Skin to skin, first breastfeeding sessions, cuddles, comfort, breast stimulation, suckling, and bonding. All of this can be anywhere from days to months for mums with a baby in the neonatal intensive care unit (NICU). These moments are cherished and remembered as milestones in a precious fragile life.
Vulnerable babies born prematurely or with medical conditions, are born with a challenging start to their lives. Some parents have time to prepare for this with a diagnosis in utero. However, for other parents it becomes a total surprise when one’s baby is quickly whipped away at birth for lifesaving care and treatment. No matter how or what the circumstances are, any NICU mother will face difficulties.
Feeding a NICU baby may be one of the biggest challenges.
Breastfeeding, formula feeding and nasogastric feeding. All of these present their own set of challenges that a NICU mum and her baby have to face.
The road to breastfeeding your baby in the NICU can be a slow and gradual progression. It can be weeks or even months until a baby is ready to independently and exclusively breastfeed. When the time arrives, this moment becomes an exciting and memorable milestone. Some of the limitations a mother faces begins with the access to her own baby. This access can be limited since the newborn may be in an incubator, under photo therapy lights or attached to many machines and tubes. Skin to skin bonding (which stimulates oxytocins, milk production, and a good latch) may be minimal or even non existent.
Often times, a mother is forced to find other means for bonding and breastmilk production. These may come in the form of expressing breastmilk, looking at photos and hand holding their baby.
Formula feeding a baby in the NICU may be out of a mother’s control.
A newborn baby needs calculated nutrition right at birth and in the days or weeks following. A mother may struggle with not producing enough breastmilk to sustain her baby. Formula feeding then becomes the right choice for them at the time. There can be some benefits with formula feeding a baby in the NICU.
The time and stress with breastmilk production, expressing and/or latching dissapear. This time is often replaced with bonding and recovering. If feedings are hourly or second hourly some can be attended by a partner or nursing/midwife staff. However, formula feeding can also come with some challenges, especially to a mother who was desperate to breastfeed.
Another very common means for nutrition in the NICU is nasogastric feeding. For any newborn baby, feeding are energy consuming since they must happen around the clock. Precious little ones in the NICU need all the energy they can get to fight for their health and sometimes their life.
Some babies, especially premature babies, have trouble with sucking and swallowing; this can impact on their nutrition intake and therefor their growth and wellbeing. As mentioned above, nasogastric tube feeding is a common source of feeding in the NICU, the good thing about it is that it can be done during a baby’s sleep without disturbing them to complete the feeding. Nasogastric feeding saves them energy and gets the job done. Another positive is that a mother is able to cuddle and hold her baby and even latch him/her to the breast all whilst having a nasogastric feeding. This experience for both mother and baby holds so much value on their wellbeing and recovery.
For many NICU mums, figuring out how to feed your baby and give them the best start in life, raises many questions and anxiety.
A baby requires nutrition, growth as well as around the clock, timed and measured feedings. The decisions and anxiety regarding how to best feed a baby are some worries that a mum of a full term healthy baby may not experience to the fullest. For mums, feeding is a synonym of bonding and cuddling. It’s a desire and a goal.
All mums experience the same body and breast changes after birth. Facilitating a NICU mum to have the same opportunities as any other mum is important for the baby’s and her wellbeing. Keep in mind that a mother’s mental health can be affected due to her feeling like she has failed her baby in some way.
Remember that no matter what feeding option you choose, you are doing what is best for your baby at the time given the circumstances. Don’t be hard on yourself.
What was your personal experience with feeding your baby while at the NICU?
I am a busy mum to 3 children, I have had 3 very different pregnancies and breastfeeding journeys. I have worked in health since finishing school (20 years ago), it is all that I know and all that I love, I don’t see myself doing anything else. I have been a Registered Nurse/paramedic all this time and since having my family I became a Registered Midwife. My journey as a midwife has allowed me to promote and normalise birth and breastfeeding, my passion is in educating and empowering women through my HypnoBirthing education.