Nutrition in the NICU
Every family’s feeding journey will be different. Learning what your baby needs will take time and flexibility.
NICU babies need special nutrition and nurturing. Fortunately, there are many ways for babies to get the nutrition they need. With support from your NICU team, you will find a feeding strategy that works best for you and your baby.
Your breast milk
No matter how long or short your pregnancy was, your body has already started preparing to breastfeed. During the first few days postpartum, your breasts will make colostrum, a sort of “liquid gold” full of nutrients and natural antibodies that makes it your baby’s ideal first meal. Even if your baby is not “eating” yet, colostrum can be gently swabbed in your baby’s mouth. The immune-balancing benefits of colostrum can help fight infection as well as supply some early nutrition.
Your baby doesn’t need a lot of milk right away. Their stomachs are very tiny! Even a small amount will help develop your baby’s immune and digestive systems.
Donor breast milk
Delivery complications, your health, stress from having your baby in the NICU and other factors may limit or prohibit your milk production. Donor breast milk is donated by healthy, carefully-screened, breastfeeding mothers and is processed to ensure safety. Many moms who have had babies in the NICU donate their milk because they know how important it is for babies and what a struggle it can be for others to make enough.
Human milk fortification
Your premature baby has extraordinary nutritional needs as they are continuing the vital work of developing all of their body organs, particularly their brain. The American Academy of Pediatrics recommends human milk fortification for all infants less than 1500 grams or 3 pounds, 5 ounces.
Your baby’s body systems are very fragile, and human milk is as important as any other medication they receive. And for those very low birth weight babies less than 1,250 grams (roughly 2.5 pounds), it is vital for parents to understand that there are two types of fortifiers available. Several clinical studies have shown these very small preemies had better health outcomes with fed fortifiers that are 100% human milk-based rather than cow milk-based. As the best advocate for your baby, it is important for you to discuss these options with your NICU care team.
Pumping and pumping blues
The commitment to pumping can be challenging and tiring. Make pumping a priority by setting a routine and using the time to talk/read to siblings or enjoy a healthy beverage or snack. Consider reading, meditating, or listening to audio books or podcasts as a way to associate caring for your baby with caring for yourself. Hold your baby’s recently used blanket or look at photos and videos of your baby. These scents and visuals can help stimulate milk production.
Ask if pumping at your baby’s bedside is an option. At home, try to have a place set up to pump or have two kits, if possible, to cut down on the number of things to carry to the hospital. Ask for support, meet regularly with lactation, and allow friends and family to help you keep the equipment washed and to encourage you.
If pumping or donor milk is not available
There may be times when formula is an option for your baby. If your baby is over 32 weeks, and donor milk is not available, formula will nourish your baby well. Talk with your baby’s doctor about options for your baby.
It is not uncommon to grieve if complications keep you from pumping or breastfeeding. This change in expectations can be frustrating and often leads to feelings of guilt and inadequacy. These feelings are normal and reflect your strong desire to care for your baby. If pumping or breastfeeding is not for you, there may a sense of relief to move beyond that hurdle and begin focusing on other things. Embrace your feelings and feel confident in sharing them openly with your partner, friends, family, peer mentor and care team. They can provide the support you need to navigate the challenges associated with a NICU stay.