NICU — four letters no one wants to think about when they’re pregnant or about to give birth. But as much as ignorance is bliss, what actually helps us when things veer off course is being prepared and informed about our options. And that’s especially true if you want to breastfeed your NICU baby.

Breastfeeding and keeping your milk supply up when your little one is in the neonatal intensive care unit can be stressful. You are dealing with your baby’s special needs right now; and though studies show that premature babies need breast milk even more than full-term babies, NICUs in America are often not set up to support early breastfeeding. But with a good support system and a little know-how, you can push through these obstacles and initiate a healthy, successful nursing relationship while your newborn is still at the hospital.

Here are 8 tips to help you nurse your baby in the NICU and get you both on the road to a beautiful breastfeeding journey.

1. Extend your birth plan to your postpartum wishes. Everyone talks about the “birth plan”– or what we, at Birth Day Presence, like to call your “birth preferences.” While you’re thinking about your birth preferences, it’s wise to make an “in case of NICU” plan or requests, with a specific focus on breastfeeding. Mention the fact that you want to breastfeed, do skin-to-skin as much as possible, and do everything you need to keep your milk supply up.

2. Find out ahead of time how the NICU at your hospital works. If your baby ends up in the NICU, can you stay with him or her? For how long? Do they have International Board Certified Lactation Consultants on staff to help NICU babies breastfeed and to help new moms express breast milk for the babies who can’t nurse yet? Can you sleep next to your baby overnight? (Note that, unlike Swedish NICUS, a lot of the facilities in America can’t accommodate parents overnight because of lack of space or insurance issues. But it’s worth asking ahead of time).

3. Begin breastfeeding as soon as you can. Most progressive NICUs will prioritize breast milk and breastfeeding. But there’s still the misconception that premature and other babies in intensive care can’t breastfeed. But it’s really not the case. So read on the topic and be prepared to advocate for yourself and your baby.

4. Consider hiring your own Lactation Consultant. To effectively breastfeed a preemie or any baby with special needs, you might need support with latch, flow, and more. If the hospital doesn’t offer someone who can really sit with you and help you nurse your baby who might be connected to wires and other medical support, hiring a private consultant can make a big difference.

5. Start expressing your milk as soon as possible. If you can’t breastfeed yet but baby can take your milk, give him or her colostrum and then breast milk as it matures. That said, not all babies are able to feed by mouth while in the NICU. Some will need sustenance through an IV or feeding tube. So begin expressing colostrum by hand or breast pump as soon as possible. This will let you body know that it needs to make breast milk. You’ll need to express milk as often as your baby would breastfeed (about 8-12 times in every 24-hour period) in order to create and keep up your milk supply. You can ask the hospital for a double-electric pump, which is the most effective, and lactation consultants can provide support and guidance in doing this.

6. If possible, stay in the NICU near your baby. Bring in a lounge chair or a cot if you have to! If it is possible to stay with your baby, do. If this simply is not possible, consider staying in a hotel right next to the hospital so that you can come in easily to nurse or hold or touch or talk to your baby.

7. Give your baby as much skin-to-skin time as possible. It will do wonders for you and your baby. To learn more, check out Mary Esther Malloy’s interview with Nino Birth’s amazing founders Dr. Nils Bergman and Jill Bergman here. There are many carriers out there that make this easy and possible, like The Nesting Days or Vija Skin-to-Skin Shirt. If for some medical reason you are truly unable to hold your baby, ask if you can at least touch and talk to him or her.

8. Learn more about Donor Breast Milk. If you cannot produce breast milk, there are many wonderful resources to still provide your little one with the best nutrients possible. Donor breast milk is a great alternative to consider.

9. Persist, even when you get home. If breastfeeding in the NICU just wasn’t possible, do skin-to-skin with your baby as much as possible, every day. Just relax together at home and let your baby freely suck or lick your nipples. Even if the baby doesn’t latch, skin-to-skin can really help, and it is still possible to start breastfeeding at this stage. Again, a breastfeeding professional can help.

We all hope our babies don’t end up in the NICU. But if yours does, you don’t have to be sidelined. Whether it’s love, skin-to-skin contact, breast milk, or any combination of those, what you have to offer will crucially complement the doctor’s care as your baby gets strong and stable enough to come home. If breastfeeding in the NICU proves impossible, know that no matter how your baby feeds, the love and care you and your team provide is the most important thing.

Original photography by JADA SHAPIRO, BIRTH DAY PRESENCE.

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