UVA Health System Blog

Stories about the patients, staff and services of UVA


Breastfeeding in the NICU

On August 18, 2011 | At 8:30 am

Breastfeeding helps NICU babies thrive.Breastfeeding Challenges

When I had my first child, I had no idea that breastfeeding would take work. Like most babies born at or after their due date, my newborn daughter was equipped with the instincts and energy necessary to nurse. But first I had to cue those innate responses – and I had to be taught how to do that. It took my baby and me quite a lot of practice – and support and encouragement from the hospital nurses – to figure it out.

For mothers with babies in the Neonatal Intensive Care Unit (NICU), breastfeeding can take even more work.  Premature infants don’t have the physical strength it takes to suckle until around their due date.

Given the right amount of attention and instruction, babies in the NICU can learn to successfully breastfeed.

According to Ann Kellams, MD, pediatrician and Medical Director of the Newborn Nursery, the nurses and doctors in the NICU at UVA encourage mothers and infants through a progression of stages. At least twice daily, she says, “Babies experience skin-to-skin contact with the mother. This activates the infant’s innate preference for the mother, progressing to where a baby will even try to lick a drop of expressed milk from her breast.”

The Big Deal About Breastmilk

Meanwhile, the nurses either feed the infants by tube feeding or intravenously, if the gastrointestinal system has yet to mature.

So if babies survive all right without breastmilk, what’s the big deal with breastfeeding?

The benefits of breastfeeding cannot be overstated. According to Dr. Kellams, breastmilk:

  • Increases a child’s immunity against infection
  • Protects against certain childhood conditions from allergies to infections
  • Provides essential nutrients
  • Reduces the risk of SIDS, diabetes, obesity and more

She says, “The benefits to healthy infants are magnified for babies in the NICU. And they don’t just help babies survive in the hospital and beyond, but give them the best chances for a healthy life long into the future.”

Pump It Up

But it’s not just the babies who need help. Mothers lack the natural cues and triggers for milk production when babies are kept separate or are not strong enough to nurse. Stress and anxiety from having a baby in the NICU can add to the challenge.

“As soon as a baby is born we initiate pumping to help the mother’s body know the baby is on the outside,” says Dr. Kellams. “And the key is continuing to pump.” The board-certified lactation consultants at UVA also instruct women in how to manually express milk (using their hands), as the combination “increases the amount you’re able to get out.”

Along with this hands-on guidance, UVA strives to make breast pumps affordable and accessible by:

  • Providing low-cost rentals to mothers where there is a medical need
  • Selling pumps in the gift shop
  • Exploring offering low-cost pumps to employees through our pharmacy

The NICU also offers a “Mother’s Milk Lounge,” a dedicated pumping room, as well as a support group for new mothers.

Helping New Moms and Babies

Dr. Kellams applauds the NICU team’s efforts to improve breastfeeding education and support. “We’ve been running out of room for storing the milk that moms have been bringing for their babies, a sure indication that we’re making big progress helping moms give this gift to their babies.”

And all of this is important. “Human milk is a very specific support system for infants,” Dr. Kellams says. “Other animal milk just can’t substitute.”

Learn more about breastfeeding and parenting with a baby in the NICU.

Coming soon: UVA will be launching a new breastfeeding program. Stay tuned!

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Comments : 6 |

6 Comments for this post

August 18th, 2011 at 4:55 pm

Uhhhh, I’m sorry Dr. Kellams, my son was born at UVA & I WAS NOT exposed to pumping for him until the LAST day of my stay. I even went thru several gowns a night because of leaking all night. So I disagree with that statement.

August 19th, 2011 at 2:23 pm

Dr. Kellams says, “Sharla, we are sorry that things did not go well for you. The program is new, and it is stories like yours that have prompted us to make all of these changes to provide better support for new moms.”

August 19th, 2011 at 6:24 pm

In 1999, my daughter was delivered at UVA, we were pre-diagnosed with a diaphragmatic hernia. I insisted on breast pumping for her. I was frustrated early on but kept it up. One of the NICU Nurses (aka Angels) told me later with my production, I could have fed the whole unit. Some do better than others but the key is support networks and a bit of determination. Unfortunately our daughter did not survive but I also found and donated my milk to help others. Please look into that for families who may be left with a freezer full of milk, it helps to know that you could help others.

One thing I have learned with hospitals (all of them) you sometimes must be demanding as a patient or advocate for your child’s care in order to make things happen. Sometimes it is also – others can not read your mind too. Sharla – sorry you went through what you did. I’m also glad there is more support for breast feeding and pumping – it will go along way to help these infants and the mothers!

August 19th, 2011 at 7:06 pm

I couldn’t agree more about the importance of breastfeeding premature and surgical babies. My first child was 6 weeks premature and as a new mom I had no clue what to expect with breastfeeding/pumping and wasn’t really provided much help. My son had a hard time with nursing, but now I think it was because I was not educated or patient enough because he needed so badly to just gain weight. I gave in and bottle-fed him but still pumped every 3 hours for 6 months to ensure he got breastmilk. 2 years later I had a daughter, also in the NICU but she was past term. She was born with a congenital diaphragmatic hernia and was fed intravenously for 5 weeks. At 3 weeks old she had surgery and 2 weeks later she was FINALLY able to get “my milk” through a feeding tube. I was not able to hold her until she was 5 weeks old so skin to skin was not possible until that time. Doctors, nurses, speech/occupational therapists, and lactation specialists said she might have trouble with taking a bottle and breastfeeding would be nearly impossible for her. They enclosure me to work on bottle feeding her to get her off the feeding tube sooner. She was sent home from the NICU refusing to eat orally so I continued to tube feed her at home. After MUCH patience and HARD work and PERSISTENCE (with a 2 year old son running around the house) 1.5 months after being sent home from the NICU my daughter was doing the impossible…BREASTFEEDING! She is now 6 months old and thriving on breastfeeding and baby food – she will not take a bottle! I wish all mothers to follow their maternal instincts and do what they feel is best for their baby. Additionally, I hope that all medical professionals will encourage breastfeeding and provide the necessary information and assistance to all mothers!

August 22nd, 2011 at 11:32 am

Elizabeth, Thank you for sharing your story. It is extremely heartening that you were able to share your breastmilk after what must have been a tremendous loss.

August 22nd, 2011 at 11:35 am

Heidi, Your story is inspiring and amazing – thanks for taking the time to share your experience and encourage other mothers. Good luck to you and your little ones!


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