Breastfeeding your hospitalized child

Ten steps for breastfeeding success for the hospitalized infant

If you follow these ten steps below, you should be able to establish and maintain a milk supply so you can breastfeed your baby when they are able.

1. Make the decision to provide milk for your baby

• Human milk is both food and medicine for your baby.
• It protects your baby in ways that infant formula cannot.

2. Establish and keep up your milk supply

• Pump every three hours for a minimum of eight pumps per 24-hour period.
• Pump every two hours for some pumping sessions if you are spacing some more than three hours.
• In the first few days of pumping, you will only produce a little bit of breast milk, but it is still important to pump regularly.
• Write down your pumping times and amounts in a pumping log.
• By the end of first week, you should be producing 500 to 1000 ml of breast milk in a 24-hour period.
• If you are producing less than 500 ml in 24 hours, talk to your nurse and find out how to make more breast milk.

3. Label and store your breast milk

• Label all milk that you pump with your breast milk label, which includes your baby’s full name, medical record number, and date and time the milk was pumped.
• All milk will be stored in your baby’s bin in the refrigerator or freezer at the hospital.

4. Remember to bring fresh milk every day

• We will use fresh milk to prepare your baby’s milk.
• If we don’t use all your fresh milk we will freeze the rest.
• If you have many frozen breast milk containers, we may send some home
• Consider where you will store the frozen containers.

5. Start skin-to-skin care (kangaroo care)

• Hold your baby skin-to-skin every day. Ask your nurse to show you how.
• For more information, see guidelines for skin-to-skin care.

6. Start non-nutritive sucking

• When your baby is ready, after pumping, we will help you position your baby at the breast.
• During tube feedings, it is helpful to position your baby skin-to-skin at the breast and let your baby taste and lick drips of your milk. Your baby may latch on and suckle a bit.

7. Practice breastfeeding as much as possible

• Once the baby is able to feed by mouth, visit your baby as much as possible so you can practice breastfeeding.
• The more breastfeeding practice your baby has, the quicker he or she will learn.

8. Know if your baby is getting enough milk

• We will weigh the baby before and after breastfeeding with a breastfeeding Baby Weigh Scale® - the only scale to know exactly how much milk the baby takes from the breast.
• Learn how to do this. It is important to weigh the baby exactly the same way before and after feedings (for example, you cannot change the baby’s diaper).

9. Get ready for discharge

• Before going home, come and stay all day or all night to feed and care for your baby.
• Plan to be in the hospital for more breastfeeding sessions if you can.
• Remember to take home your breast milk from the hospital freezer and refrigerator. You may need a larger freezer to store your milk.
• Talk to your baby’s nurse about transporting your milk home.
• For more information, see guidelines for transporting breast milk.

10. Be patient during your first few weeks at home

• Your lactation team will help you develop an at-home feeding plan.
• You will go home feeding your baby just like you were feeding in the NICU.
• For the first few weeks at home you will probably need to pump, and possibly give breast milk in bottles a few times each day.
• Be patient. Within a few weeks you will both be in a routine and breastfeeding will be easy.