Feeding your baby after the NICU

KEY POINTS

  • After your baby leaves the NICU, you can feed her breast milk, formula or both.

  • Your baby gives you cues for when she's feeling hungry and when she's had enough to eat.

  • Your baby most likely is eating enough if she's gaining weight and makes six to eight wet diapers 4 to 5 days after birth.

  • If you have trouble feeding your baby, ask for help from your baby's health care provider or your lactation consultant.

  • If you're feeding your baby from a bottle, use a cup of warm water to warm breast milk or formula. Never microwave your baby's bottle.

What does your baby eat after the NICU?

Breast milk (milk from your breast) is the best food for babies in the first year of life. Breast milk has antibodies that help keep your baby from getting sick. It contains nutrients that help your baby grow and develop. And it changes as your baby grows so he gets exactly what he needs at the right time. This is true even if your baby was born prematurely. Premature birth is birth that happens before 37 weeks of pregnancy.

In the NICU, you may not have been able to feed your baby the way you wanted to. For example, some babies in the NICU can't breastfeed directly (feed from the breast). They may not have a good suck, swallow breathe pattern to be able to breastfeed well, or breastfeeding may be too tiring. Now that you're home, you and your baby can get used to breastfeeding together.

You can feed your baby your own breast milk or donor breast milk. Donor breast milk is breast milk that a woman donates to a milk bank. A milk bank receives and stores donated breast milk, tests it to make sure it's safe and sends it to families of babies who need it. Donor breast milk is prescribed by your baby's health care provider. It has all the benefits of your own breast milk.

Formula is a milk product you can feed your baby instead of breast milk. If you're not breastfeeding or if your baby needs extra nutrients, he may need to have formula. Your baby's provider can recommend one that helps your baby get all the nutrients she needs. Sometimes babies get both breast milk and formula.

How do you know when your baby is ready to eat?

Babies eat a lot, and each baby is different. Some babies are hungrier in the morning, and other babies are hungrier at night. Most babies eat every 2 to3 hours, or eight to 12 times a day.  Over time, you get to know your baby's eating habits.

Ask your baby's provider about how often to feed your baby to make sure she's gaining enough weight. If your baby sleeps for long periods of time, you may need to wake her up every few hours to eat.

Look for and learn your baby's feeding cues. Feeding cues are signs that your baby is hungry. Feeding cues include:

  • Rooting. This is turning her head toward anything that touches her cheek or mouth.
  • Sucking movements or sounds
  • Putting her hand to her mouth
  • Crying. This is a late feeding cue. Try to feed your baby before she starts to cry.

To make nighttime feedings easier, you may want to put the baby's crib in your room so she's nearby during the night. The American Academy of Pediatrics (also called AAP) recommends that you and your baby sleep in the same room, but not in the same bed, for the first year of your baby's life but at least for the first 6 months.

How do you know when your baby has had enough to eat?

Look for your baby's cues. These are some ways your baby is telling you he's full:

  • He starts and stops feeding.
  • He unlatches often or spits out bottle.
  • He slows down or falls asleep.
  • He gets distracted easily.
  • He closes his mouth or turns his head away.

Your baby most likely is eating enough if he's gaining weight and makes six to eight wet diapers 4 to 5 days after birth. If you're worried that he's not getting enough to eat, tell your baby's provider.

Who can help you with breastfeeding after your baby leaves the NICU?

Most NICU babies can learn to breastfeed. It may take time and practice for you and your baby to get comfortable with it. Be patient and ask for help if you need it. You can get breastfeeding help from a lot of different people:

  • Your health care provider and your baby's provider
  • A lactation consultant. You can find a lactation consultant through your health care provider or your hospital. Or go to the International Lactation Consultants Association.
  • A breastfeeding peer counselor. This is a woman who breastfed her own children and wants to help and support mothers who breastfeed. She has training to help women breastfeed, but not as much as a lactation consultant. You can find a peer counselor through your local WIC nutrition program. Or visit womenshealth.gov/breastfeeding or call the National Breastfeeding Helpline at (800) 994-9662.
  • A breastfeeding support group. This is a group of women who help and support each other with breastfeeding. Ask your provider to help find a group near you. Or go to La Leche League.

Can you pump and store breast milk?

Yes. If you're breastfeeding, a breast pump helps you remove milk from your breasts. You may have used a breast pump in the NICU. Or you may want to use a one now that your baby is home because you're going back to work or school. Some moms use a breast pump because they want a break between feedings or so their partner can feed the baby.

After you pump, put your breast milk in containers (bottles or bags) and store them in the refrigerator or freezer. Put just the amount of milk your baby needs for each feeding in the container. Breast milk doesn't last forever, so write the date on the container before you store it. Fresh breast milk is safe at room temperature for 4 hours.

If you're using formula, how do you know what kind to get?

If you're feeding your baby formula, your baby's provider can tell you what kind to get and how much to feed your baby. Some babies leave the hospital on regular infant formula. Other babies need a special formula that has more calories or certain nutrients. Prepare the formula using the package directions or using instructions from your baby's health care provider. There are three kinds of formula:

  1. Ready-to-use liquid formula. You pour this formula right into your baby's bottle.
  2. Concentrated liquid formula. You add water to this liquid formula before giving it to your baby.
  3. Dry or powdered formula. You add powder to the water before giving it to your baby. Use the scoop that comes with the formula to measure the right amount. Put the water in the bottle first, then the formula, and shake well to mix.

If your baby doesn't drink all the formula within 1 hour, throw it away. Give her a new bottle of fresh formula at his next feeding.

How do you make bottle feeding safe for your baby?

If your baby has done well with the nipples and bottles used in the hospital, ask to take some home with you. And ask the NICU staff where you can buy them. If the nipples and bottles used in the hospital didn't work well, try different kinds to find the ones your baby likes. Clean and store the nipples and bottles as it says on the package directions.

If you're bottle feeding, warm the bottle before you give it to your baby. Put the bottle of milk or formula in a cup of warm water. Test the milk on your wrist to make sure it's not too hot—it should be lukewarm. Never microwave your baby's bottle. The breast milk or formula can heat unevenly and burn your baby's mouth.

When bottle feeding, hold your baby upright and support his head so he can breathe and swallow in a comfortable way. You and your partner can take turns so that both of you feel comfortable feeding your baby. Bottle feeding is a great way to be close and bond with your baby.

Last reviewed: June, 2019