In many cases you can breastfeed your NICU baby. Certainly, pump your breastmilk until baby is able to latch. In some cases mom (or dad) can hold baby on her chest. For example, in cases of jaundice, place a bili-blanket underneath your baby on your chest and shine lights on both mom and baby. You may need to advocate with your doctors or nurses in order to be able to do this. Having regular consultations with a lactation consultant may help.
If/when you are able to breastfeed your baby, your doctor or nurse will need to measure baby before and after feedings in order to confirm how much baby is consuming. Any “guesses” or “estimates” could be very incorrect. This is especially important to do if you are feeling pressured to supplement with formula, which is most likely to occur in the first few days after birth before your milk has come in. Pump after nursing to encourage your milk to come in more quickly.
If baby can’t breastfeed for a long enough amount of time to get all they need, you can use a Supplementary Nursing System(SNS) to give your baby more (formula if necessary or pumped breastmilk if you have it) at the same time she is nursing, thus giving her more milk for less work.
Another option that may come in handy is a nipple shield. Nipple shields can be helpful if the baby is ill or small because it can make breastfeeding easier. It’s also helpful if mom has inverted nipples or if a preemie that has been bottle (formula or breastmilk) fed is resistant to switching to the breast. A device called a “latch assist” nipple everter by Lansinoh can help prepare your nipple before breastfeeding and make it easier for your baby to latch. Similar results can be obtained by utilizing a pump for a few minutes before attempting to have baby latch.
Don’t be fearful that extended breastfeeding might mean using a nipple shield or SNS for months and years. Most (if not all) babies will wean off of the breastfeeding assisting devices easily and quickly with assistance from a lactation consultant. Keep in mind that incorrect latch doesn’t only apply to breastfeeding baby. If it is uncomfortable to pump, you may have the wrong size of breastsheild. A lactation consultant, especially one experienced with new mothers pumping in NICU should be able to assist you with this.