Breastfeeding a NICU Baby: An IBCLC Guide to Pumping, Storing, and Feeding

Navigating baby feeding after delivery is an overwhelming experience. But navigating baby feeding while your baby is in the NICU can feel almost impossible. You may be feeling scared and exhausted, but if feeding your baby with breast milk is something you want to do, it’s possible with the help of some experts.In today’s blog post, lactation experts from SimpliFed offer some practical tips on establishing and maintaining a milk supply while navigating a NICU environment. 

The Importance of Breastfeeding for NICU Babies

Breast milk has many benefits, especially if your baby is in the NICU. Breast milk contains growth hormones and nutrients specific to your baby's needs. Breastfed babies have a lower risk of asthma, obesity, type 1 diabetes, and sudden infant death syndrome (SIDS). Breastfed babies are also less likely to have ear infections and stomach bugs. Most importantly for preterm babies, breast milk can reduce the risk of necrotizing enterocolitis (NEC), a life-threatening bacterial infection. 

Establishing Breast Milk Supply and Pumping in the NICU

• Reduce stress
• Promote healthy weight gain
• Help to reduce the chance of developing postnatal depression 

And so much more!

Try to avoid separation as much as you can.  Talk to the hospital staff about staying or visiting as much as possible. Be your advocate and speak up for what you need. 

If bringing your baby to the breast isn’t possible, start to pump as soon as possible after delivery. Start by hand expressing. You can massage your breasts or try different motions to start milk flow. Position your thumb above the nipple and your fingers below the nipple about 1 to 2 inches behind. Press your fingers and thumb back toward your chest while compressing your fingers and thumb together. Release and repeat. 



Once your milk has come in you should start pumping frequently to support your supply. Breast pumps mimic the mechanics of breastfeeding, but the pumping schedule should mimic how much your baby is feeding.  A typical newborn needs to feed every 2-3 hours. 

To help you succeed with this routine, choosing the pump that works best for you is key. Most pumps land in the following categories: electric, wearable, and manual. 

Whatever pump you use, make sure it works for your and your family. You can talk to your hospital team about using a hospital-grade pump while you’re on site. Usually these pumps need wall outlets, but are strong and can express milk quickly. A hands-free option could help you pump while holding your baby or while multi-tasking when at home. At any time you should meet with a lactation consultant who can help you pick the right pump, discuss part sizing, proper cleaning, routines and so much more. 

Hot Tip: If you can’t be near your baby while pumping, use a picture of them to look at, play videos of them from your phone, and hold on to blankets or clothes of theirs. Not only is it comforting, but it will also help stimulate your milk. 

Storing and Transporting Breast Milk to the NICU

Storing breast milk has very specific temperature guidelines. We’ve included a helpful grid below: 

If you are pumping at home and bringing milk to the hospital there are several storage containers, like Milk Stork's Milk Cubby, on the market you can use. Depending on how long you’ll be storing you can always use a thermos or other food-safe storage container. 

It’s also very important to understand your hospital's NICU protocols for handling breast milk. They may have specific guidelines you’ll need to follow, specific containers or even times of day you can bring milk in. Ask the hospital staff to explain this to you. 

Feeding Your Baby in the NICU

Feeding your baby is going to look different, and this is okay. There are many different ways that your expressed milk can be given to your baby. Some babies may need an NG tube or small thin tube inserted into the baby’s nose that delivers food (or your milk) to the stomach. They may also feed via a spoon or even a cup. If you can feed your baby with a bottle of expressed milk, paced bottle feeding is essential. Paced feeding lets your baby’s facial muscles draw milk from the nipple and control the pace of milk.

If your baby is being fed when you’re at home, ask the team to play a recording of your voice. Leave a blanket or shirt that you have worn with your scent on it. Even ask a nurse to keep a journal of every feeding.

Transitioning to Direct Breastfeeding

Breastfeeding is learned as your baby develops. As you transition to feeding do not expect everything to come quickly. It may be difficult to establish a good latch due to the size of the baby’s mouth. This may cause some pain. Mastering certain breastfeeding holds can help you with this, while also establishing good posture for your back, neck, and shoulders. It’s important to seek out help or advice from a lactation consultant during this time.

Coping with Challenges of Breastfeeding in the NICU

Breastfeeding is difficult for anyone and setbacks are a normal part of the NICU journey. Remember and remind yourself that everything is temporary. One of the best ways to accomplish your breastfeeding goal is through support. Breastfeeding is not meant to be done alone and seeking the right level of care when you need it has long-lasting benefits. Lactation consultants can meet with you in the hospital, at home, or even virtually.

Seek out like-minded moms and encourage each other to ask for help or guidance. Stress can decrease your milk supply. That’s why having a village around you is so important. Stay positive, and remember to focus on yourself as much as possible. Take time to do your favorite things. Exercise, journal, and watch your favorite comfort show. And know you are not alone.

Support Systems and Resources for Breastfeeding NICU parents

Along with your family and friends, there are support groups in place that can help you on this journey, like NICU Connections and Hand to Hold. Talk to the NICU staff about the support groups they offer. They may even know of groups in your community. Schedule frequent appointments with your lactation consultant, even if your baby is not with you.

Breastfeeding a NICU baby is difficult. But you are never alone. If you need support please schedule an appointment with our virtual lactation consultants. SimpliFed providers can meet you wherever you are, virtually through your phone. For more information or to schedule an appointment, please call or text SimpliFed at 888-458-1364.