Advice from a NICU nurse (in a BFing friendly, progressive unit, unlike her hospital it appears)....
If I were your friend:
!. Kangaroo care, kangaroo care, kangaroo care!!!!!! Keep that baby glued to your chest 24/7 if you can. They sleep better, they grow better, they BF better, your supply is better. You can't do too much KC!! I tell my mamas to be prepared to sit there until their bladders pop
I also say dads can do it too, but t doesn't do much for their milk supply
2. There's no reason why an almost 37wk baby can't be EBing in the NICU. At my hospital, the baby (depending on condition, of course) would BF with pre and post weights. If, for example, we wanted the baby to take 30ml, if the baby BF 10ml we would tube feed the rest. No bottles. We also do what's called "cue based"... instead of saying "You need 30ml every 3 hours" we say "You need 120ml in 12 hours; how you take that is up to you" (comes out to the same amount). We then supplement with tube feedings as needed during that 12 hour period so they don't fall too behind. So the baby who wants to eat every 1-2 hours can. The baby who likes to sleep 4 hours can. We also try to give EBF babies realistic volumes... 60ml in a 1 day old is NOT realistic; 5-10 ml is. Of course, there may be conditions where a baby truly needs lots of fluids, but if they're that sick they're getting it from IV fluids, not feedings.
3. Look into a nipple shield... a soft silicone nipple that goes over your own nipple. A baby can latch onto this with less effort and get more milk vs just the breast. Not ideal, but better than a bottle. When the baby is stronger you wean them off the shield. Talk to a lactation consultant.
4. Hospital grade double pump. See if insurance covers the rental.
5. Other ways to help the baby suck: there are oral stimulation exercises that occupational therapists or speech therapists can demonstrate. They involve stroking of the cheeks and gums. Keep oral experiences as pleasant as possible. Offer q-tips dipped in BM for baby to suck on. Keep a soft fleece square in your bra and have baby lie with her head on it while she sleeps to get your scent when you can't be there.
6. Be a pain in the butt. You're not there to make friends with the staff. You're there to advocate for your child. Rock the boat. Be the squeaky wheel. Write everything down
. The plan for the day, what happened that day, test results, etc. Get a written, agreed upon plan posted at the bedside ("No bottles, no pacifiers, no formula, etc"). Yeah, some nurses dislike families like this but others silently applaud. You may make our 8 hour shift less agreeable, but it's a small, forgotten time in our life. Whereas a short NICU stay where the BFing relationship was not honored will effect your and your child's life forever.
ps-- just saw how long ago this post was; hope the baby is home and doing well! And I'll keep this post up in case it helps someone else... and since I took all this time to rant
I hate backwards hospitals...