Supporting Breastfeeding Moms in the NICU

by: Kathy Mason, RNC-NIC, BSN, IBCLC, Riley Hospital for Children at IU Health

Mothers who are pumping breast milk for a baby in the NICU encounter many barriers and stressors that can affect and cause problems with breast milk production.  Some of these barriers include separation of mother and baby, travel to and from the hospital, mom’s physical issues related to just giving birth, food and accommodations, and possibly the care of other children at home, various financial stressors, and the support mom has from dad and other family members or friends.

It is important for moms who are separated from their babies to start pumping breast milk within two to six hours of delivery if possible. Double pumping with a multi-user or hospital grade pump is recommended. At Riley Hospital for Children at IU Health, moms usually arrive two or three days after delivery. To help them adjust to the demands and stressors associated with providing milk for a baby in the NICU,  a comprehensive team of professionals -- social workers, a financial counselor, and lactation consultants -- work with moms to provide assistance. Riley Hospital’s private NICU rooms allow moms to stay in the baby’s room with the option to sleep and pump there. If moms prefer, they may obtain a room at the nearby Ronald McDonald House.

To effectively establish an adequate milk supply, moms need to pump every two to three hours, or eight to 10 times a day.  This includes pumping at least once in the middle of the night.  Frequent pumping in the first two weeks is necessary to mimic the natural rhythms of a breastfeeding baby, so that even if baby is not able to eat at the time, mom will have adequate milk supply for later.  Some interventions important for new moms are holding their babies skin-to-skin if possible, pumping close to the baby, and using breast massage, breast compressions and hand expression during the process.

Moms with babies in the NICU face many challenges – they are tired and stressed, and they need comprehensive support from a team of experienced professionals. With the appropriate assistance, more and more moms are able to provide milk for their babies in the NICU setting, giving their babies all the advantages that human milk provides. This is especially important for premature and sick infants to obtain the best health outcomes.