Breast Feeding Support
The NICU has lactation consultants dedicated to serving the NICU family. Knowing the importance and benefits of human milk to the sick or premature infant, our lactation consultants aim to assist the NICU family to achieve their breastfeeding goal or to provide them with the necessary information regarding the benefits of human milk to make an informed decision regarding the type of feeding they will choose for their infant.
Colostrum Mouth Care
All infants, regardless of what gestational age or weight they are born at, benefits from the milk a mother produces immediately after birth. This milk, called colostrum, contain high levels of immune agents which protect the infant against infection.
Family Advisory Council is a group of “graduate NICU parents” who have had a baby in the NICU and will be able to provide current NICU parents with emotional and informational support. You are able to provide a unique form of support that only another parent who “has been there” can give.
Lactation & Breastfeeding Support
Feeding Your Baby
Your baby is about to begin an important step towards going home…oral feeding.
Going from tube to breast/bottle feeding will take some time, but will be an exciting new step in your baby’s progress. You along with the nurses, lactation consultant and/or oral motor feeding specialist will partner together as your baby begins to feed by mouth.
While beginning to feed by mouth is an exciting time it can also be challenging. Each baby is different and will develop skills and move along at his or her own pace. Most babies do not begin to coordinate their suck-swallow with breathing until sometime between 34-36 weeks corrected gestational age.
It is very important that we begin to watch and respond to the signals your baby sends telling us he/she want to eat. These signals are called hunger cues. We start to look for these cues and assess feeding readiness with a scale around 32 to 34 weeks. This scale is posted in your baby’s room and on the back of this page, so that you can participate in the scoring.
Your baby can start to feed by mouth when he or she show feeding readiness scores of 1 or 2. Each baby is different and may be more or less hungry at different times of the day. The goal for each feeding is to make it a nurturing experience. A successful feeding is not based on how much your baby takes. A successful feeding is safe, nurturing and developmentally appropriate for each baby. Most babies will take different amounts at each feeding. Over time your baby will take an amount to provide good nutrition for growth and development over each 24 hour period.
Important Things to Remember:
- Quality of feeding is more important than how much your baby takes
- The area should be calm, quiet and with dim lighting
- To keep your baby focused on feeding:
- Swaddle with hands to mouth
- Limit changing the baby’s position as this can distract and increase energy use
- Minimize talking as this can also distract the baby
- No rocking or bouncing the baby
- No twisting or twirling of the bottle nipple
- If your baby falls asleep and stops sucking, he/she is telling you he/she is done; avoid trying to wake him/her to continue to feed.
- If your baby loses “tone” (limp arms, feels heavy in your arms) continuing to feed becomes unsafe because your baby could be at risk for choking
Once your baby begins breast/bottle feedings, we will use the Quality of Nippling Scale to track your baby’s feeding progress. We will teach you how to use this scale to make your own assessments of nippling quality when you are feeding your baby.
We look forward to working with you and your baby! Your baby’s nurses are always available for questions and will assist you as we begin this process.
Feeding Readiness Scale
|1||Alert or fussy before care
Rooting and/or hands to mouth, sucking on pacifier
Good tone (indicates autonomic stability)
|2||Drowsy, but alert once handled
Some rooting or sucking on pacifier
|3||Briefly alert with care
No hunger behaviors or change in tone
|4||Sleeps throughout care
No hunger cues or change in tone
|5||Apnea/bradycardia or desaturation with care;
Tachypnea greater than baseline or needs increased oxygen with care
Quality of Oral Feeding Scale
|1||Breastfeeds or nipples with a strong coordinated suck throughout feed|
|2||Breastfeeds or nipples with strong coordinated suck initially, but tires with progression|
|3||Breastfeeds or nipples with consistent suck, has difficulty coordinating swallow with respiration;
Requires and responds to external pacing
|4||Breastfeeds or nipples with a weak/ inconsistent suck;
decreased length of active sucking and increased length of rest intervals
|5||Unable to coordinate suck/swallow/breathe pattern despite pacing;
Has A/B’s or significant amount of liquid loss and/or tachypnea significantly greater than baseline
Both scales have been adapted with permission- Infant Driven Feeding Scale (S. Ludwig and K. Waitzman)