.  Though I fully understand that it is not for everybody and many moms are giving up on breastfeeding, I believe that the most nutritional food you can give to your baby is breastmilk.

Breastmilk is unique for every mom. It is designed to address the specific needs of the baby, especially for premature babies. Milk coming from premature mothers has a higher amount of nutrients to nourish her baby. It also prevents infection of their underdeveloped digestive system. Since premature babies have not fully received the proper nutrition compared to full-term babies, they need breastmilk the most.

My Birth Story

It was a July morning when I had faint spots on my underwear.  We went to the hospital to check what could possibly be the cause.  My test all looked normal so I was sent home.

After dinner on the same day,  I started to feel heaviness on my back and the cramps were getting stronger.  We rushed back to the hospital where the doctor on duty said I was ready and would be having my baby soon.

Though the idea of finally giving birth was a relief, that was not the right moment.  I was only on my 34th week of gestation.  I was aware of the complications and risk of premature delivery of my unborn child but the pain was unbearable. 

My baby was coming out.

Within an hour since I got into my room, I delivered my precious one.  The moment I held him I knew something went wrong.  I briefly held him in my arms because he was rushed to the NICU.

Breastfeeding in the NICU

As soon as I was able,  I went to the NICU and saw my tiny little baby.  He was just around 4 lbs.  The sight of monitors and tubes was overwhelming.  I cried and asked God to make me strong. I held him.  His body was so delicate.  

Since my baby can’t directly feed on me yet, I pumped my colostrum out. Colostrum is a thick, yellowish milk right after delivery.  It is packed with nutrients and fats that babies can easily digest. 

I got only a few drops but that was enough to feed him.  The nurses lent me the NICU breast pump and gave me vials to store my milk.  

When my energy was restored, my baby and I tried directly latching. Although I breastfed my other 2 sons, I can never be called a breastfeeding expert. Holding my preemie baby, making him open his tiny mouth, expressing my milk even to the littlest drop were challenging.

The lactation nurse was so helpful. She tried to explain everything I needed to know how to breastfeed a premature baby in the NICU.  

Breastfeeding NICU babies is totally different. They have an underdeveloped jaw so they don’t have mastery yet of sucking, they easily get tired and want to sleep more than ever. And because their mouth is so small and depending on the size of mom’s nipples, gagging is not unusual.

Throughout my 2 days in the hospital, I pumped every 2-3 hours, even if nothing much was coming out. Then when I visit the NICU, I would do skin-to-skin for 5 minutes, 10 minutes non-nutritive sucking (practice sucking even when there is no milk to swallow), 5 minutes bottle feeding and another 5 minutes to hold him.  I was not allowed to stay for more than 30 minutes since preemie babies need a lot of resting.

Discharged But the Baby Stayed

Going home without my baby broke my heart.  But there was no stopping.  I had two more boys waiting for me to come home.

I pumped continuously every 2-3 hours for 10 minutes on both sides using my own breast pump.  By the third day after giving birth, I felt my breast become sore and started to produce more milk. I brought home more milk bottles from the hospital and sticker labels to properly identify my milk.

At night, I had my pump kit at my bedside: Coleman with ice packs, milk bottles, breast pump. Pumping religiously meant waking up even in the wee hours of the morning.

Everything I pumped the whole day and night will be brought to the hospital the following day. I put all the bottles in an insulated bag with ice packs, properly labeled, handed them over to the NICU for my baby’s consumption.

My breastfeeding routine was skin-to-skin with my preemie baby, non-nutritive sucking, bottle feeding then holding him until my time was up.

Since my milk was starting to build up, bottle was no longer recommended.  I started using milk storage bags.  

Baby’s Finally Going Home

After 10 days in the NICU, my premature, delicate baby was finally going home.

It was a relief that my baby was home, at the same time scary because we had him just by ourselves.  

Day 10 and he still can’t do direct latching.  Pump then feed.  I bottle fed my freshly pumped milk then store the unused stash since I was producing more than what he needed.  We still practiced non-nutritive sucking twice a day.  Though he was latching, barely felt him suck.  He just slept on it.

Feeding him at night was even more challenging.  I had him by myself at night.  I pumped for 10 minutes, bottle feed (which took forever to finish), store the unused stash for freezing.

After a month of continuously pumping and practice sucking,  my baby started to latch properly. I started to lessen my pumping session and did direct feeding instead.  Inch by inch, we were transitioning from bottle to breast, night feedings were  less exhausting. Sleep became a friend.

I couldn’t be more happy when finally, breastfeeding my premature NICU baby was a success!

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Tips on How to Breastfeed a NICU Baby

Pump as soon as you are able.

A mother’s breast starts to produce milk as early as 16 weeks.  Technically, you are producing milk even if you don’t feel it.  As soon as you are able, express it.  Your body will tell you how much milk your baby needs.

Pump regularly.

Once you started, don’t stop. Pump every 2-3 hours to help you maintain a good milk supply. Give your baby freshly expressed milk then store the unused stash.

Practice non-nutritive sucking.

Practicing non-nutritive breastfeeding in between bottle can strengthen his jaw muscle and prepare your baby for direct latching.

Get a good breast pump.

Ask your insurance if they cover a free breast pump, if not buy something that suits your budget but do not compromise the quality.  You may want to consider some factors when looking for a pump like good fit, quality, frequency and purpose of pump.

Do skin-to-skin or kangaroo care.

Kangaroo care is directly putting your baby on your  bare chest without any clothes except for diapers. It is especially advised for premature babies while they are still in the hospital.  Skin-to skin contact benefits both babies and parents.

Eat well and hydrate yourself.

The best way to take care of your baby is to take care of yourself first.  Eat nutritious food and drink plenty of water.  Breastfeeding your baby will make you extra thirsty so go get that water bottle by your side.

Rest when you can.

You will never understand sleep deprivation until you have a baby so better sleep while you can.  And when you really feel exhausted, try to take quick naps or sleep when the baby sleeps.

Follow the proper storage and milk preparation guidelines. 

Ask for help. 

Find a lactation consultant who will guide you through the process.  Breastfeeding a full term baby is far different from premature ones.  It takes time and patience to get you going.  Ask your husband to give you a hand. After expressing your milk,  let him do bottle feeding.  Remember, this is not your journey alone.

Did I ever think of giving up breastfeeding?  Not a bit.  Yes it was hard. I barely slept at night. It took my energy and patience at times.  But thinking of how my NICU baby will benefit from breastfeeding made me a stronger mom I am today.