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5 Tips For Breastfeeding Your Preemie in the NICU

Skin to Skin

5 Tips For Breastfeeding Your Preemie in the NICU

Skin-to-skin is a great way to support breastfeeding later on when your baby is too little or sick to breastfeed. 

Here are some of the many benefits of skin-to-skin:

  • It allows you both to bond and start a wonderful relationship
  • It produces feel-good hormones in mama that kick-start milk production
  • It stabilizes baby’s vital signs and reduces their stress
  • It stimulates baby’s’ digestive tract and creates interest in feeding for baby. You smell like a gourmet buffet to your baby! 

How To:

1 – Eat, pee, and pump beforehand to make sure you’re comfortable during the process.

2 – Wear clothing that can easily be moved aside.

3 – Ask your nurse to help you place him on your chest and then cover him with a blanket and hat.

4 – Get comfy! Ideally you’ll stay there skin-to-skin with him until it’s time for the next cares with is usually about 2.5 hours.

Pump Early, and OFTEN

5 Tips For Breastfeeding Your Preemie in the NICU

How do we get off to a strong start with breastfeeding a preemie?

We have to mimic what would happen if you had a full term baby! We’re trying to trick your body into turning on that supply of milk. How do we do this? Pump and hand express! Most hospitals have the Medela Symphony pump. This is the hospital grade Jaguar of pumps! Even if you have your own pump at home I would recommend using the hospital pump whenever you come to see your sweet baby. 

How often should you pump? 

Every two to three hours for 15 minutes. This is exactly what a term newborn would do to bring that milk in! If you are able to pump every two hours during the daylight hours and then go every three hours after going to bed that’s a great goal to shoot for. I know, waking up in the night to pump when you’re already exhausted physically and emotionally is SO hard! But going long stretches between pumping signals to your body to produce less milk. The frequent pumping is the best thing you can do to boost your milk supply for the rest of your breastfeeding journey. So it’s very important, especially in the first week or two to empty those breasts FREQUENTLY!

If you’ve missed the boat on this and you’ve stumbled upon this blog later in your journey, don’t fret! There are ways to boost your milk supply if you ever end up struggling with low supply. If you only get a few drop or nothing at all the first few days, DON’T WORRY! This is completely normal. Just keep pumping and  your milk will come in! The pumping in the beginning is putting in an order to your brain to start producing that liquid gold for your little one. 

Combining hand expression with pumping 5 times a day for the first 3 days can make a huge difference as well! A study performed by Stanford University by Dr. Jane Morton proved that with early had expression and pumping moms, on average, can make 60% more milk months down the line! It is also completely normal for the amount of milk you produce to vary from day-to-day or time of day. This is because of many factors including things like your hormone levels and even your state of mind during pumping. 

Check out how to get the right fit flange for your nipple size here.

Colostrum Oral Care

If you’re at the point where you’re making a few drops when you pump, you can collect that milk using a small feeding syringe provided by your nurse or a Q-tip and give that milk to your baby. Coating the baby’s mouth with colostrum provides immeasurable benefits! ONE DROP of colostrum has an estimated 1 MILLION immune cells in it! The makeup of your colostrum, or the first golden colored milk, and your mature milk is different than it would be for a full term baby. Your body knows to make it easier to digest for a sensitive preemie and to make it extra protective of their little GI tract. This is so great for your preemie who is more at risk for infection than a baby who is full term. Breastfed preemies get less infections and discharge earlier than formula fed babies. This is something that only you can provide your baby and it’s one of the best ways to support your baby’s health while they get strong enough to thrive on their own!

Koala to Laid Back Position

Once he’s big and strong enough to breastfeed the Koala Position can be very helpful when breastfeeding a small baby. 


Sit your baby upright on your thigh with their legs straddling your thigh. 


Bend your knee up to your breast and latch them in a similar way as you would in football hold. This upright position really helps new moms be able to see their baby open wide and latch onto the breast! It’s easy to hold them up to the breast this way when their bottom is supported by your leg.


Lie Back! 

Koala hold makes it easy for you to recline in your chair after baby starts sucking. By laying back this allows gravity to help your little one stay on the breast with a nice, deep latch. Preemies have very little neck strength to stay latched deeply for the whole feed. It is very common for them to slide off of the nipple and start sucking on the tip of nipple only which does not remove milk from the breast. This is also painful for mom as the baby gets older. 

Pumping – Before or After Breastfeeding?

This depends! When you’re first starting to breastfeed your preemie they may not have developed good suck-swallow coordination. Your babies’ doctor may want you to start out “dry breastfeeding”. This means that you would pump beforehand to mostly empty your breast before latching your baby on. This allows them to practice breastfeeding without becoming stressed or choking with the milk flow. When doing the dry breastfeeding it’s a great idea to start a tube feed at the same time so that your baby associates a full belly with breastfeeding.

If your baby is tolerating feedings from a bottle, they likely can breastfeed without mama pumping beforehand. One exception to this is if you have a heavy let-down. This is when milk first starts to flow. If a lot comes out at once this can be stressful to a baby that needs extra time to develop their breastfeeding skills. If your baby chokes and sputter, squirms and pulls off the breast at the start of a feed, it may be a good idea to pump for 5 minutes beforehand so that the start of the feeding is not so overwhelming for baby. 

If neither of these situations fits you and your baby you likely don’t need to pump beforehand and instead pump when the feed is finished. 

Paced Bottle Feeding

Paced bottle feeding technique is a great way to bottle feed  for many reasons. It gives your baby control over the flow of milk and also better allows baby to take breaks during a feed. You can mimic breastfeeding using this technique which can prevent your baby from developing a preference to the bottle. Check out the technique here!

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