NICU Archives - The Motherly Heap

Breastfeeding a Preemie in the NICU

Jordan N. — Fri, 21 Jan 2022 01:06:02 +0000

Did you deliver your baby early? Were you planning to breastfeed your baby after birth? Breastfeeding in the NICU can sometimes take you by surprise when you have a preemie. If you’re a first-time mama, it can get overwhelming. Learning the ropes of breastfeeding pumping while worrying about your preemie and your health makes your early experiences as a new mom more demanding. There are multiple ways to gather breastfeeding information a little at a time. You’ve probably researched it already before giving birth. Take those lessons in as you navigate breastfeeding your preemie baby in the NICU. You may also be worried if your milk will be enough or have to use donor milk for the first few days. But, Mama, again, there’s no right or wrong way to address these questions, depending on your circumstance. My personal experience: I breastfed my 28-weeker preemie daughter in the NICU, and our journey wasn’t that easy but worth it. It was exhausting and hard. I was a working mom when I had her, so I also pumped while I worked during my breaks. Finally, we reached over two years on our breastfeeding journey that started in the NICU. Also, for my disclaimer – I am a breastfeeding advocate. I support all moms who choose to breastfeed, use donor’s milk and use formula milk. I don’t shame anyone for their choices. Whatever you decide to do with regards to feeding your baby – I am all for baby’s fed and happy and a happy mama too. Your breastfeeding journey isn’t the same with any NICU mama. But, knowing what to expect when breastfeeding a preemie in the NICU can help you feel secure and informed. Reasons a Preemie needs Human Milk. Best suitable nutrition for your baby Lowers the risk for Necrotizing enterocolitis NEC (infection in the gut), Sepsis (infection in the bloodstream), and other health problems. They are getting the extended passive immunity your baby needs in the first few weeks/months. Part of your baby’s treatment plan. A study suggests it helps develop preemie babies’ brains and help a sickly preemie. What can you expect when you plan to provide breastmilk to your Preemie Baby or start breastfeeding in the NICU? Preemie babies may have multiple health conditions when delivered or become sick preemies during their NICU stay. Early preemies may not have the coordination to suck, swallow and breathe yet. Your breast milk may come in between 3-4 days after giving birth. It’s natural to feel worried about this Colostrum in the first 24 hrs to 2 days is enough for your preemie baby needs. It may be a few drops of breastmilk at a time. Moms may use hand expressing at this time. You can help stimulate milk production with frequent pumping sessions. Per orders, the NICU staff may fortify the breastmilk you provide for your early preemie with multi-nutrient such as calcium, phosphate, and more; may need more protein, etc. It is crucial because the very low birth weight preemies consuming your breast milk may not get sufficient nutrients for better neurodevelopment and overall growth. Get proper nutrition for yourself. Your top priority as a breastfeeding mama is taking care of yourself. Your body will need what it can get to produce milk. Hydrating frequently keeps your body balanced to function correctly and supports a good milk supply. Establishing your milk supply even before your preemie can direct feeding is crucial. Slow start of milk supply: stress, worry, personal recovery from birth can affect your milk supply. Your body can sometimes limit prolactin production – which helps you make milk for your baby. Non-nutritive sucking for preemie practice and milk stimulation. This method is encouraged in the NICU setting to help preemies practice coordinating their breathing, sucking, and swallowing reflex; mom benefits in bonding and more milk supply. Weight Feeding: Before and After – Preemies are weighed before they have a breastfeeding session and weighed afterward. The difference will show how many ounces of human milk they have transferred from mom. You will see a lactation consultant during your NICU stay. In my experience, I’ve seen my lactation consultant throughout my hospital admission and even the entire NICU stay of my daughter. She provided me with information on how to get started with pumping and increasing my milk supply. During NICU visits, I also spoke with the lactation consultant about breastfeeding techniques, pumping troubleshooting, creating a proper latch, and addressing breastfeeding issues. A lactation staff can be a valuable resource for any NICU mom who plans or breastfeeding their babies. NICU nurses will help you out as well. They’ll be there to show you how they do tube feeding, explaining the TPN and when your baby will transition to oral feeding. They also showed me how to bottle-paced-feed my preemie daughter with my breast milk. Some NICU graduates may go home with a feeding tube; it’s best to get lessons from the assigned nurses of your baby. One-on-one teaching sessions can help boost your confidence in feeding your preemie at home. Ask questions and write them down if you need to, so you’ll be able to refer back once your baby is discharged. Most Common Questions When Breastfeeding a Preemie in the NICU How does the NICU feed preemies? As mentioned above, having a baby in the NICU, you will witness different preemie feeding methods: Feeding tubes with your breastmilk. A nasogastric tube (NG) will be placed on your preemie and adequately secured in place. The nurses will deliver your milk through this feeding tube at scheduled times. Total parenteral nutrition (TPN) through an intravenous line with specialized nutrition for preemies. There’ll be constant monitoring of the TPN, blood draws, and rates adjustments. Breastfeeding – where you come in. Paced bottle feeding – this method mimics how a baby does while breastfeeding. The baby controls the milk intake, takes breaks, and gives cues when the baby is full. Some helpful