Kids Health Info

Breastfeeding a baby in hospital

  • Providing breastmilk is a special way for you to be involved in your baby's care while he or she is in hospital. Breastmilk is the best source of nutrition for your baby. If your baby cannot breastfeed because they are sick, you can express your breastmilk. Remember that any amount of breastmilk is better than none. There are several helpful specialists in hospitals available to help and support you with breastfeeding or expressing.

    Benefits of breastmilk

    • Your breastmilk uniquely meets your baby's needs.
    • Breastmilk contains a number of factors such as antibacterial and antiviral properties to reduce the chance of infection.
    Having your child in hospital may mean your baby's feeding is interrupted or temporarily stopped.  It is best to maintain familiar routines for your sick child, so weaning your baby at this time is not advisable or necessary.  The nursing staff caring for your child will do all they can to help you establish or maintain your milk supply until your baby is well enough to breastfeed.

      Breastfeeding in hospital

      If possible, continue to breastfeed your baby as often as you usually do at home. Hospitals can be a noisy, busy place. There are parent rooms and breastfeeding rooms if you prefer to breastfeed or express breastmilk in a quieter or more discreet place.

      • If this is the first time you have breastfed, or if your baby has not breastfed for a long time due to illness, feel free to ask for extra help or support from the nursing staff.
      • Pull the curtain around your child's bed to create a quieter and more private space.
      • Get a comfortable chair and try to relax for a minute or two before starting to breastfeed.
      • Spend a few minutes playing gently with your baby so that they are gradually waking up and getting ready for the feed. Wait for signals from your baby that they are ready to start feeding.
      • If you are taking any medications or are concerned about these affecting your baby, please ask the nursing staff.

      Positioning and attachment

      Always make sure your baby is positioned correctly and attached well at the breast. This helps you to continue to produce the right amount of breastmilk. This is especially important when baby is unwell and may have a drip or other medical equipment or needs to fast for procedures.

      • Hold your baby at the level of your breasts, close to you on his side with your baby’s chest and body against your chest/stomach.
      • Support the baby’s body along your arm with their bottom and legs wrapped around your side. There should be no gap between you and baby.
      • Baby’s head should be tilted slightly backwards with his mouth at the level of your nipple or slightly under your nipple.  Chest to chest and chin to breast.
      • Support your breast if needed but keep your fingers well back from your areola (the darker area around your nipple).
      • When baby starts to open mouth wider after the initial gape, bring him to your breast gently by moving his upper body.  Don't push baby's head forward.
      • Try not to change your position or release your hold on your breast until your baby is rhythmically sucking and swallowing well and there is no pain in your nipple or breast.

      A well attached baby has lips very wide apart, flat against your breast and flanged outwards. Your baby’s tongue should be cupping your breast tissue and the tip should extend past his/her lower gum line (sometimes this can be seen when baby is drinking). Your nipple should be in the back of the baby’s mouth and not in the front of the mouth. You should have no pain but there may be some discomfort in the very early days - this should settle over time.

      Always ask for help if you are unsure.

      brestfeeding image

      If you need to leave your baby

      If you need to leave your baby, try to leave enough expressed milk for the nurse to feed baby while you are away, making sure it is clearly labelled with your baby’s hospital sticker and placed in the ward temperature controlled fridge. Discuss with the nurse about how much milk to leave. Try expressing a little milk after each breastfeed or between feeds (about one and a half hours before the next feed) to build up enough breastmilk supply for the time you are away. If your baby needs supplements or formula, the hospital or the doctor may advise on a specific type.

      Keeping up a milk supply

      If your baby is too sick to breastfeed, or you need to stop breastfeeding because your baby is ill, express regularly to maintain your supply of breastmilk. Remember, any amount of breastmilk is better than none.

      • Express at least six to eight times a day.
      • You can express as often as every 90 minutes if you want to.
      • If you have missed expressing once or twice in a day, try to express several times close together to bring the total number of expressions up to about six for the day.
      • The number of expressions needed will be less for an older baby.

      Your anxiety and worry at this time is natural, and may cause a drop in your supply. Expressing milk, or feeding your baby often, as well as trying to relax first will help stimulate your supply. Try not to worry about how much milk you are getting. Even a little breastmilk is helpful for your baby. Ask the nurse for advice if your supply is seems to be dropping or you are having problems with expressing milk.

