Ebony Paul, MS is interning at MMBA as she works to complete her dietetic internship to become a Registered Dietitian focusing on pediatric and maternal health. She has written a blog post to guide NICU dietitians and lactation consultants in their support of breastfeeding moms.
This post is targeted as an educational post for NICU Registered Dietitians and lactation consultants about how to best support a lactating mom and her baby in the NICU.
Spending time with your baby in the NICU when the circumstance is unanticipated can create stress and challenges for the family. As NICU healthcare providers, it is important to be supportive to NICU families as they are going through these unexpected and challenging times. In addition to the unforeseen lengthy hospital stay, lactating moms may also face challenges in feeding their baby. Stress, limited bonding time, lack of privacy, and other medical complications are a few challenges a lactating mom may face when trying to maintain their breast milk supply. With the tips below in mind, you’ll be equipped to aid the successful feedings of these babies while they are still in the NICU and once they are able to go home with their families.
Drink Plenty Fluids
Water is a crucial component when it comes to maintaining one’s breastmilk supply. As one breast feeds, their body is losing fluid. The Academy of Nutrition and Dietetics recommends lactating moms to drink around 16 cups per day of water. Remind them that this can come from food and beverages! A helpful suggestion is to drink a large glass of water each time one pumps or breastfeeds.
Importance of a Nutritious, Balanced Diet
It is recommended by the CDC that lactating women intake an additional 300 – 400 kcal daily to help support their increased energy needs during lactation. To be well-nourished, lactating women should aim for approximately 2000-2800 kcal per day. This range is dependent on her age, body mass index (BMI), activity level, and where she is exclusively breastfeeding or both breastfeeding and formula feeding.
Rest
The body will naturally produce more milk when it’s rested, so encourage mom to get as much rest as she can. Remind her that taking care of herself is also taking care of her baby.
Moms on a Vegan or Vegetarian Diet?
Supplementation of iron, vitamin B12, Omega 3 fats such as EPA and DHA, and other nutrients may be recommended for lactating moms who are following a vegan or vegetarian diet. Plant source foods generally have lesser amounts of these vitamins and specifically contain only non-heme iron, which is less readily absorbed by the body than heme iron found in animal protein sources.
Giving Room for Grace
Every mom is different and it is important as healthcare providers that you ensure mom and baby feel supported during this challenging time. The pressure to adequately breastfeed may feel overwhelming for NICU moms. Gentle encouragement and regular visits from your team’s lactation consultant can help relieve some of the stress mom may be feeling and give her a sense of normalcy throughout this experience. Breastfeeding may not work for everyone, and that is okay.
For moms who are not producing a lot of breastmilk or who may not be responding well to breast pumps, donor breast milk can be a great option. Human milk banks accredited by the Human Milk Banking Association of North America (HMBANA), such as Mothers’ Milk Bank at Austin, provide safe donor breast milk that has been screened,pasteurized and tested for safety following strict standards. Hospitals should have donor breast milk stocked and dispensed primarily to babies who are born premature or very ill, to help to fill in this gap.
Resources:
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Nursing your baby – what you eat and drink matters. Nursing Your Baby – What You Eat and Drink Matters. (2022, April 13). https://www.eatright.org/
health/pregnancy/ breastfeeding-and-formula/ nursing-your-baby-what-you- eat-and-drink-matters -
Centers for Disease Control and Prevention. (n.d.). Maternal diet and breastfeeding. Centers for Disease Control and Prevention. https://www.cdc.gov/
breastfeeding-special- circumstances/hcp/diet- micronutrients/maternal-diet. html#:~:text=Yes.,amount% 20they%20consumed%20before% 20pregnancy. -
Frequently Asked Questions – Mothers’ Milk Bank Austin. Mothers’ Milk Bank at Austin. (2024, August 8). https://milkbank.org/faq/
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Torres, L. A. (2023, August 18). Human donor milk in the Nicu. Hand to Hold. https://handtohold.org/
everything-you-need-to-know- about-human-donor-milk-in-the- nicu/