Support for breastfeeding moms in the Tacoma General NICU
In the neonatal intensive care unit (NICU), breastfeeding is often a completely different experience — one that can take even the most experienced breastfeeding mother by surprise.
More than 90 percent of moms with babies in the NICU at MultiCare Tacoma General Hospital plan to breastfeed. And even though it’s hard work, most of them are able to reach that goal.
Some of our smallest patients are born as many as 18 weeks early. Many babies born prematurely don’t have the muscle strength, coordination, energy or basic understanding of how to eat because feeding skills usually develop starting at about eight weeks before a baby’s due date.
Pumping builds a healthy supply
So what do we do in those 10 or so weeks between birth and beginning to physically eat?
We start by helping moms pump to build and maintain her milk supply. That pumped milk is then given to baby through tiny feeding tubes until he’s able to do the hard work of eating.
The first hours after delivery are crucial to building a strong milk supply and providing milk for a preterm baby. Our labor nurses, as well as our mother-baby nurses are well practiced at getting mothers pumping soon after delivery if baby is admitted to the NICU.
Our lactation team then follows up to answer any questions mother may have about pumping and milk production. The lactation team also gets mom a strong hospital-grade rental pump to use while baby is unable to breastfeed.
Once mom is discharged from the hospital, our team of lactation consultants continues to follow up with her throughout her baby’s stay in the NICU answering any questions that may come up along the way such as:
- How much milk she should be getting when she pumps?
- Is the pump fitting and working properly?
- Is engorgement normal?
- How to manage blocked milk ducts
- How to keep the stress and anxiety of having a preemie from decreasing her milk supply
Working together to help mom and baby thrive
Once baby is developmentally ready to try breastfeeding, the care team really comes together to help mom and baby thrive.
The lactation nurses work with mom and baby and the bedside NICU nurses in helping baby latch and coordinate sucking, swallowing and breathing — an advanced skill that we take for granted outside of the NICU.
Feeding skills are gradually developed and breastfeeding assessments are often coordinated between lactation consultants and Mary Bridge Children’s Hospital speech therapists.
The NICU dietitians also collaborate to help baby breastfeed well and grow. Often mother will need to continue to pump after baby is discharged and until her baby is big enough to take all of her milk.
Many premature babies will follow up with lactation, speech therapy and a dietitian after discharge in order to continue developing good feeding skills.
Every day support for fragile babies
Our Level IV NICU at Tacoma General cares for around 800 babies every year. The NICU has the capacity to care for as many as 70 babies and usually has almost 60 babies under its care every day.
We know from many studies that preterm babies do best when fed their mother’s milk and it is the national recommendation that babies be breastfed. If a preterm baby’s mother is unable to pump or she is on medications that make us unable to use her milk, we use pasteurized donated breast milk from a milk bank to feed her baby.
About The Author
Sarah Newport is a certified Neonatal Intensive Care Nurse and certified Lactation Consultant at MultiCare Tacoma General Hospital. She was a bedside nurse in the Level IV Neonatal Intensive Care Unit at Tacoma General for several years before shifting into the lactation specialty for the NICU. She lives in Tacoma with her husband Matt and their three children.More stories by this author