How we support breastfeeding in the NICU

We know that breast milk offers more than formula can and yet for preemies, getting that powerful source of nutrients can be very difficult. The TMC International Board Certified Lactation Consultants are here to help. (Thanks to Melissa for sharing her experience breastfeeding a premature baby and to Jenifer Smith and Vanessa Porter, International Board Certified Lactation Consultants at TMC for the insights.)

I knew the minute I learned I was pregnant that I would breastfeed.  There was no question.  Loads of evidence prove the benefits of breastfeeding for the average child and mom.  Even better, for someone like me, who has a history of severe Inflammatory Bowel Disease, evidence pointed to a lower instance of IBD in our children if they were exclusively breastfed.  I certainly didn’t want my child to go through what I went through (that included months in the hospital and many horrific surgeries), so any chance I could give them for better health was gospel to me.  So I had determination and big boobs — what else could I need, right?

Wow, was I naive.

My son arrived six weeks early after a difficult pregnancy. He couldn’t latch, but it didn’t matter because my milk took its time to come in, and when it did, I had a true low-supply issue.

Some of the barriers to breastfeeding an infant in the neonatal intensive care is prematurity and infant’s inability to suck. Pumping during this time is absolutely essential.

But I was determined that whatever the problem was, I was going to overcome it.  If my son later got sick with IBD, I knew that I could not live with myself if I gave up.  If I tried everything to succeed and failed, I knew that I could live with that knowledge, but giving up without exhausting every avenue of hope would have left me with guilt and my son with a greater chance of developing IBD.  So I was on a first-name basis with galactagogues including steel-cut oats, almonds, fenugreek, blessed thistle, Reglan, Domperidone and both a Medela Pump in Style Advanced and a Medela Lactina.

The lactation nurses spend a lot of time in the NICU at TMC.  We help mothers with pumping to establish and maintain a good milk supply. Studies show that colostrum and breastmilk are an essential part of (medicine) the premature infant’s treatment and care. The body recognizes when the baby is premature and the milk that is made is ideally suited for that particular baby’s needs.  As the infant is able to come to breast (as early as 32 weeks), lactation nurses are available to assist with the slow progression of breastfeeding. Praising the mother for her efforts help keep her motivated to continue with this gradual process. We promote skin-to-skin (kangaroo care) as early and often as possible.  This practice helps increase a mother’s milk supply and also helps stabilize the baby.

Overcoming the issues we had breastfeeding was one of the most difficult things I had ever done.  I know many people will think that it is crazy and would have long given up and just used formula.  But I couldn’t do that.  I believed in my heart that if I tried and didn’t give up that I would eventually succeed.  And to keep this short, we eventually succeeded and breastfeeding got back on track and became easy, satisfying for both of us, and I had a sense of comfort knowing that if one day my son does follow the path of IBD that I did everything possible to give him a fighting chance against it.  And I can live with that.

At TMC we have an extensive follow up plan allowing us to detect early issues and offering intervention, whether it be with pumping, assisting with first and subsequent breastfeeds or giving emotional and moral support. The Lactation department feels this is a critical part of the feeding plan. When these babies are discharged home we also telephone home to check on the infant’s progress and answer any questions that may arise. Many of these infant go on to exclusively breast feed.

Our lactation consultants offer programs to help mothers breastfeed from the NICU to our breastfeeding support group.   In this blog post meet TMC IBC Lactation Consultant who contributed to this post.