The “problem” with pumping your breasts to make milk for your baby is the pump is not your cute, portable baby with a soft mouth. The pump represents a baby unable to breastfeed in the NICU initially, due to:

• Anatomy
• Premature birth
• Diagnosis
• Nothing by mouth (NPO)
• Diagnostic testing
• Separation of mom and baby

Many moms desire to breastfeed their newborn. A NICU stay can certainly throw a wrench in that plan, especially when unexpected. Most private insurance companies do provide a breast pump for the expectant or newly delivered mom. When the delivery is premature, mom will unlikely have a pump available for home use. If mom does have a pump, it may not be the quality best suited for a NICU admission or lengthy stay. Locating a quality breast pump in a timely manner is crucial to establish a full milk supply.

Pumping milk requires a commitment of time and some organization. Pumps are more difficult to travel with than a baby.

Pumping includes:

• Supplies (labels and bottles)
• 15 to 30 minutes to pump with a double breast pump
• Time to clean the pump kit after use
• Pumping a minimum of 8 times in 24 hours (with at least once during the night) to establish and maintain a breast milk supply 

Most moms understand the health benefits of breast milk for their infants. The NICU infant is at greater risk of infection and complications. Mom will also benefit from providing milk for her baby, including decreased risk of certain cancers as well as other health issues.

There are a few women that are unable to establish a full milk supply. Several reasons include mom’s health history, previous breast surgery, a few medications, and delayed onset of beginning to pump (when able, it is recommended to begin pumping one hour after delivery). Mom certainly should begin pumping within the first 24 hours (understanding mom may have had a complicated delivery, which may delay pumping).

Most moms respond to a quality breast pump. There are some women that have reported it is not comfortable to pump or awkward. When a mom desires to ultimately breast feed her infant, it is important for her to have support to remain motivated to pump as often as necessary. Support can come from the father of the baby, grandparents, siblings, close friends, and staff. A special diet is not required (although for the mother to feel her best, she does need to eat). Moms with other children at home and/or returning to work while their infant is in the NICU certainly feel the pull in many directions. 

Pumping can be rewarding when a mom knows she is nourishing her infant. Many moms report feelings of “it’s the one thing I can do.” 

Lactation at CHKD is here to support you, whatever your lactation goals may be.

My take away for moms (and families) is:

• Seek lactation assistance as soon as you notice any changes in your milk supply or your breasts. It is always easier to troubleshoot sooner than later
• Find your “tribe” of support people

About Kitty Katz, IBCLC

Kitty Katz has been an International Board Certified Lactation Consultant (IBCLC) for 29 years, 20 of those in CHKD's Neonatal Intensive Care Unit. She is also a member of the NICU Family Advisory Council. She loves to spend time with her family, including her husband, two daughters, their husbands and four grandchildren.