Challenges with Breastfeeding in the NICU

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Babies born prematurely are often kept in the NICU for a few days before being reunited with the mother. Breastfeeding infants in the NICU can be particularly challenging. Both the infant and mother need special care and attention during this time. Let’s look at some of the major challenges with breastfeeding in the NICU.

1.Limited milk production

Being separated from the baby may also affect a mother’s ability to produce breastmilk. Since the baby may not be able to exclusively breastfeed, many mothers fear that their milk production will slowly reduce. Mechanically expressing this milk at regular intervals is an option but it can be a very tiring process.

2.Baby’s feeding schedule does not match the NICU regimen

Every baby has unique feeding habits and needs. Unfortunately, the NICU timetable is standardized for all babies. Breastfeeding must take place at regular intervals as per the NICU’s schedule. The amount of time babies are allowed to breastfeed for during each session is also regulated. When this does not match with the baby’s own feeding needs, it can make the baby cranky or tired. This could make him/ her fall asleep at the breast instead of feeding.

3.Lack of privacy

The breastfeeding experience is a very personal, private one. But, when your baby is in the NICU, this privacy may be hard to get. Many new mothers are shy about breastfeeding in public. In attempting to protect their modesty and allow the baby to feed, the experience could become awkward and uncomfortable for mother and child.

4.Inability to nurse properly

A premature birth is amongst the most common reasons for babies to be sent to the NICU. Your baby’s ability to breastfeed in the NICU depends on how prematurely he/she was born. Babies born after the 36th week should be able to breastfeed. Those born between 32 and 36 weeks can suck and swallow but may have difficulty latching on to the nipple. Babies born around 28 weeks may find it harder to breastfeed. Respiratory and cardiovascular issues may further complicate breastfeeding.

5.Conflicting advice on breastfeeding

Preterm babies look and feel very delicate. This can make the mother a little apprehensive of holding her own baby. Since a NICU is visited by many mothers, doctors, nurses, etc., she may get conflicting advice on when and how to breastfeed her baby. This can dampen her confidence and make her believe breastfeeding is harder than it really is. In some cases, the fear may be so much that the mother chooses to bottle-feed instead.

6.Difficulty bonding with the baby

One of the toughest parts of having your baby in the NICU is the physical distance between mother and child. Mothers also feel limited in their ability to care for their babies. Not being able to hold your baby can make it difficult for the mother and child to bond.

Overcoming the Challenges

There is no doubt that a mother’s milk is the best source of nutrition for a newborn baby. Thus, though it may be challenging, mothers must find a way to breastfeed their baby as much as possible.  Since feeding within NICU timelines may be difficult, mothers should turn to expressing their milk and bottle-feeding this milk to their baby. Ideally, a mother should start pumping breastmilk within 12 hours of giving birth. You may repeat this once every 2-3 hours. Whenever possible, try to have skin-to-skin contact with your baby. This helps alleviate stress and builds a strong bond between mother and child.

Do not be discouraged if you are unable to express sufficient milk. This is a common experience for many mothers. In such cases, instead of relying on formula, you could turn towards pasteurised human donor milk. This refers to breast milk expressed by other lactating women. Donor milk is pasteurized and safe for babies. It has similar nutritional values as freshly expressed breast milk and retains most of the critical properties like immunoglobulins, oligosaccharides etc. These unique components are not available in any commercial infant formula as they are derived from bovine milk.

In Conclusion

Having your baby kept away from you in the NICU may be stressful but as far as possible, do not let this stop you from breastfeeding your baby. Remember, no formula can compare to the nutritional benefits of human milk.

References:-

https://www.researchgate.net/publication/49832231_Mothers’_Breastfeeding_Experiences_in_the_NICU

https://blog.neonatalperspectives.com/2019/03/18/how-can-nicu-nurses-best-support-breastfeeding/

https://www.unitypoint.org/waterloo/if-baby-admitted-to-the-nicu-.aspx

https://www.medela.in/breastfeeding-professionals/nicu/feeding/challenges

https://www.ameda.com/milk-101-article/breastfeeding-and-your-preterm-baby/

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