Nursing in the NICU

Around 1pm, on a grey, rainy November morning, I was admitted to labor and delivery at 34 weeks with my first child, after being diagnosed with preeclampsia and already having been through a pre-term labor scare at 29 weeks. But this time was different, and after a very difficult 36 hours, my daughter Lucy was born.

She was a large 34-weeker at 7lbs. I had to receive multiple blood transfusions after a massive post-delivery hemorrhage. They rushed Lucy off to the NICU while I was unconscious, so the first food she ever received was a bottle of formula, given by my husband. But by the time she was ready to eat again, I was bound and determined to nurse her.

Lucy under the jaundice lights

Breastfeeding was always incredibly important to me. I had read all the books and taken classes early to make sure I got it. I had no reason to think my pregnancy wouldn’t be typical. So when it wasn’t, I had to figure out how to nurse successfully in the NICU.

Our first roadblock came with her immature suck. Preemies don’t have the suckling reflex that full-term babies have. They are also incredibly sleepy, and keeping them awake long enough to feed them can be a problem.

To combat the sleepiness, we would take her out from her little bed in the NICU, fully undress her and change her

diaper. This would startle her enough to wake her and try to get a good latch. We would sometimes have to tickle her feet or change her diaper midway through to keep her awake.

Another thing that helped tremendously was starting to pump immediately, The more I could pump, the better.  The NICU had a freezer-refrigerator combo where I was able to store extra milk. I think pumping really helped establish my supply when I couldn’t get Lucy to nurse as often as a full-term baby would.

The other benefit of pumping was the ability to supplement breast milk while using an SNS system, or supplemental nursing system. A SNS is basically a little vile connected to a tube that you attach right above your nipple. While baby is at the breast they not only get the milk coming from you, but an extra trickle from the SNS, too.

The SNS is great for babies who are trying to learn to nurse but lack the strength to latch on for long periods of time. If you’re nursing a baby in the NICU and they’re concerned about weight loss, request an SNS to use with pumped milk. This will give added calories while still keeping baby on the breast.

Milk-drunk Lucy at home

Practicing kangaroo care could be a whole other post, but NICU moms know how important it is. Skin-to-skin is best for you and baby. The more time together, the better for milk production and getting your little one better. Spending those valuable minutes snuggled close is also good for the breastfeeding bond.

My final bit of advice is to make sure you’re very firm with your requests. Tell everyone you plan on breastfeeding who will listen to make sure no wires get crossed and you get every opportunity to nurse that you can.

Allison Klaine lives in a little town in Illinois. Her NICU baby will be 5 next month, and her other little guy just turned 3.



One Response to “Nursing in the NICU”

  1. Kenda Wathen says:

    My oldest was born at 34 wks as well. She was a bit smaller than Lucy, weighing in at 5lbs 14 oz. My nurses got me pumping right away and that was a great help. We practiced kangaroo care and got her nursing as soon as possible. She did well and we supplemented with pumped milk as well. She is now a healthy and happy 11 yr old.