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Breastfeeding and Lactation: What is the NICU Nurse’s Role?

NICU nurse with baby

When you became a NICU nurse, you probably didn’t imagine yourself spending much, if any, time supporting breastfeeding and lactation. You probably imagined yourself standing next to ventilators, navigating tangled lines, leads and tubes, or giving medications. You might not have realized that part of the NICU nurse’s role is promoting and supporting breastfeeding.  

How, exactly, can the NICU nurse do that?

Advocating for the best

There’s no question about the superiority of human milk for infants who are born prematurely or otherwise compromised.

For some NICU babies, human milk is literally a life-saving fluid. The NICU nurse is often in the position of having to explain to the family that their wishes to formula feed are not in the best interest of the baby’s survival. This takes tact, compassion, and superior communication skills.

Sometimes, the NICU nurse finds herself advocating for use of donor milk. Donor milk is so effective that some health insurance policies now cover it. However, persuading the baby’s family as well as the baby’s neonatologists that it’s the best choice isn’t easy. The nurse who advocates for it will need to develop some very diplomatic communication skills.

Another part of the NICU nurse’s role is to become actively involved in writing or updating a policy for donor milk. One cannot be involved in policy-writing without a fundamental understanding of the issues.

Helping parents to get answers to questions

Understandably, parents who have a baby in the NICU feel very overwhelmed, frightened, and confused. Some even blame themselves for the situation.

Often, these families can’t articulate a question. In that case, the NICU nurse’s role is to help them raise questions, and to provide answers. I recently generated 45 questions for which I believe every family deserve answers.

In my experience, discharge planning for the NICU baby often has little “planning” related to breastfeeding. Here, I’ve suggested several discharge-related questions parents should ask before leaving the NICU.

Giving practical help

Often, newborns who are born many weeks before term are unable to suckle the breast.

The NICU nurse’s role is giving tips and techniques for hand expressing, pumping, or using cups, spoons, or other devices.

Empowering parents to assume their role

More than parents of babies born at term, parents of preterm or compromised infants feel unequipped to take on the full mantle of parental responsibility. However, the NICU nurse’s role is to do the physiologic care-giving, and to help the parent do the parenting.

It’s hard to imagine anything more empowering than breastfeeding a baby. When we encourage parents to do that, we relinquish our own “in charge” position. For those precious moments, that baby is experiencing the quintessential parenting interaction.

Sometimes, nurses need to think out of the box. Or, we need to support parents who think out of the box!

During my interview with her, I asked Jennifer Canvasser to describe how she had talked the NICU nurses into letting her do babywearing. I even admitted that if I had been the nurse, she would have needed a compelling argument to get me to agree to it!

Luckily Jennifer was hugely successful in babywearing her preterm twins, but none of that would have happened if the NICU nurse had not encouraged the process.

If you’re a NICU nurse, you might want to get my 7 tips for safely babywearing for premature babies.

Advocating, answering questions, teaching, helping, empowering — all of this is part of the NICU nurse’s role in supporting and promoting breastfeeding and lactation.

If you’re a NICU nurse, how do you support parents in their breastfeeding journey? If you’re a parent, have you found support from NICU staff? Share your experiences in the comments below! 

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