The complete resource for NICU families from admission to discharge and beyond

How do I establish lactation?

Breastmilk is the perfect food for babies and is an extremely important part of NICU care that only MOM can provide. To do this, mothers must pump their breasts and bring their expressed breast milk (EBM) to the NICU when they visit. Pumping isn’t hard, but it’s not very pleasant and it requires motivation to keep at it. Making breast milk takes a lot of energy for your body and, if your body thinks it’s unnecessary, it will stop. Breastmilk production is a supply and demand process: If your breast is empty, your body will fill it up! Immediately after birth – especially a preterm birth – your body doesn’t know you have a baby to feed. You must tell your body to establish lactation (e.g. milk production). Pumping is how you do this without a baby to nurse. Healthy term babies will nurse in the delivery room, and this sucking motion on your nipple stimulates your brain to tell your breast to begin making milk. It takes 3-5 days for your milk to come in. It is extremely important that you continue to pump every 3 hours around the clock during this time because, if you don’t, your body will think it doesn’t need to make the milk and will turn its energy elsewhere. (Making milk takes more energy for your body than growing a baby. See “How to lose the baby weight” for more information.) In the early days, you will produce colostrum, a yellow oily substance that is power-packed with nutrition. Collect it if you can and bring it to your NICU nurse for your baby. Get lots of rest, drink lots of water, and try to relax. (Yeah, right!) The stress hormones are opposite the milk-production hormones. When your milk comes in, you will know it. It is not subtle! The best remedy for an engorged breast is to empty it!

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