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Feeding your baby in the Neonatal Unit

NICU baby foot NICU

Why is breast milk important?

Expressing breast milk is a really positive way to help your baby to get the best possible start in life. Neonatal staff and midwives will be happy to support you to do this. Breast milk has a number of important extras that are not found in formula milk. These boost your baby’s immune system, aid digestion and help to protect against infection. It also reduces the risk of babies developing a bowel condition called necrotising enterocolitis (NEC) which is usually related to immaturity of their bowel. Even if you had not planned to breastfeed your baby at home, we would encourage you to express breast milk while your baby is on the Neonatal Unit, as it has been shown to be extremely important for sick and premature babies.

Starting to express

Expressing is best begun as soon as possible after the birth of your baby, to get your milk production started (ideally within the first 2 hours). Nurses and midwives can support you to hand express your colostrum, and show you how to use breast pumps. Both expressing and breastfeeding work on a system of supply and demand. The more you express or breastfeed, the more you will produce. It’s really important to express at least 8-12 times (at least every 2 to 3 hours) in 24 hours, including at night, in order to establish your milk supply.

How to encourage milk production

Try to be as relaxed and comfortable as possible when expressing. Photos or videos of your baby, or a blanket with their scent on can help (ask our staff about bonding squares). Skin to skin contact (also called kangaroo care) and time at the breast, will help to boost your milk supply, and the neonatal team can help you with this when your baby is well enough.

Start with a few minutes of massaging the breasts and nipples. At first, hand expression is a good, simple way to start expressing small amounts for your baby. Many parents move on to using our hospital’s electric pumps once their supply starts to increase (however you can start using a breast pump at any point that feels right for you). Double pumping (expressing from both breasts at the same time) can make it quicker and provide important double stimulation which helps supply. Some people find that heat on the breast (i.e. a warm flannel, or a shower) before expressing can help. Early, effective and frequent expression is important in order to build and maintain milk supply while you are separated from your baby.

How much milk to expect

Don’t be worried if you only get small amounts of milk in the first day or two. Every little bit helps your baby, and your body will continue to make more milk if you keep expressing frequently. Frequency of expressing in the first week or two helps to determine your future supply, so it’s important to express at least 2-3 hourly during this time (including at night) and avoid long gaps.

Moving from nasogastric tube feeds to oral feeds

As your baby gets older, they will start to show signs of readiness for feeding by mouth. If you plan to breastfeed, the NHS recommends waiting until around 4-6 weeks after establishing breastfeeding before introducing bottles at home if you wish to. This is because young babies can develop a bottle preference and be less likely to breastfeed. We have the option of offering cup feeds if babies are looking for a feed and the breastfeeding parent is not on the unit. If babies are bottle feeding we ask that you bring in their own bottle so that they can get used to it before discharge.

After you are discharged home

If you are being discharged while your baby is with us, you will need to buy or rent a pump for use at home. Please visit this page for more information.

Further sources of support can be found at:

National Breastfeeding Helpline: 0300 100 0212

www.breastfeedingnetwork.org.uk

La Leche League

Bliss – For babies born premature or sick

Twins and Multiple Birth Association (TAMBA)