ParentingU Podcast: Breastfeeding in the NICU

Sep 9, 2022 | Parenting

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No one plans for a stay in the neonatal intensive care unit (NICU), but families who are experiencing that reality can still meet their breastfeeding goals with support.  

Becca Miller, SLP, speech language pathologist and official lactation consultant at Our Lady of the Lake Children’s Hospital, helps tackle some fears those parents may be feeling and offers her tips for breastfeeding in the NICU in this ParentingU podcast episode 

Overcoming Fears 

It’s scary for parents, when their baby is born prematurely or with complex medical conditions and needs the highest level of specialized care in the NICU.  

One thing moms know how to do is feed their babies. Our NICU teams know how to help moms work past any anxiety and fear to pump and produce milk to give to baby before their able nurse directly. 

Once it’s safe for baby to latch on, our team can then help mom find comfortable positions and be able to feed their baby as they would like. 

No Typical Day 

How often a NICU baby goes to care depends on their gestation at birth. For example, a baby born at 23 weeks’ gestation would be touched every three to four hours, have their vitals taken and be fed. If the baby’s temperature is less than 97°F the team will first try to warm them up before feeding. 

A concern the team is trying to avoid is NEC, or necrotizing enterocolitis, the most common and serious intestinal disease among premature babies. NEC happens when tissue in the small or large intestine is injured or inflamed. 

If baby is unable to breastfeed but warm and well enough to be fed without the risk of NEC, mom can pump, and her milk can be fed through a nasogastric feeding (NG) tube. 

Some moms are able to breastfeed their NICU babies directly, but even those babies who do not yet have a coordinated suck-swallow-breathe rhythm can be placed on mom’s breast for non-nutritive sucking and skin-on-skin contact. That good work can provide nipple stimulation to increase her milk supply and practice for baby to establish and improve their ability suck-swallow-breathe while feeding. It’s also an important way for parents to bond with their newborn. 

Coping with NICU Stress 

Miller recommends finding at least one person on the NICU team who can help demystify the workings of the unit, explain what the machines, monitors and procedures can. 

“Know that your medical team is looking out for your baby 110%,” she says. “We’re doing everything from a place of love. We’re really watching your back and really care for you and your baby.” 

Breastfeeding Supports in Our NICUs 

Pumps are important for NICU moms, to establish and maintain their supply, and we make available pumps with a variety of flanges for the most comfortable fit when pumping. We also offer manual pumps that allow moms to be mobile and pump outside if they need a break. 

Staying hydrated and well-nourished is important for all breastfeeding moms, and when a mom has a baby in one of our NICUs she can receive three meal vouchers per day. 

Our lactation consultants are always available as well and are ready to answer questions and offer support.  

“Moms just have to ask, and there are so many ways we can help you be sure breastfeeding and pumping go the way you want it to go,” Miller says. “Some feeds and pumping sessions are going to go bad, but some are going to go really well. Take it one day at a time, one feed at a time.” 


We hope your family never needs a NICU, but it’s good to know what’s available—just in case. Across our health system we offer access to the highest quality family-centered care:

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