NICU Breastfeeding: Building a Breast Milk Supply

After giving birth, your body is ready to produce milk when your breasts are stimulated. If your baby is unable to breastfeed, the NICU nursing staff and breastfeeding counselors at Lurie Children's can help you develop and maintain a good supply of breast milk.

Developing Your Supply

• Use an electric breast pump and a double pumping kit. If you don't have either of these, tell your baby's nurse.
  • Before pumping, wash your hands for at least 20 seconds to prevent germs from getting in your milk.
• Start pumping as soon as possible after your baby's birth. If you wait, you may not be able to develop your supply.
• If you don't have an electric pump, we may be able to help you with getting an electric pump to use at home.

How Often Should I Pump?

• For the first two weeks after birth, pump every 2 to 3 hours. This is as often as your baby would breastfeed - about 8 to 10 times per day.
  • The number of pumpings for every 24 hours is more important than the number of minutes you pump at each session.
  • Each pumping signals your body to make more milk.
• In the first few days after birth, pump for 15 minutes per breast.
• We will provide you with a pumping log to help you keep track of your schedule.
  • Remember, it is VERY important that you pump at least 8 to 10 times a day!
• Empty your breasts each time you pump. Empty breasts signal your body to make more milk; full breasts tell your body to make less.
  • As you produce more milk, watch for your breast to stop dripping milk, and then pump 2 minutes longer.

Where Can I Pump at the Hospital?

You have a hospital grade electric pump located in your baby's room. It is kept in a drawer by the closet. This pump is available for your use only while in the hospital. The pump must stay in the patient room at all times. There is a lactation room located on the north side of the NICU. Ask your nurse to escort you to the room if needed.

How Much Milk is Enough?

It may take up to 2 weeks to establish a full supply of breast milk. It is normal to only get a few drops of milk for the first few days to a week. Save those drops! This is called colostrum, and may look thicker than your regular milk supply that will come in. Colostrum has very important infection-fighting properties that are important for your baby. We can feed your baby the colostrum you pump as soon as they are ready to eat. Keep pumping and be patient for your milk to come in.

Maintain Your Milk Supply

After you have a good supply, you may be able to pump less often. Try sleeping for one 5 to 6 hour stretch at night. Be sure to watch your milk supply, as pumping less often can cause a decrease in milk volume. Always empty your breasts each time you pump.

What is "Let-down"?

Let down is when your breasts release milk, in response to signals from your hormones and nervous system. Relaxation is the key. Let-down happens easier if you are not tired or stressed. Find what works for you. Here are some ways to enhance let-down:

• A warm shower
• Warm packs on your breasts for a few minutes
• A comfortable place to pump: chair, rocking chair, couch, or bed
• Pillows for back support
• Supplies within easy reach
• A favorite non-alcoholic beverage
• Listen to relaxing music
• Look at pictures of your baby
• Skin to skin contact or "kangaroo care" before pumping

Before and during pumping, gently massage your breasts to help milk flow. Start your pump at low pressure. Gradually turn up the suction so that you feel a deep pulling sensation. The highest setting may not be needed. Pumping should NOT hurt.

How Do I Store My Milk?

If your milk will not be used within 4 hours, pour it into a plastic bottle with a secure lid. We will provide you with these bottles. Label the bottle with the date and time the milk was pumped. Your nurse will give you breastmilk labels with your baby's name and medical record number. These labels will also have a barcode on them that will be scanned before each feeding, to make sure your baby gets only your breast milk.

If your baby is not eating, freeze your milk right after pumping. When you bring your milk to the hospital, keep it cold in a small cooler with ice or ice packs. The hospital has limited storage, but we will store a portion of your milk in our breast milk freezers and refrigerators.

Refer to this cart to make sure any stored milk is still safe to use for feeding your child:

Check in with the nurse often to keep a close track of your milk supply that is stored here at the hospital. At discharge, we will provide you with information for storing breast milk at home. When your baby is ready to go home, ask your nurse to check the freezer for any of your milk so you can take it home.

How Should I Clean the Pump Kit?

Each pump kit comes with a manufacturer's booklet containing instructions for cleaning your pump and pump kit.

Be sure to follow these steps to clean the different parts of your pump kit after each pumping session:

• Separate the parts that come in contact with milk.  If you use the disposable bottles, you do not need to clean these.
• Wash the parts with warm, soapy water. You may bring a small bottle of dish soap to leave at the hospital.
• Rinse thoroughly.
• Air-dry on a clean towel or paper towels, covered with another towel.
• Ask your nurse for a plastic basin to wash and dry your pumping kit.
• We also have microsteam bags to sterilize your kit once daily. The bags are good for 20 uses. Use only clean parts for each pumping to prevent germs from getting into the milk.

What Else Do I Need to Know?

Studies show that skin-to-skin contact (also known as Kangaroo Care) increases milk supply. Kangaroo Care can increase breastfeeding hormones oxytoxcin and prolactin to trigger milk production. Try to do it daily if your baby's condition allows. Ask your baby's nurse if you may Kangaroo an hour before pumping. We have additional information about the benefits of Kangaroo Care available.

Pumping not only helps you make milk, it also helps your uterus (womb) shrink and decrease bleeding.

Stay healthy to keep up your milk supply. It is important to:

• Eat a well-balanced diet. Your body may need up to 500 more calories per day than when pregnant.
• Continue taking your prenatal vitamins.
• Drink 8-10 glasses of water daily. Try to drink a large glass of water before pumping. If your urine is light yellow, then you are drinking enough water.
• Get enough rest.

Meal tickets are available at the hospital for breastfeeding mothers. Each ticket is worth $6 and you may get 3 tickets every day - one for each meal. They are only valid at our hospital cafeteria and you may get them from the unit secretary on your floor.

While bathing or showering, wash your breasts with water only and pat dry. Avoid soap or lotion on your breasts because they can be drying and cause irritation.

We have further information to help you if you have other discomforts during pumping.

Remember: When your baby is ready to go home, ask your nurse to check the freezer for any of your milk so you can take it home.

When Should I Ask for Help?

Ask your nurse or ask to speak with a Breastfeeding Counselor if:

• You have breast pain
• Pumping hurts
• You are worried about your milk supply
• Your baby is now able to feed from your breast

Questions?

This page is not specific to you and your baby, but provides general information. If you have any questions while at Lurie Children's, please ask your nurse or request to speak to a Breastfeeding Counselor. We will continue to support you throughout your baby's course in the NICU.

Support Sites & Organizations

• La Leche League International
• Kellymom: Breastfeeding and Parenting
• American Academy of Pediatrics
• Medela
  
  

The information included on this page is for informational purposes only and is not intented to substitute in any way for medical education, training, treatment, advice, or diagnosis by a healthcare professional. A qualified healthcare professional should always be consulted before making any healthcare-related decisions.