By Melissa Lawlor, CNM, IBCLC, Robin’s Nest Midwifery PLLC
Photos: Courtesy of Melissa Lawlor
Scrubbing your hands at the industrialized metal sink with astringent hospital-grade soap, you glance around the room, taking in the sights and sounds of the Neonatal Intensive Care Unit (NICU). There are plastic incubators holding the sickest of the sick, wires and tubes, IV bags, dimmed lights, drawn curtains, hushed voices and the constant beeping of monitors. Physicians and nurses walk around competently providing care for the most fragile of human beings—the premature babies of the NICU.
Being a mother with a baby in the NICU is not something that is envisioned. And yet, according to the World Health Organization, one out of 10 babies are born prematurely, before 37 weeks’ gestation.
Premature babies are at higher risk for many life-threatening medical conditions. Breastmilk has specific components that decrease the following diseases: necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS) and late-onset sepsis. Research shows that premature babies who are fed breastmilk have decreased rates of hospital readmission during their first year of life, and the American Academy of Pediatrics recommends breastmilk as optimal nutrition for these babies.
A hospital-grade electric breast pump is essential to provide milk for your NICU baby, as these pumps are designed to increase and maintain breastmilk supply. Hospitals with NICUs may offer free loaner breast pumps, breast-pump set-ups in the NICU and/or breast-pump rentals (there are businesses who rent them). Fact—NYS insurance law requires coverage for comprehensive lactation support, counseling, equipment and supplies.
Most importantly, the sooner you begin breast pumping for your NICU baby, the faster your milk will “come in.” Advocate for yourself and your baby. Ask for the hospital International Board Certified Lactation Consultant (IBCLC) to visit you. A recommended double breast-pumping schedule is eight to 10 times daily for 15 to 20 minutes. Clearly label the milk container with the preprinted hospital ID medical record number, the date and the baby’s name. Store in the fridge, and transport refrigerated breastmilk to the NICU in a cooler with ice. For breastmilk that is not going to the NICU immediately, label and freeze.
When you are pumping, every drop counts! In the hospital you may not get any colostrum during the first pump sessions. This is normal! Keep pumping. Over the course of a week, by maintaining a pumping schedule, your breasts will begin to transition from colostrum to breastmilk, and you will be able to pump up to two ounces at each session.
If you are experiencing breast-pumping difficulties, seek out support from the hospital IBCLC or a private-practice IBCLC.
Lastly, given the medical importance of breastmilk, some hospital NICUs utilize pasteurized donor breastmilk from the New York Milk Bank. For women who are not able to pump breastmilk or do not produce enough of it, this is a viable option. NYS Medicaid covers the cost of donor breastmilk for premature babies. More information on pasteurized donor breastmilk can be found at www.nymilkbank.org. █