01 Aug It’s not that simple.
(August 1, 2014) Why are so many babies without their mother’s milk? Many people are surprised to learn that up to 70% of mothers who have a baby in the NICU have difficulty providing an adequate supply initially. There many factors that can contribute to a mother not being able to meet all of her baby’s need for milk. Much of the milk processed by HMBANA milk banks is used by neonatal intensive units (NICUs) for medically fragile infants such as premature babies.
Mothers whose infants are in the NICU face a special set of circumstances that may make breastfeeding a temporary or long term challenge:
Physical: Thyroid conditions, anemia, breast surgeries, pituitary problems, and a variety of other medical conditions can result in decreased milk supply. For many issues, an adequate supply can be reached once the underlying cause is addressed.
Prematurity: A woman begins having the ability to produce milk midway through pregnancy and babies do not develop a suck/swallow/breathe reflex until 32 weeks gestation. These two factors can influence milk supply. Premature babies often cannot breastfeed directly for several weeks so mothers must pump their milk and pumping is simply not as effective and efficient as nursing.
Pumping and the NICU environment: Pumping takes time and effort. It must be done every couple of hours to mimic the schedule of a newborn and to maximize yield. In ideal circumstances pumping can be a challenging experience and the NICU setting is a far from an ideal environment. Having a sick infant is exhausting both emotionally and physically. The NICU is a stressful place. There are ups and downs, emergencies, meetings with hospital staff. Mothers are discharged from the hospital once they are medically cleared so they need to commute to the hospital. If their home is far from the hospital or if there are children in the home things begin to get even more complicated.
Labor and Delivery Factors: Research has shown that mothers who have lengthy labors or have cesarean sections may have delays of sometimes several days in their milk “coming in”.
Mother’s milk may not be an option: In some cases, a mother’s prescribed medication or substance abuse may mean that she cannot provide breast milk at all for her child.
While it may seem that the odds are stacked against them, mothers of NICU babies usually go on to make an ample supply of milk and successfully breastfeed their infants. Good lactation support and education is crucial and can greatly increase success rates.
Mother’s own milk is ideal so donor milk is not meant to be a substitute but rather a supplement until mother can provide a full supply. The use of donor milk has been shown to increase breastfeeding rates in the NICU and babies who receive donor milk have significantly higher rates of exclusive breastfeeding upon discharge.