While in the hospital, we always aim to keep mum and baby together, and your baby will routinely 'room in' with you. However, if your baby requires more extensive medical support after birth, they may need to be transferred to a Special Care Nursery/Baby Unit, or a Neonatal Intensive Care Unit (NICU). Very occasionally, babies may need to be transferred to another hospital with a higher level of care available. Sometimes, there can be medical reasons why a baby may not be able to feed directly at the breast, often due to prematurity, NICU admission, or the baby needing to be transferred to a different hospital from the mother. This is where having a plan to support your breastfeeding journey becomes crucial.
This can understandably be a very distressing situation for a new mum and family, and it is usually quite unexpected. I have worked with a number of families over the past year who were in this exact scenario. While navigating this time, it is really important to protect and support your breastfeeding journey if you are planning to breastfeed. Hospitals are busy places with midwives being stretched to capacity, and unfortunately, breastfeeding support is often not the priority, especially when babies are admitted to the nursery/NICU and mums are on the postnatal ward or discharged home.
This is a situation that we all hope we will never be in, but it is so important to have strategies to support breastfeeding in those early days so that you can get back on track when you are both able to settle in at home.
What are the common reasons why a mum and baby may be separated at birth and unable to directly breastfeed?
Baby is born prematurely.
Baby is unwell and needs respiratory support or other medical care in the nursery/NICU.
Mum is unwell and in ICU.
Baby needs surgery.
In these instances, you may still be able to spend as much time as you like with your baby, so physical separation may not occur, but your baby may be too unwell or premature to directly feed at the breast. Even if your baby is not strong enough to feed at the breast, skin-to-skin contact should almost always be an option—discuss with your care provider whether it's possible to have skin-to-skin with your baby. Skin to skin has a whole host of extra benefits for premature babies!
What Can We Do to Support Breastfeeding in These Crucial First Days and Weeks?
Nipple stimulation and frequent removal of milk from the breast are two important factors in producing enough milk for your baby. Unfortunately, we often see mothers who were separated from their baby in the first 24-48 hours struggle with their milk supply, which can be linked to inadequate stimulation during those initial days.
Generally, this plan will involve hand expressing or using an electric breast pump at least 8-12 times every 24 hours, and engaging in skin-to-skin contact or attempting breastfeeding as soon as possible. Starting expressing within 12-24 hours after birth is crucial—delaying can impact milk supply. If your postnatal ward midwife does not discuss an expressing plan with you, please ask about it, as it is really important! Ensure you have the correct flange size, as one that is too big or too small can cause pain, damage, and limit the amount of milk that can be expressed.
Remember, in these early days, it is not so much about how much milk you can express, but ensuring there is adequate stimulation of the nipple and breast to establish your milk supply.
When you book your Postnatal Midwifery Package with us you will receive messaging support from your midwife between appointments, and whilst in hospital after your baby is born - this comes in super handy for navigating situations like this as you'll have your midwife cheering you on and supporting you every step of the way. If you're interested in learning more about our postnatal support head here!
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