tips to be successful at paced bottle feeding a preemie. How to keep up with milk supply for your preemie? Hand expressing – you use your hands to massage your breast and help express the milk into a sterile container or syringe. You are pumping every 2-3 hours for the first two weeks, day and night. Time your pumping schedule with your preemie feeding schedule in the NICU. How long to pump depends for every mom. Some moms don’t feel full on their breasts between sessions. Don’t pump for more than 30 minutes. Average pump sessions from 15-20 minutes. Power pumping sessions: additional pumping sessions as needed Spend as much time with your preemie in the NICU Kangaroo care when possible – skin-to-skin time with your preemie. Some call it therapeutic touch, some healing hugs. RELATED POST: Kangaroo Care for NICU Babies Proper Latch and Positions A gentle approach and patience are what a NICU mom needs to breastfeed a preemie. Breastfeeding babies need to have a proper latch when feeding; however, it can be challenging for preemie babies to do that. Oral muscles development, tongue function, and coordination are needed to do proper latching. A speech therapist will often work with your baby and the lactation consultant to assist you. They will check for tongue-ties and other oral feeding issues involved. Keep working with the NICU staff as you learn how to breastfeed your baby. Position your preemie as much as you and she are comfortable and undistracted during breastfeeding in the NICU. Usually, you will have a recliner next to the NICU isolette, prop up pillows behind you, and one under the side where your baby is feeding. Preemie Feeding Issues in the NICU Preemies need to learn how to feed (suck, swallow and breathe) Feeding too fast may lead to oral feeding aversion, more spit-up incidence Practice paced-feeding to give preemie time to develop and adjust to the feeding. It also lessens their energy used while feeding. Sleepy preemie – preemie babies get tired quickly. It’s essential to consider the timing of primary care and feeding times. Nipple diversions – either breast or bottle, some preemies may not adjust properly to the switch. Moms can use temporary nipple shields until the preemies are reintroduced to mom’s nipples each feeding. Preemie feeding is challenging enough. Some NICU babies will have therapists work with them with oral exercises to help develop muscles and learn to feed. When do you start directly feeding your preemie baby? It will depend on how your preemie is doing medically, how your baby has adjusted to non-nutritive practice feeding, your baby’s gestational age, and readiness. Most preemie babies start to do direct breastfeeding around 34 weeks. However, early preemies under 34 weeks can also do limited breastfeeding sessions with moms. It depends on every preemie, health condition, and other feeding factors. What If I can’t provide Breast Milk? Donor human milk – these breast milk are donated by moms who are thoroughly screened and health checked. The donated milk undergoes pasteurization to eliminate possible pathogens. For the first 24 hours, we used donor’s milk donated by a mom in the NICU my daughter was admitted. I am forever grateful for her for being able to share her milk. I was sick from severe preeclampsia and couldn’t produce milk yet. My preemie daughter was able to receive that mom’s gift. Preemie formulated milk – specialized milk for premature babies. PAUSE: It’s okay if you want to stop for your benefit/health. No one can force you to pump or breastfeed your baby. Your decision is your own, and it can change at any time. Don’t feel pressured to produce if you aren’t able or feel you’re going insane with providing milk for your preemie. Your health and mindset are important too to care for your NICU baby. This post contains affiliate links to products. If you purchase from these links, I may earn a small commission at no cost to you. Please see the full disclosure. What pumps should I use to help my milk supply? The pump Having a reliable and quality pump makes all the difference in any pumping/breastfeeding mama.If it doesn’t fit what you need, it’ll only sabotage your efforts. Research and ask around any pumping moms you know or lactation consultants for pump options. Will my insurance cover the pump? Renting options? Most insurance will cover the pump or pay for part of the cost. You may also want to check the possibility of renting a hospital-grade pump and send an insurance claim to cover the cost. Hospital-grade pumps are available in the hospital where your NICU baby stays. Check out this Medela Pump I rented. The commercial personalized pumps are readily available in stores or online, with plenty of options to choose from portability, quality, flexibility, and cost-effectiveness. I was able to use the hospital pump during my admission. I rented one from the hospital on the day I got discharged. You can extend rent periods or return the pump whenever you have your pump. Honestly, the Medela hospital grade pump was a lifesaver for my early pumping days. It delivers the perfect suction and encourages milk production when I wasn’t producing enough. I purchased the Spectra Two pump for home use and work; I got the Medela Pump in my pumping bag, and my insurance covered the cost. Also, I recommend getting a Haakaa silicone milk collector. Pumping Accessories: Properly sized flanges – for comfort and to prevent nipple issues.Bottles for PumpingPumping storage bagsPumping tubes and duckbillsNipple creams What if I take regular medications and pain medications while pumping/breastfeeding? Most importantly, speak with your healthcare provider and your baby’s doctor about taking medications while pumping/breastfeeding. Some medications can affect your baby. However, if you are in pain from childbirth, you most certainly don’t have to skip the prescribed medication regimen. If you had a C-section birth, you want to keep on top of the pain before it gets worse. Learning more about breastfeeding and medications can help you...

