Breastfeeding Your Hospitalized Baby

Mom nursing a preemie

You can still breastfeed your baby if your newborn term baby has to stay in the hospital after birth, or if your breastfeeding baby needs to be admitted to the hospital after being at home. Some babies can breastfeed during their whole time in the hospital. Most babies may not be able to breastfeed at the breast during all or part of their hospital stay, because of illness, procedures, or surgery.

A nurse will give your child nutrition fluids through an intravenous (IV) tube before and after certain surgeries and procedures.   

As your baby recovers from surgery, a nurse will give your child breast milk through a nasogastric (NG) tube that goes through their nose or mouth into their stomach. This tube is used until your baby is well enough to begin feeding by mouth or at your breast again. If your baby will not be able to have any food by mouth for a long period of time, a pacifier can be used to help comfort your baby by allowing him to suck.

Build up your milk supply even if your baby cannot breastfeed

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It is important to build up and maintain a breast milk supply for your newborn baby, even if your baby cannot breastfeed. Begin pumping within 6 hours of your baby’s birth or as soon as you are able. Pump both breasts at the same time for 10 to 15 minutes with an approved hospital-grade double electric breast pump. Most hospitals have hospital-grade double electric pumps you can use at your baby’s bedside or nearby. Please check with your nurse or lactation consultant where to buy or rent a hospital-grade pump to use at home if you will not be able to stay in the hospital with your baby.

If you have been breastfeeding, you will need to pump your breasts the same number of times you were breastfeeding your baby within a day. Some mothers who have been breastfeeding may find if difficult to produce breast milk with a breast pump. It is important for these mothers to pump at least 7 to 8 times in 24 hours.

Please see Expressing Breast Milk for Your Hospitalized Baby for more information about pumping and how to store and transport breast milk to the hospital.

Low milk supply

Some women find their milk supply decreases or changes once the baby is hospitalized. Stress can decrease your breast milk supply. Your breast milk supply can also be affected by your emotional state as your baby’s condition changes. You may find that your supply decreases the day your baby has surgery or procedures. As your baby recovers, your milk supply usually increases with regular pumping.

It is important to maintain your pumping regimen even though your milk volume is less than you expect. Some women pump less volume with a pump than their baby would take from their breast. Once your baby begins to breastfeed again, your milk volume usually increases.  

You can arrange a referral with a lactation consultant if your breast milk supply does not increase with regular pumping.

"Power pumping" is used to help increase breast milk

"Power pumping" is used to help increase breast milk volume.

When you are near your baby, there is usually an increase in the amount of hormones that produce breast milk. When you are in the hospital with your baby, we suggest you spend 20 to 30 minutes holding or sitting near your baby and then pumping. You can repeat this every 1½  to 2 hours while you are in hospital. Because you are pumping more often, you will get less milk per pump session, but the total number of pump times over 24 hours will increase your breast milk.

When you start to pump more often , you will usually not see an increase for 2 to 3 days.

Helping your baby to breastfeed

When your baby can feed at the breast, some babies eagerly latch and suck. Most babies need some time to get used to their first feedings at the breast after a hospitalization.  

Breastfeed when your baby shows signs of hunger

Your baby will start moving, sucking, and rooting when he feels hungry. Rooting is when your baby opens his mouth wide and tries to latch to your nipple and areola. The areola is the dark area around the nipple. Your baby needs to take a large mouthful of the areola, especially the part covered by his lower jaw.

Ask your nurse how to manage your baby’s care so you can put your baby to the breast as soon as you see hunger signs.

Holding your baby

Start by holding your baby close to you and facing you. Some breastfeeding positions may be better for your baby than others. Generally the recovering baby does better in a more upright position such as the football, cradle, or cross cradle position. Ask your nurse or lactation consultant for help.

Let your baby have some time to lick at the breast. You can squeeze some drops of milk onto the baby’s lips and let the baby smell and taste your milk. It is important to never to try to force the baby to take the breast. If your baby's condition permits, holding your baby on your chest, upright, skin to skin, between your breasts helps your baby feel secure. Studies show your body temperature can increaseby 2 degrees to keep your baby warm. Most babies relax when they feel your warmth and familiar heartbeat. They then feel comfortable to search and latch onto the breast. It may take many days to get your baby comfortable at your breast.

