Feeding your baby in the NICU
In the beginning, your baby may need help to get all the milk they need when breastfeeding.
You can:
- compress and massage your breast while your baby is feeding to help your baby get more milk in less time
- supplement your baby with expressed breastmilk, human donor milk or formula if your baby still does not drink enough while breastfeeding
Feeding cues
Babies use cues to tell us when they are ready to feed, if they are enjoying their feed, and when they need to stop or take a break.
When you see your baby’s cues and respond to them, you build trust with your baby. Your baby’s enjoyment during feeding and time with you are very important.
Cues your baby wants to feed
- awake and alert
- hands and fingers to face
- sucking hands or fist
- moving head side to side
- smacking or licking lips
- searching with open mouth
Cues your baby is enjoying the feed
- awake and focused on eating
- face and body relaxed
- hands near face
- regular pattern of sucking, swallowing and breathing
Cues your baby needs a break from feeding
- wide eyes, worried look
- gulping, milk spitting or spilling from sides of mouth
- nostrils widened, breathing pattern changes
- coughing or choking
- squirming or arching back
- fingers spread or making a “stop” sign
Cues your baby is full
- slows or stops sucking or swallowing
- comes off nipple, appears relaxed and content
- hands away from face, arms open and relaxed along body
Feeding expressed breastmilk
You can fee expressed breastmilk to your baby using different methods. Choose the method that best suits you and your baby’s needs.
- bottle
- nipple shield: a device that fits over your nipple. It may help your baby latch, suck and stay on the breast. Your milk will come through the holes at the tip of the nipple shield.
- naso-gastric or orogastric tube: a tube that goes into your baby’s stomach through his/her nose (nasogastric tube) or mouth (orogastric tube) to feed your baby.
Non-nutritive sucking
Non-nutritive sucking is a way for babies to satisfy their urge to suck. It helps with digestion, coordination of sucking and breathing and can help soothe your baby.
Your baby can do this by sucking at your breast after you have expressed your milk. You can also talk to your care team about other methods such as sucking on your finger or using a pacifier.
Learning to breastfeed
A preterm baby goes through specific stages as they learn to breastfeed. This is like learning any new skill.
Start breastfeeding your baby when they show signs of wanting to feed. Some babies are able to breastfeed once a day and others are able to breastfeed many times each day.
Steps to breastfeeding
These guidelines may help you and your baby learn to breastfeed.
- Hold your baby skin-to-skin.
- Look for feeding cues in your baby. They may be waking up, rooting, sucking and putting their hand to their mouth. These are signs that your baby is learning to coordinate sucking, swallowing, and breathing.
- Position your baby so their mouth is close to your nipple and watch for your baby to lick and sniff.
- Express breastmilk onto your nipple and gently rub it along the baby’s lips.
- Your baby may latch on to your nipple and begin to suck and swallow.