Breastfeeding in the NICU: How to Solve a Unique Challenge

First published August 2017
Updated April 2026

Note: We use the term “breastfeeding” to encompass all forms of lactation, including direct breastfeeding, chestfeeding, and providing expressed human milk in a bottle.

Soon-to-be parents often imagine what their baby will be like, what will happen during the delivery and how their lives will change. No prospective parent wants to imagine their child will end up in the NICU, an intensive care unit especially for babies, but it’s a situation many families face. This separation is never easy, especially for the mother and baby when it comes to breastfeeding.

Some babies have to go to the NICU immediately after being born. Many of the hormones involved in making milk are stimulated by the baby’s presence, especially baby’s presence at the breast. As soon as the lactating parent is able, they should be encouraged to visit their baby in the NICU. Many NICUs have open visiting hours, meaning parents are welcome to visit any time of day or night.

Most babies can be placed skin-to-skin with the birthing parent in the NICU, even shortly after birth or surgery. This is called skin to skin and it is very important for breastfeeding, baby’s development, and strengthening the maternal-infant bond. Parents should ask the medical team in the NICU when they will be able to do skin to skin.

One of the most common reasons for a baby to go to the NICU is because the baby was born early, or premature. Babies who are born prematurely need human milk even more than term babies. Studies show that premature babies are at higher risk of infection than babies born on their due date and human milk has been shown to help prevent infections in these babies. That is why human milk is really important for premature babies in the NICU; it’s a medicine that only the lactating parent can give.

When a parent delivers a baby early, they are at higher risk for not making enough milk. Women are exposed to hormones when they are pregnant that cause glands in the breasts to increase in number so there will be lots of them to make milk when baby is born. Women who deliver a baby early are not exposed to these hormones for the same amount of time as women who deliver on their due date. They may not have as many glands to make milk, so it is very common for these women to have trouble keeping a full milk supply.

The best way to make as much milk as possible, is to pump as early after delivery as possible (preferably in the first hour) to stimulate the release of hormones to make milk and to obtain the colostrum that is made in those first few days. Colostrum is the very best kind of milk, loaded with antibodies and factors to help baby’s immune system, which is why it is often referred to as “liquid gold.”

Colostrum is a small amount of thick, dark yellow liquid that doesn’t look like regular milk because it is concentrated with so many good things. Sometimes it is easier to get this milk by using hand expression after you pump. Every drop of colostrum is very important! It is normal to get very little milk in the first 3-5 days after delivery, but it is important to keep pumping during this time to increase milk supply.

Some hospitals have donated breast milk available to use until a parent’s own milk comes in. Donor human milk is screened and pasteurized. It has many of the same benefits, but a parent’s own milk is even better! A parent who delivers early will make milk specifically designed for their premature baby. This special milk has more protein and electrolytes to help their premature baby grow.

It is also important to make sure you continue to pump 8-10 times every 24 hours with a hospital grade electric breast pump and hand express afterwards to get any milk remaining in your breasts. If you have trouble with your supply, remember you have lactation specialists and nurses that can help! It is a lot of work but ANY amount of human milk you can give your baby is very important!

Click here for more information on the Nationwide Children's Hospital Neonatal Intensive Care Unit.