A nipple shield helps the baby become more comfortable at the breast

A baby who has only been able to suck on a soother for a long period of time may not recognize your breast as a place to feed. Try not to take this as a sign your baby does not want to breastfeed.

A nipple shield made of silicone is used to help the baby become more comfortable at the breast. A soft but firm nipple shield made of silicone is placed over the mother’s nipple. It is used to help mimic the familiar texture of the soother to "trick" the baby onto the breast. The shield is used until your baby eagerly roots and latches to the breast. The baby is then ready to breastfeed from your nipple alone. The time needed for this to happen varies from baby to baby.

A lactation consultant will advise if you need to use a nipple shield, provide the appropriate size shield, and see how well your baby breastfeeds with it in place. You will need to pump after feeding until the baby takes full feedings with the nipple shield. The amount of milk the baby takes with the nipple shield is closely monitored. The intake can be monitored by test weighing.

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The contact nipple shield has a cut away that allows your baby sensory contact with the breast.

Helping your baby with feeding coordination

A baby needs to coordinate sucking, swallowing, and breathing. This is not as easy as it may seem.

If you have a large milk volume or fast let-down, it helps to pump off some milk before latching your baby. The decreased milk flow and volume allows your baby to better coordinate suck, swallow, or breathe as he returns to breastfeeding.

If your baby exhibits difficulty with feeding coordination, an occupational therapist may be asked to assess your baby’s ability to suck and swallow safely.  

Using breast compressions

Once your baby is latched and sucking well you may notice your baby getting tired before taking a full feed. Once you do not hear your baby swallowing, use “breast compressions” to allow your baby to receive more breast milk. You will squeeze the breast between your thumb on one side of the breast and your four fingers on the other side. Your thumb and fingers need to be well back of the areola. You squeeze the breast as long as the baby is sucking and stop when the baby stops sucking. Watch that your baby is swallowing the breast milk without difficulty.

How much your baby is breastfeeding

In hospital, the medical team needs to know more accurately how much the baby is taking when breastfeeding. The baby can be weighed before you breastfeed and again afterward. The difference in weights in grams tells us how much the baby breastfed. One gram is considered one mL of breast milk.

For more information, please see Breastfeeding: Test Weighing Your Baby.

Once your baby is breastfeeding again at home, you will be able to tell your baby is getting enough breast milk by observing how your baby sucks and swallows when breastfeeding, how many wet and soiled diapers your baby has in 24 hours, and how your baby gains weight.

For more information, please see Breastfeeding: How Do You Know Your Baby is Getting Enough Milk?

If you are only breastfeeding at the breast, it is very important for your baby to be seen and weighed by your medical caregiver or at a breastfeeding clinic 2 days after your baby’s discharge from hospital.

Taking care of yourself while your baby is in the hospital

Having a baby in hospital is tiring for the mother. There are many procedures as well as the concern about your baby’s condition that interrupt your normal routine for you and your baby. It is important that you try and get adequate rest and nutrition. Remember you need to drink enough that you are not thirsty and to have healthy meals and snacks throughout 24 hours.

Many mothers have other children to care for as well. Try to get help from friends and relatives to take care of your other children, so that you can be in the hospital with your baby. Try not to feel guilty if this is just not possible.

Try to maintain your milk supply and work on getting your baby to breastfeed at home. You may find that your breastfeeding baby has shorter feeds more frequently than when your baby was on the hospital schedule. This is a normal part of recovery until your baby is well and gets back to previous feeding routines.

Going through a hospitalization can be difficult. Reach out to staff to get the help you need. Lactation consultants can help you with breastfeeding and breast milk supply. Doctors, nurses, occupational therapists, social workers, chaplains, and volunteers can also help you understand and care for our baby. Once you are at home you can find help with breastfeeding from your local breastfeeding clinics and local health connections.

Key points

  • Most babies may not be able to breastfeed at the breast during all or part of their hospital stay, because of their illness, procedures, or surgery.
  • It is important to build up and maintain a breast milk supply for your newborn baby even if your baby cannot breastfeed. You can do this by pumping.
  • Most babies need some time and some help to get used to their first feedings at the breast after hospitalization.
  • Take care of yourself while your baby is in the hospital.
11/6/2009
 




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