Planning for the Unexpected

Planning for the Unexpected

June 28, 2023 Infant

Becoming a new parent can be an exciting and joyful time. You spend months getting ready — from buying a car seat to choosing a crib. However, if your little one arrives several weeks early, it can catch you by surprise and mess up those well-laid out plans.

Neonatal Intensive Care

Neonatal Intensive Care

When a baby is premature or has a condition that requires medical help, they are taken to the neonatal intensive care unit (NICU). The NICU is a special area in the hospital where infants receive treatment and support while their tiny bodies mature and get strong enough to go home. It can be very scary for parents who have never been inside a NICU. There are wires, monitors, strange equipment and a team of health care professionals making decisions about your baby’s care. Moms can feel disconnected and helpless. Some of the care, such as giving medications, must be left to the hospital staff. But you can play a very important role in other ways, especially when it comes to nutrition.

Feeding Your Baby

If you had your heart set on breast/chestfeeding, it can be disappointing if your baby is not strong enough to do that at first — but don’t despair! You can still provide human milk, which can help your baby get stronger faster and may prevent some life-threatening problems, too. You can express your milk using a breast pump. Most hospitals have these available; after delivery, request a pump for use in your room. If your baby can’t nurse directly, you may wonder how they will get your milk. The nurse will place a thin plastic tube into your baby’s mouth or nose, which goes down into their stomach so they can receive the milk. If they are too young to tolerate anything in their belly yet, your human milk can be stored in the NICU freezers until ready for use, even if it’s several weeks later.

Feeding Your Baby
Good Milk

Establishing A Good Milk Supply

Take these steps to ensure a good supply of human milk for your little one:

  • ✓ Establish a pumping schedule: pump every 2-3 hours. It’s easy to forget to pump when your baby is not crying for milk yet. Set an alert or reminder so you don’t miss a session.
  • ✓ Ask your baby’s doctor when you can try Kangaroo care, the practice of holding your baby in their diaper against your bare chest for skin-to-skin contact. This closeness can increase your milk supply and get your baby used to your smell. It has also been proven to help premature babies control their heartbeats, breathing and temperature.
  • ✓ Around 32 weeks gestational age, babies start to develop their sucking reflex. (Gestational age is a term that means how many weeks along a pregnancy is, but is also used to tell how old a preemie is.) Ask your baby’s health care team when your baby can be put to your breast/chest to practice. Even if your baby isn’t ready to try at 32 weeks, try again each week.
  • ✓ After you’re discharged from the hospital, ask if the NICU has a private ‘pumping room’ where you can pump in between visits with your baby. Many hospitals provide the machines and moms just have to bring the tubing and storage containers. Also, check with your local WIC clinic, as they may be able to provide you with a pump to use at home.
  • ✓ Take care of yourself by eating regular healthy meals and snacks and drink plenty of fluids.
  • ✓ If you need help, call your WIC breastfeeding peer counselor. They are experts on breastfeeding and can offer advice on pumping too.

Don’t be surprised during the first few days of pumping if you only produce a few drops of colostrum and milk. This is perfectly normal and it is all your baby needs. Your body will adjust to the amount your baby needs over time, as long as you continue to pump regularly. Visit your baby often, especially around a scheduled feeding time. Let the nurses know you want to be the one to hold your baby while they receive a feeding (bottle or tube).

Don’t be surprised during the first few days of pumping if you only produce a few drops of colostrum and milk. This is perfectly normal and it is all your baby needs. Your body will adjust to the amount your baby needs over time, as long as you continue to pump regularly. Visit your baby often, especially around a scheduled feeding time. Let the nurses know you want to be the one to hold your baby while they receive a feeding (bottle or tube).

Prevention

Not all premature births can be prevented, but you can do your part to lower the risk of your baby being born early:

  • ✓ Don’t smoke.
  • ✓ Gain the right amount of weight.
  • ✓ Make sure to have folic acid in your diet even if you are not planning a pregnancy: take a daily vitamin supplement or eat cereal that has 400 mcg of folic acid.
  • ✓ See your health care provider as soon as you are pregnant.
  • ✓ Don’t drink alcohol or take street drugs.
  • ✓ Take care of your health, especially if you have diabetes or high blood pressure.
Prevention
Side-Lying

Side-Lying Hold

  1. For the right breast, lie on your right side with your baby facing you.
  2. Pull your baby close. Your baby’s mouth should be level with your nipple.
  3. In this position, you can cradle your baby’s back with your left arm and support yourself with your right arm and/or pillows.
  4. Keep loose clothing and bedding away from your baby.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You want to rest while baby feeds
  • You are breastfeeding in the middle of the night
  • You and your baby are comfortable in this position
cross-cradle

Cross-Cradle Hold

  1. For the right breast, use your left arm to hold your baby’s head at your right breast and baby’s body toward your left side. A pillow across your lap can help support your left arm.
  2. Gently place your left hand behind your baby’s ears and neck, with your thumb and index finger behind each ear and your palm between baby’s shoulder blades. Turn your baby’s body toward yours so your tummies are touching.
  3. Hold your breast as if you are squeezing a sandwich. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  4. As your baby’s mouth opens, push gently with your left palm on baby’s head to help them latch on. Make sure you keep your fingers out of the way.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby is premature
  • Your baby has a weak suck
  • Your baby needs help to stay latched
  • Your baby needs extra head support
  • You and your baby are comfortable in this position
Football

Clutch or “Football” Hold

  1. For the right breast, hold your baby level, facing up, at your right side.
  2. Put your baby’s head near your right nipple and support their back and legs under your right arm.
  3. Hold the base of your baby’s head with your right palm. A pillow underneath your right arm can help support your baby’s weight.
  4. To protect your back, avoid leaning down to your baby. Bring baby to you instead.
  5. Reverse for the left breast.

This hold is useful when:

  • You had a C-section
  • You have large breasts
  • You have flat or inverted nipples
  • You have a strong milk let-down
  • You are breastfeeding twins
  • Your baby likes to feed in an upright position
  • Your baby has reflux
  • You and your baby are comfortable in this position
CRADLE hold

Cradle Hold

  1. For the right breast, cradle your baby with your right arm. Your baby will be on their left side across your lap, facing you at nipple level.
  2. Your baby’s head will rest on your right forearm with your baby’s back along your inner arm and palm.
  3. Turn your baby’s tummy toward your tummy. Your left hand is free to support your breast, if needed. Pillows can help support your arm and elbow.
  4. To protect your back, avoid leaning down to your baby. Instead, bring your baby to you.
  5. Reverse for the left breast.

This hold is useful when:

  • Your baby needs help latching on
  • You and your baby are comfortable in this position
laid-back

Laid-Back Hold

  1. Lean back on a pillow with your baby’s tummy touching yours and their head at breast level. Some moms find that sitting up nearly straight works well. Others prefer to lean back and lie almost flat.
  2. You can place your baby’s cheek near your breast, or you may want to use one hand to hold your breast near your baby. It’s up to you and what you think feels best.
  3. Your baby will naturally find your nipple, latch, and begin to suckle.

This hold is useful when:

  • Your baby is placed on your chest right after birth
  • You have a strong milk let-down
  • You have large breasts
  • You and your baby are comfortable in this position