      Preparing to express breastmilk

      Collect everything you need first:

      • Sterilised cup or basin to collect the milk.
      • Sterilised sealed bottle or containers to store the milk (not necessarily a baby's feeding bottle). Select the best size of bottle for the amount of milk your baby is taking. Ask the ward for some small throw-away bottles if your baby is having very small amounts.
      • Sterilised pump (if you are using one).
      • A comfortable chair.
      • A drink and snack to help you relax and a photo of your baby if you aren't with them when expressing.
      • Label with your baby’s name.

      Hygiene

      Always use sterilised or disinfected cups and equipment when expressing. You can sterilise by either boiling, steaming or with a chemical product.  

      • Personal hygiene is important.
      • Wash your hands with soap and water and dry them thoroughly before starting to express.
      • Express the milk into the sterilised cup or basin.
      • At the end of expressing carefully transfer the milk into the sterilised storage bottles.
      • Do not touch the inside of the container, bottle or lid.
      • Seal with the cap provided.

      Expressing breastmilk

      • Hand expressing by gently compressing the ducts behind the areola (the darker area around the nipple) in a steady rhythm, is the gentlest way to express breastmilk.
      • A manual pump is easy to use or there are various electric pumps.
      • It is best to express for up to 20 minutes to empty the breast. Start on one breast. When the flow slows down, swap to the other side and then swap back. Milk will start to drip, then spray out as the 'let down' reflex works.  
      • Remember to wash your hands before you start and use sterilised pump parts or cups to collect your milk, and bottles to store your milk.
      • Refrigerate the milk as soon as you finish and keep the milk cool while you bring it to the hospital.

      Pumps

      • There are a range of manual and electric pumps on the market to hire or purchase from hospitals and/or pharmacies.
      • Electric pumps can also be hired from some maternity hospitals, pharmacies and through the Australian Breastfeeding Association.
      • Always feel free to ask for extra help or support from the nursing staff.

      Storing breast milk to use at home

      breast milk storage at home

      If you express more breastmilk than your baby will use, it can be stored for later. You can keep fresh breastmilk at the back of the fridge for three to five days to use at home (but not to bring into hospital). Frozen milk should only be used as a back up to fresh milk. It can be kept in the freezer section of a refrigerator for two weeks. It can also be kept in a deep freeze for six months. When you are ready to use it, it should be thawed out in a container of hand hot water and used within 24 hours of thawing.

      If you need to bring expressed breastmilk into hospital, bring chilled (not frozen) milk within 24 hours of expressing. It should be carried in a small esky with ice or a cooler pack to keep the milk cold. These steps ensure that the quality of your expressed breastmilk is at its best. Frozen expressed breastmilk should not be brought into hospital; you can leave this at home for later use.  (Refer to the Kids Health Info factsheet Breastfeeding at RCH).

      Re-establishing breastfeeding

      Expressing may not maintain your usual breastmilk supply as effectively as your baby's sucking. Once feeding starts again after your baby’s illness or surgery, frequent breastfeeds will increase your supply so that it matches your baby’s needs once again.

      Your own diet

      In the anxiety and worry of having a sick baby, it is important to remember to look after yourself.  Have water ready to sip on while you feed or express. To meet your energy needs, remember to have a sandwich or snack each time you breastfeed or express milk. Most women can eat their normal range of foods without causing problems for their baby. Try not to have more than three to four cups of tea or coffee a day.

      Key points to remember

      • Breastmilk is the best source of nutrition for your baby.
      • If your baby cannot breastfeed because they are ill, you can express your milk.
      • Any amount of breastmilk is better than none.
      • There are several helpful specialists available in hospitals to help and support you with breastfeeding or expressing.

      For more information and support

      • Your own Maternal and Child Health Nurse.
      • Lactation consultants.
      • RCH Nutrition website.
      • Australian Breastfeeding Association Breastfeeding Helpline, tel. 1800 mum 2 mum (1800 686 268).
      • Australian Breastfeeding Association books and website ( www.breastfeeding.asn.au).

      Other Kids Health Info factsheets:

       
      Updated by RCH Dietitians and Lactation Consultants, September 2013 

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    Disclaimer
    This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.