Pumping in the Hospital for a NICU Baby

Having your baby admitted to the NICU can be unplanned, and emotional for parents. For breastfeeding moms, a hospital grade breast-pump may become their new, and unwelcome best friend.

Hello new mom, we'll be getting to know each other intimately!

You never imagined that you and your baby would be separated in the hospital, but now here you are, in your postpartum room, with your baby in the neonatal intensive care unit. You're grateful for the specialized care he is receiving, but feeling emotional, worried, and sad that he isn't strong enough to be with you. A nurse rolled a pump into your room and showed you how to use it, and even though you followed her instructions, you only got drops. Or maybe, the only thing you noticed was some moisture in the pump flange. Does this mean you won't make very much milk? NO! Don't let a slow start shake your confidence and faith in this process.

For NICU moms who are pumping, getting only drops in the early days is typical, but it can be very discouraging. Another common phenomenon is getting a few mls from the first pumping session, but then dwindling amounts with subsequent sessions, decreasing to absolutely nothing! We call this "the dry spell." It's nothing to worry about, but sometimes new moms lose their motivation to pump when they aren't collecting anything, especially when their baby is receiving donor human milk in the NICU. It’s helpful to keep in mind a few things. First of all, pumping gets your lactation hormones circulating, and often you can feel this happening as your uterus cramps and you begin to feel sleepy. Pumping is sending important milk-making signals, even if the output is minimal. Secondly, as you do begin to collect small amounts in syringes, know that your colostrum is highly specialized, when compared to donor human milk, or formula. Colostrum is packed with antibodies, and when you've delivered a premature baby, your preterm colostrum is even more specialized to provide exactly what your baby needs. Donor human milk is a wonderful resource, and safe, but it’s been pasteurized, so some of the live components have been killed. (but luckily not all of them) When you've had a premature baby, using donor milk instead of formula reduces your baby's risk of necrotizing enterocolitis, and will get your baby home faster.

If you aren't yet collecting colostrum with your early pumping sessions, try hand expression right after you pump. When done correctly, this can sometimes extract more volume than the pump can! Here's a good video to show you the technique: https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html

When you're able to visit your baby in the NICU, let the nurses know that you would like to put baby to breast as soon as it is possible. Even when your baby has feeding and oxygen tubes, they can try to latch. I've helped many moms breastfeed while baby is receiving oxygen or has an NG tube in their nose. Once a 33 week old baby surprised me by latching and nursing like a champ, just as the mature milk was beginning to arrive. Her mom was very proud!

As a NICU mom, you need a lot of encouragement to pump around the clock as you wait for your volume to increase, so let your support team know to offer some cheerleading! And in the meantime, the benefit your baby gets from the drops of liquid gold colostrum, is unmatched!