Slumped in a chair in the Special Care Nursery, the new mom held her baby, hoping to breastfeed. Both the mother and baby were very new and very, very tired. Her baby had been born a month early and the mother had given birth only a few hours ago. It was a momentous time of wonder, worry and exhaustion.
It’s likely you didn’t imagine a birth day like this. If your baby has to be cared for in the Special Care Nursery (SCN) or Neonatal Intensive Care Nursery (NICU), there will be many concerns. Each one of your questions is valid. There are a few points that I’d like to clarify.
1. Having your baby on a schedule is still compatible with breastfeeding.
Preterm babies are often slower to rouse and show their hunger cues. Feeding according to a schedule, at least every two to three hours, maintains their energy. Providing breast milk another way, via a cup, a bottle, an at breast supplementer, will be fine. As their brain grows and is closer to full term, babies usually become more active, organized and vigorous with feeding. Rest assured, the time your baby spends skin to skin at the breast is how your baby learns to breastfeed.
2. Breast milk is good enough though your baby may need fortifiers added.
Babies born with a very low birth weight and/or who are very preterm have different nutritional needs than a full term baby. They have little or no reserves of fat to draw on like a full term baby does. Your breast milk is still very valuable, providing components specific to your growing human. Fortifiers added to the breast milk are a particular boost while the baby grows to full term. (That is different than using only formula.)
3. Babies may be too small/tired/sick to actually breastfeed.
However, you can build your supply until they are able to start breastfeeding. It’s important to massage and express breast milk within the first six hours, and regularly after that. Your lactation hormones are at their highest in the first six hours and first two weeks. When your baby is stronger and more active, you will have the supply ready. If you wait until weeks later, you will have compromised your supply.
Parents are understandably worried. All this takes time and energy. Care for your body as you care for your newborn.
Rest to recover. Nap between feeding and pumping times. Eat a balance of protein/fat/carbohydrates every two to three hours…. similar to how your baby needs to feed! Getting regular nourishment helps with milk making and recovery.
Pump early and often…. starting within the first six hours after birth. Frequency, specifically eight or more times in 24 hours, builds your milk supply.
Love the little things. How does your skin with your new baby smell? What is the shape of your child’s ear? Talking with other parents who’ve had this experience is so validating. The March of Dimes has online groups where you can share your story
Another way to connect is Postpartum Support International… through their website and/or their phone line.
1 800 944 4773 #1 English #2 Spanish
Meeting with an IBCLC can be most helpful to help you understand the needs of your baby while in the nursery and also at home. Here’s one way to find an IBCLC.
The mother I described in the beginning of this story was tired. She was afraid if her baby didn’t latch, all was lost. Having her questions answered helped her understand: she could take a nap and come back in two or three hours. She could provide breast milk. She understood her body was doing a lot. She said these are the things she would focus on doing.
Skin to skin. Provide breast milk for the baby. And for the parents:
Rest. Pump. Love.