Breastfeeding education for new parents is improving, but often leaves out parents whose babies are facing medical challenges. Breastfeeding and lactation can be difficult in the best circumstances, and adding your baby’s medical needs to the picture adds a layer of complexity. If your baby cannot latch for medical reasons, then you must rely on your breast pump to bring your milk production up to full volume. So to all parents with a baby in the NICU, these are my tips as a Breastfeeding Medicine physician to help you rock pumping for your baby in the NICU.
Tip #1 To Rock Pumping: Pump often on a consistent schedule.
During the daytime, pump every two to three hours from the start of the first pumping session to the start of the next pumping session. Each pumping session will take 10 to 20 minutes. During this time, you will likely see 2 to 3 periods of heavier milk flow (we call these ‘letdowns’). Overnight, you should take one 4-5 hour break between sessions. This is a marathon – you will need that rest.
Tip #2 To Rock Pumping: Get the right pump parts.
Use the right fitting pump parts for your body. Work with your hospital’s lactation team ASAP to get help with this. Pro tip: your pump part size can change over time, so be sure to get help again if things don’t seem to fit the way they did at first.
Tip #3 To Rock Pumping: Pump at the right setting.
Start with a low suction strength on your pump, then slowly turn it up until you feel the tiniest bit of a pinch. Then turn it down one level. Your pump should never cause pain. If it does, then you should get it checked out right away. I strongly recommend having your hospital’s lactation team evaluate your pump settings to be sure everything is optimized.
Tip #4 To Rock Pumping: Hand expression.
Add just a couple of minutes of hand expression at the end of each pump session. Especially in the early days, this can help you to get the most milk possible out. Eventually with a proper pump fit, this should be less necessary. Ask your lactation care team to show you how to do this.
Tip #5 To Rock Pumping: Make Pumping Suck Less. Think about your baby – snuggle something that smells like your baby and look at photos or videos of your baby. Relax as much as possible by listening to calming music, doing breathing exercises, or anything that helps you calm your body and mind while pumping. Distract yourself and try not to focus on how much milk you are pumping. All these measures increase your happy cuddle hormone levels, which helps the milk flow more easily.
Tip #6 To Rock Pumping: Aim for the right goals.
If you are directly breastfeeding, then it usually takes up to 4 or more weeks to reach full milk production volumes. But when you’re pumping for a baby in the NICU, we want you to reach maximum milk production more quickly. We aim to reach specific milk volume goals that are designed to help you make enough milk for the longest time possible. This means you may make more milk than your baby actually drinks at first – don’t worry, your baby will catch up over time.
On Day 1 you might only see drops of milk – this is normal! This first milk is very concentrated and nutritious. Every drop counts. By day 2-5 you should see an increase in the amount of milk you pump. By day 6 you should get at least 350 mL (or 11-12 ounces) of milk total over 24 hours. By day 8 you should get at least 500 mL (or 16-17 ounces) of milk total over 24 hours. By day 14 you should get at least 750 mL (or 25 ounces) of milk total over 24 hours.
If you aren’t hitting these goals, do not panic. Get help immediately from your lactation care team to learn how you can improve things. Normal milk production is about 25 to 35 ounces per 24 hours. If you make less OR much more milk than this, then get help to optimize your milk production.
Tip #6 To Rock Pumping: Get help early and often.
Reach out to your hospital’s lactation care team as soon as possible to help you get a good pumping routine started. Then work with them frequently to optimize things as you go. This is not an easy task, and you will need help along the way. You can find more tips to rock pumping in the NICU here. You can also download a free NICU Pumping Guide handout with these tips and more to keep with you through your NICU pumping journey.
Tip #7 To Rock Pumping: Pat yourself on the back.
Whether you make 1 drop of milk or a full volume of milk each day, stop and pat yourself on the back. You are doing an amazing job in a very difficult situation. You are a good parent. Your worth to your baby is not measured in drops of milk produced, even if it sometimes feels that way.
Medical Disclaimer: The information in this blog is general information and is not to be used as individual medical advice. Please always talk with your physician and your healthcare team before making any medical decisions for yourself and your baby.
