Providing Colostrum for your Baby in the NICU
What is colostrum?
-Colostrum is special, early milk made in the first few days after delivery (generally the first 24 pumps or feedings).
-Colostrum has unique ingredients that protect newborn babies.
– Colostrum is like a medicine that only a baby’s mother can provide.
How do I collect colostrum for my baby?
– You can use the materials in this kit to collect colostrum for your baby.
– Hand expression and pumping are both important, effective ways to collect colostrum and boost milk supply. Hand expression should be done for about 5 minutes to collect colostrum in the small containers and then you should pump for 15 minutes using the regular bottles.
– All milk MUST be labeled with either the infant or mother’s label and the date and time of expression written on the label.
How will the colostrum be used?
– Using syringes, either you or your baby s NICU nurse can gently place colostrum to the insides of your baby s cheeks, where it will be absorbed into the body and help his or her immune system.
– Oral colostrum care is very safe, even in the smallest and sickest babies in the NICU, and it may help prevent infection in your baby.
Please let your nurse or lactation consultant know if you have any questions or need any help!
Establishing and Maintaining a Good
Milk Supply for Your Preterm Baby
Stimulating the breast often during the first days and weeks
after giving birth is a great way to get a good milk supply. For
moms who deliver preterm babies, it is important to begin
expressing milk as soon after delivery as possible. To get your
body to make more milk you must remove the milk your body
has already made, so it is important to express milk every two
to three hours (8 to 12 times every 24 hours).
In addition to expressing your breast milk using your hands
(hand expression) and pumping frequently, there are other
things you can do to help build your milk supply:
-Empty your breasts as often as your baby might eat (every 2-3 hours).
-Try to pump both sides at the same time using a hospital-grade electric pump.
-Have a calm, soothing routine when you pump:
Use a warm cloth to warm your breasts.
Sit in a comfortable chair with a table close at hand.
Have a drink nearby such as water or milk (pumping makes you
Have your pump supplies within reach (extra bottles, washcloth for
drips, and lids for bottles).
Play calm, soothing music in the background.
If possible, pump while you can see and hear your baby. If you are
away from your baby, have his/her picture or a blanket or piece of
clothing that he/she has worn recently. Seeing, hearing, and smelling
your baby are very powerful ways to get your milk to “let-down.”
-Pump after you hold or feed your baby.
-Massage all areas of your breast before and during pumping to help the milk to move from the deeper breast tissue to the nipple where it exits the breast (also called “hands on pumping”).
-Have your partner massage your upper back and between your shoulder blades to help relax you and help the let-down reflex.
Herbs, Nutritional Supplements and Medications:
-A balanced diet is very important—your body needs fuel and building blocks to make milk.
-Continue to take prenatal vitamins or multivitamins while you are producing breast milk.
-A bowl of oatmeal each day may help maintain or increase your milk supply. Oatmeal is a healthy addition to your diet and will cause no harm to mom or baby.
-Before you begin taking a new medication or supplement, discuss the risks and benefits with your healthcare providers and a trained lactation specialist.
-Fenugreek may help increase your milk supply when taken as a part of a balanced diet that includes plenty of liquids. There is limited information about the safety of fenugreek, especially for moms of preterm babies, but there are very few warnings of it causing harm. Other things
should be done before starting a supplement such as fenugreek.
-Herbal preparations such as “lactation tea” sometimes contain fenugreek, milk thistle and many other herbs. These products may contain herbs that decrease milk supply or can cause harm to babies.
-There are no prescription medications available in the United States that will increase milk supply.
Things that do not help your milk supply or may cause harm:
-Reglan may cause permanent side effects in you or your baby and is not recommended for increasing milk supply.
-Beer, hops, and brewer’s yeast do not improve milk supply. Multiple studies show decreased milk production in the hours after ingestion as well as poor feeding and increased drowsiness in babies.
-Over hydration: while dehydration will affect your milk supply, drinking too much water may be dangerous as well. “Drink to your thirst” means you should drink water or low-fat milk when you feel thirsty (on average 8-10 eight ounce glasses a day). So basically, drink a glass every time you
feed or pump.
-Mint: peppermint and spearmint may decrease your milk supply.
-Too much caffeine will decrease your milk supply.
-Cold medications containing decongestants or anti-histamines usually cause temporary decrease in milk supply.
-Some birth control medications may affect your milk supply. Have a careful discussion with your healthcare provider about birth control options that will have little or no effect on your milk production. Breastfeeding alone is not considered effective birth control.
Other considerations, if the above techniques have not helped:
-Anemia can cause difficulty developing a good milk supply.
-Some women in the post-delivery period have low levels of thyroid hormone. Discuss this with your healthcare provider (OB or primary care physician)—often correcting the imbalance improves milk production.
-Retained parts of the placenta may cause a failure to produce enough hormones to produce milk, and can cause also illness, pain, bleeding and infection in the mother. Removing those parts of the placenta will often correct this problem.
-A small number of women lack the hormones that are important for breast milk production. Your healthcare provider can help you decide if checking for these rare conditions is needed.
–Please contact your lactation consultant if you have any concerns about your milk supply. The first month after birth is a critical time for developing a lasting supply. Our lactation team is here to help you be successful.