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Kangaroo Care for NICU Babies

Jordan N. — Thu, 18 Nov 2021 14:44:51 +0000

Babies born prematurely have extensive need for medical interventions. However, what struck me the most was preterm babies’ responses to skin-to-skin experiences with their mothers. This healing and therapeutic experience are called Kangaroo Care or Kangaroo Mother Care for NICU babies. Having gone through a NICU experience when my daughter was born has been a frightening journey for our family. Prematurity had not been on my radar when I became a mom, but life has many surprises. What I loved and looked forward to the most during our stay in the NICU was the Kangaroo Care time. I remember holding my preemie daughter for the very first time. It was scary because of how fragile she was; simultaneous, it was a beautiful moment. First, the nurses helped me get settled on the recliner. Then, they carefully handed her to me on my chest along with the attached wires on her. The happiness I felt when she snuggled around me was incomparable. I grasped the reality of her being born at that time. I know, she was born five days ago. But when we both had that moment together, to be this close with skin-to-skin, I felt blessed – I was her mom. She was mine. Kangaroo care became our daily mommy-me time. I couldn’t imagine not holding her for a day, and my heart ached when I couldn’t as I lay on my bed at home. My husband did kangaroo care with our daughter too. When we visited with our son, he was close by gently putting his hand on her arm or back. We forged our family bond during this difficult NICU time. Our kangaroo care time was sacred to me, to our family. How and When Kangaroo Care Became part of the NICU Developmental Care As soon as kangaroo care is initiated, it can help your premature baby tremendously. However, it also depends on when babies are stable enough to be held by mom/dad per every NICU protocol. Even the tiniest premature babies can benefit from these moments of skin-to-skin contact with their mothers. Two physician-researchers first developed the kangaroo mother program in the late 1970s in Columbia. Back then, premature babies died of respiratory issues, infections and had very high death rates. The moms acted as human incubators and also did exclusive breastfeeding during the study. Conventional incubators were challenging to obtain at that time. Moms who were holding their premature babies most of the day – their babies thrived and survived. A new clinical trial was conducted among 2944 mothers and 3211 infants (2.2 lbs-3.7 lbs birth weight) with two methods: immediate kangaroo care and conventional care (kangaroo care initiated only after premature infant stabilization). The trial found that those infants who received immediate kangaroo care had an improved survival rate of 25% than infants stabilized before kangaroo care. This study involved four different hospitals in Africa and one hospital in India. The Benefits of Kangaroo Care for Premature Babies Stabilize their vital signs (heart rate, respirations) Promote growth and development, such as gaining weight Connection with parents. Keep the baby warm. In deep sleep and more calm wake hours for brain development. Reasons Why Kangaroo Care Helps Mom Too Helps with healing Supports breastfeeding Lowers stress and anxiety Fosters bonding Promotes confidence as you care for your premature baby. What can you expect during Kangaroo Care time? Talking with the NICU healthcare providers when you can do kangaroo care with your premature baby is essential. Once everything is determined that your baby can receive kangaroo care, you will be informed by the NICU staff. The nurses will assist you in getting situated first before they’ll get your baby out of the isolette. Then, the NICU staff will provide a comfortable seat or recliner to you. Wires and equipment are connected to your baby. It will not get in the way, so don’t worry. Make sure you take a bathroom trip ahead of time. Eat your meal, and you can pump your milk before doing kangaroo care. Silent your phone or keep distractions out of the way. Your baby will be placed tummy