Feb 01

Making Milk For Your NICU Baby

Basic Rules Of Pumping

Start pumping right away! Pumping within the first hour is the best, try to do it as soon as you can after baby is born.

You can use either an electric pump or hand expression to stimulate your milk.

The first days after birth and when you go home are CRITICAL for good milk production.

DO NOT GO HOME WITHOUT A PUMP. Be sure you get a good pump to go home with.

When you first pump, you may see drops of milk or no milk at all. This is normal. Try to be patient, continue pumping and log your milk volume on a log book or app— you will be surprised how quickly it increases- usually by the end of the first week.

Click here to download our log book

Early milk, called colostrum, is especially important because it contains concentrated antibodies to provide protection from infection.

So every milliliter (mL) of this early milk is a benefit to your baby- every mL has over 1,000,000 immune cells in it!

Pump for 15 to 20 minutes every four hours (six times a day).

Check out this great video to see how mothers around the world use their hands to provide colostrum and stimulate milk production.

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Milk For NICU Babies

A full-term baby feeds at the breast 8 to 12 times per day during the first few days following birth, which stimulates milk production.

Sick or premature babies are usually unable to do this, so mothers of these babies need to use a pump or their hands to express milk— at least initially — until their babies are ready to breastfeed.

REMEMBER-It’s important to start pumping as soon as you can.

Mothers who pump soon after delivery make twice as much milk as those who wait.

Pumping as early as the FIRST HOUR after birth is important to help mom end up with a good milk supply weeks later.

Premature babies are often born to mothers who are ill, or ill prepared to have a baby so early. So do the best you can and enlist others to help you succeed.

It is very important to have an established milk supply early so that there is always enough milk for your baby.

A good goal is to make 600 mLs (20 ounces) or more of milk each day by the end of the second week.

This amount is what your baby will need by the time they are ready to go home.

Providing Breastmilk For Premature And Ill Newborns

Providing breast milk for a premature or seriously ill newborn may be a challenge, but it is usually possible and it is certainly an effective way to enhance your baby’s health, growth, and development.

Even if your baby is unable to breastfeed at first, you can begin expressing your milk immediately after giving birth.

When your baby is stable, they can have the milk fed to them by a tube or by letting them sip the milk from a tiny cup or bottle.

No matter how your breast milk is delivered to them, your milk provides the best nourishment possible at a time when such an advantage makes a big difference.

Premature Milk

Mothers of premature babies produce breast milk that is slightly different in composition, at least for the first several weeks, and this difference is designed to meet your baby’s particular needs.

Premature milk is higher in protein and minerals, such as salt, and contains different types of fat that she can more easily digest and absorb.

The fat in human milk helps to enhance the development of the baby’s brain and neurologic tissues, which is especially important for premature infants.

Human milk is easier for infants to digest than formula and avoids exposing their immature intestinal lining to the cow’s milk proteins found in premature infant formula.

The milk you produce in the first few days contains high concentrations of antibodies to help your baby fight infection.

Even if your baby cannot breastfeed yet, expressing breast milk from the beginning will ensure that your milk supply is maintained until your baby is able to nurse.


Your first step in providing your baby with breast milk is to enlist the support of the medical personnel who will care for your infant at the hospital.

Notify your baby’s pediatrician and neonatologist, if one is caring for your baby, of your desire to breastfeed and to provide your expressed breast milk for your baby.

Your doctors can arrange to have your expressed milk fed to your baby or for you to breastfeed your infant in the neonatal intensive care unit (NICU).

Many hospitals now provide private areas for nursing and trained specialists to assist breastfeeding mothers.

Ask your baby’s nurse or a lactation consultant in the NICU for assistance.

These experienced members of your support team can show you how to assemble and use an electric breast pump, teach you to express milk efficiently, and give you advice on storing breast milk.

If you are able to directly breastfeed, they can help you adjust your nursing position to your infant’s small size.

Many neonatal intensive care units encourage parents to room in continuously and keep the baby skin to skin, sometimes referred to as kangaroo care, because this has been shown to be beneficial for stability and optimal growth and development of premature babies.

Breast milk pumping, or expression, immediately after holding your baby skin to skin is a very effective way to increase your milk supply.

Some mothers find pumping at their baby’s bedside in the NICU very helpful as well.

Lisa Stellwagen MD, FAAP  Professor of Clinical Pediatrics at UC San Diego Health
New Mother’s Guide to Breastfeeding, 2nd Edition (Copyright © 2011 American Academy of Pediatrics)
Special Thanks To Global Health Media Project For Sharing Their Important Video Work Around The Globe.