Guidelines for NICU

It isn’t unusual for twins, triplets or more to be born preterm (i.e. before their due date) and having to spend days, weeks or even months in the Neonatal Intensive Care Unit (NICU) as a result. For those families wishing to breastfeed, it is possible to do so by pumping and bringing in breast milk to the NICU to be fed to their babies.

To ensure the best quality milk for your babies, here are some recommended collecting and storage guidelines of breast milk. Remember that every drop counts and whatever is collected is the best thing for your infants. If you have any questions regarding your milk supply or how to conserve it, be sure to ask the NICU staff.

Storage and Sterilization

  1. Purchase some bottles and labels to store the milk. The bottles need to be boiled and sterilized before each use. Bags are not appropriate for storing milk in the NICU.
  2. Clearly label each bottle, including the babies’ names, date and time that the breast milk was collected.
  3. Ideally prepare bottles of 1 ounce, 2 ounces or 4 ounces, if you can, for storage.
  4. Do not overfill the bottles as breast milk expends when it is frozen.
  5. Make sure all pump material is properly cleaned and sterilized between uses.

Storage Times of Breast Milk for Preterm Infants

Storage time
Freshly expressed milk Room temperature 25C or 77F 4 hours
Refrigerated milk (store in back not on door)4C or 39F a)Refrigerator (fresh milk)

b)Refrigerator (thawed milk)

a) 48 hours

b) 24 hours

Frozen Milk (Store at back, not in door. DO NOT REFREEZE) a) Freezer compartment inside refrigerator door

b) Freezer compartment with separate door

c) Deep freezer not attached to refrigerator

a) NOT RECOMMENDED

b) 3 Months

c) 6 months

Transporting Milk
(freshrefrigerated or frozen)15C or 60F
Packed in insulated cooler with ice or “ blue ice” 24 hours

 Transporting Breast Milk to NICU

Fresh breast milk can be refrigerated and transported to the NICU on ice or “blue ice” packs in a little insulated cooler. Once at the NICU, give your labelled breast milk to the nurse in charge of your babies to be placed in the refrigerator or freezer.

If you have any questions regarding these procedures or about breast feeding in general, be sure and talk to the nurse in charge of your babies. Hospital staff will be most happy to answer your questions and help you at any point.

If you have any questions regarding pumping or storing your breast milk, do not hesitate to discuss them with the nurse or lactation consultant.

Your breast milk is important to your babies. Save ALL the milk that you pump.

References

  1. Lots and lots of great, supportive, every-topic-you-could-think-of information and resources on breastfeeding, www.themilkmeg.com
  2. Hamosh M, Ellis LA, Pollock Dr., Henderson TR and Hamosh P. Breastfeeding and the working mother: effect of time and temperature of short-term storage on proteolysis, lipolysis, and bacterial growth in milk.Pediatrics Vol. 97, issue 4 pp. 492-498
  3. Lauwers J, Shinskie D., Counseling the Nursing Mother: A Lactation Consultant’s Guide, 3rd edition p.351
  4. Riordan Jan, Breastfeeding and Human Lactation, 3rd edition. p.378-382

From Valerie Lavigne, Mom of three breastfed babies, including twins.
Adapted by Lynda P. Haddon, Multiple Birth Educator,www.jumelle.ca 
Reviewed by Erin Shaheen, Child Birth Educator, Mom of 4 breast fed babies, including twins.

Other Resources:

Multiple Births Canada Fact Sheet: Breastfeeding Multiples: Pumping Tips

Kangaroo Care For Infants

Definition

Kangaroo care has become increasingly popular for newborn infants, especially preterm or low birth weight, whereby an infant is held skin-to-skin against the chest of an adult, usually the parents.  Ideally kangaroo care will begin right after birth and continue for as long as is possible, although short periods of time are also beneficial to babies and parents.

Process

Kangaroo care - mother and twinsMom and/or Dad/partner are usually wearing an over-sized shirt, large hospital gown or loose clothing exposing their chest.  The nearly naked (diaper only) infant is placed directly on mother/father’s exposed chest and the shirt wrapped snugly around baby, drawing him into the parent’s chest where he settles and snuggles.  Instead of a shirt, a warm blanket can be used to cover the infant(s) on parent’s chest to draw her close.

Two babies, and sometimes more, can be held at the same time on a parent’s chest with support from a nurse or the other parent.  If there are tubes and wires on a baby, be sure and check with the nursing staff before going ahead with kangaroo care.  It is also good for the babies to be together.  Every hospital has its own policy regarding Kangaroo Care, so check with your hospital to find out what their policy is.

Benefits for Babies:

  • Father and newborn, kangaroo carehelps stabilize heart rate and regulates breathing
  • improves oxygen saturation levels
  • more rapid weight gain
  • helps maintain baby’s body warmth
  • babies easily accessible for easier breast feeding
  • helps relax and sooth babies, spends less time crying
  • more alert time
  • can hear heart beat, replicating womb experience
  • earlier hospital discharge
  • all newborns benefit from kangaroo care, not just low birth weight and/or preterm infants

Benefits for Parents

  • builds confidence knowing you are offering your infants intimate care and a loving start
  • early closeness to the babies promotes bonding
  • baby easily accessible for breast feeding (when with mother)
  • slows parents down to focus on their infants and less worry about other matters
  • can offer “closure” to having Neonatal Intensive Care Unit (NICU) babies

Bibiliography

 

Early Delivery

I am very interested in sharing my story of my early delivery, premature, low birth weight babies. I am happy to say I am the mother of wonderfully healthy and beautiful four-year old twins who have been amazing to watch develop. I had a fantastic, problem free pregnancy and was loving every minute of it.

At a routine ultrasound at 30 weeks, I was told my twins were not developing equally and would have to be delivered immediately – I was not given any feedback as to what the problem might be. I was induced within three days (of my ultrasound) and delivered a 4lb. 3oz. boy and a 3lb. 8oz. girl. Very big for 10 weeks early.

As it turned out, they were both developing very well, were close in weight and did not need to be delivered so early. It was a very truly, frustrating and scary time for us.

Of course we ran the gamut of incubation, tube feeding, long hospital stays, no sucking reflex, breast pumping every two hours, one baby home while one remained in the Neonatal Intensive Care Unit, living in a new city with no family or friends close by, guilt for letting them be taken from me needlessly, and lots more.

But we were so lucky there were no major health problems and I did learn a life-long lesson about being an advocate for my children. This is just a small part of our story and I would love to be able to help others by sharing it.

Thanks,

Michelle, St. Thomas, Ontario