down on your bare chest. Then a soft receiving blanket will cover your baby’s back to keep warm. You can hold your baby for an hour or how long you and the baby can tolerate it. The nurses will check your baby through the monitors, and if sometimes alarms are going off, the nurses will be nearby. Keep your drink close by and the call light close to your chair if you need help from the NICU staff. RELATED POST: Helping a Sibling of a NICU Baby Adjust Kangaroo Time with your Premature Baby You can stay relaxed while holding your baby. You can talk to your baby quietly or sing. Tell your baby the story of your family, siblings. Or you can stay quiet together as your baby sleeps on your chest or listens to your heartbeat closely. These skin-to-skin care helped premature babies thrive in so many ways. In addition, NICU babies are comforted and feel secure when close to their moms and even dads during kangaroo care. There may be times that you aren’t around in the NICU; the nurses and even therapists who work with your baby will hold them for the time being. Knowing these makes your mama heart grateful that someone besides you cares for your baby. But, likewise, you may feel a slight pang of jealousy when you walk into the NICU seeing your baby being held by the NICU staff. There’s nothing to be ashamed of. You’re the mom of your child. Nevertheless, these feelings are surfacing, maybe accompanying some guilt that you can’t be there 24/7 in the NICU. Your feelings may be unsettled right now, which is understandable. However, you can speak with the NICU staff about it if it bothers you the most. They’re there to help you and your baby. Dads can also do kangaroo care. This presents the best opportunity to also bond with baby starting at the hospital. What if you’re not ready to do Kangaroo Care Not all moms are ready to do kangaroo care immediately when able. Moms who have experienced traumatic birth or past difficult birth experiences may delay holding their babies. Some emotions are best-addressed head-on when it comes to these situations. For example, moms are having a hard time connecting with their newborns. Give yourself some time. Sitting beside your premature baby near the isolette may be enough right now. That’s okay. Coping with traumatic birth can sometimes pile on a mom’s mental space. Then seeing your premature baby and having a fear of the unknown can be too much to bear. Talk to your healthcare provider about it. Please don’t bottle it all up inside. Speak with your spouse or trusted friend. Another alternative to kangaroo care is the hand hug. You can place one hand on the baby’s head and the other hand on the baby’s tummy or chest. You may hold the baby’s arm or leg with a gentle touch. It’s natural to be fearful when caring for your premature baby, especially in your baby’s fragile state. RELATED POST: Tips for a Struggling NICU Mom: Surviving the NICU Life Giving Kangaroo Care for Premature Babies in the NICU Holding your baby skin-to-skin is part of caring for your baby. Both baby and mom will benefit from doing kangaroo care when the opportunity presents. The timing as to when this will happen will also depend on your premature baby’s condition. However, this isn’t a hindrance to kangaroo care time. There are ways in which you can still touch or hold your baby even if life-saving equipment such as a ventilator is attached. Being around your premature baby will help with your healing and also boost your confidence as a mom. Your premature baby knows mama is close by and will feel your loving touch through kangaroo care. I hope as you go through NICU time, you’ll be able to have the chance to do kangaroo care. Doing so will pave the way to a smooth transition of your premature baby into the world. Continue kangaroo care time even after babies are discharged from the NICU. You’ll feel closer and bond with your premature baby at home. You’ll remember that first time you held your baby close to your heart – as you do kangaroo care. Share your Kangaroo Care story in the comments. How was your experience? Share this post to any mom who has a baby in the NICU.

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