Feeding your baby in the NICU

What does your baby eat in the neonatal intensive care unit (NICU)?

Before your baby was born, you may have thought about what it would be like to hold and feed them. And you may have decided if you were going to breastfeed or bottle feed your baby. But now that your baby is in the NICU, you may need to change your plans. This can be upsetting for many parents. Talk to your baby’s healthcare providers for more information on what and how you can feed your baby.

Breast milk is the best food for your baby, even if they’re in the NICU. It has vitamins, nutrients, and antibodies that can help them get stronger. And breast milk changes as your baby grows so they get exactly what they need at the right time. This is true even if your baby was born preterm. Your baby's provider may recommend that your baby receive milk from a donor (donor breast milk). Donor breast milk is breast milk that’s been donated to a milk bank. A milk bank receives and stores donated breast milk, tests it to make sure it’s safe, and pasteurizes it by heating it to a high heat to kill infections and bacteria. The milk bank then sends it to families of babies who need it. While your baby is in the hospital the donor milk will be ordered by the hospital and sent to your NICU.

You may choose to feed your baby formula or supplement your breast milk feedings with formula. Formula is a milk product you can feed your baby instead of breast milk. Talk to your NICU team about which formula is best for your baby. The team will work with you to ensure your baby is getting the food they need. They also can tell you how much formula to feed your baby and how to prepare it.

How do you feed your baby in the NICU?

The way your baby is fed depends on their medical condition and their ability to suck and swallow. Here are some different ways your baby may be fed in the NICU:

• Intravenous feeding: Babies who are very small or sick are often fed through an IV (intravenous line). A provider places a small catheter in a vein in the baby’s hand, foot, scalp, or belly button into a blood vessel of the umbilical cord. The provider will then tape the catheter in place and attach the IV tubing and bag of fluid to it. A baby receives fluids and important nutrients through the IV to help them grow.
• Tube feeding: Babies who are too sick or weak to breastfeed or drink from a bottle may need to be fed through a thin tube. The tube is put in the baby’s nose or mouth, down the esophagus, and into the stomach. If the tube is put in the baby’s nose, it’s called a nasogastric tube (NG tube). If the tube is put in the baby’s mouth, it’s called an orogastric tube (OG tube). Many babies who are tube fed can breastfeed or bottle feed. Sometimes babies are fed through an IV catheter and a feeding tube.

Your baby may have a medical condition that requires a different kind of feeding tube, called a gastrostomy tube (G-tube or gastric feeding tube). Surgery is done to put the tube directly into the baby’s stomach. NICU staff will teach you how to feed your baby using the G-tube and how to care for it. Babies with a G-tube may still be able to breastfeed and bottle feed.

• Breastfeeding: Some babies can breastfeed in the NICU, while others may not be ready. Ask your nurse or lactation consultant if you can breastfeed your baby and any other questions you may have, such as how to breastfeed, how often you should breastfeed, and how to make sure your baby is getting enough milk. Here are five steps to help you breastfeed:
  1. Get skin-to-skin with your baby. First, find a comfortable place to sit with your baby. Lay your baby between your breasts so that your tummies are touching. Skin-to-skin contact helps your baby get comfortable.
  2. Tickle your baby’s lips. Gently guide your baby so that their nose is close to your nipple. With one hand, support their head. With the other hand, hold your breast and tickle their lip with your nipple.
  3. Get a good latch. When your baby opens their mouth, bring them to your breast. They should have a good mouthful of your areola. This is called latching on. When your baby has a good latch, their tongue pulls your breast deep into their mouth. If you feel their tongue at the tip of your nipple, it’s not a good latch. Their nose and chin should touch your breast.
  4. Burp your baby. When your baby stops feeding, burp them. Sit them on your lap. Support their chest and head with one hand and pat or rub their back with your other hand. After they burp, offer them the other breast. It’s OK if they want it.
  5. Release the latch. If you need to stop nursing, don’t try to pull your baby off your breast. Instead, put your pinkie finger in the side of their mouth to release the latch.

As soon as your baby can, let them practice sucking at your breast to get ready for breastfeeding. Pump your breasts until they are empty. Then, let your baby touch and taste your breast to get used to what breastfeeding is like. This is called non-nutritive sucking.

• Bottle feeding: Your baby can receive pumped breast milk or formula through bottlefeeding. Talk to your baby’s nurse about how to prepare your baby’s bottle and the best way to hold your baby when bottle feeding.

How can you give your baby breast milk if your baby can’t breastfeed yet?

If you’re planning to breastfeed and your baby isn’t ready, you can pump your milk. A breast pump helps remove milk from your breasts. Using a breast pump may feel awkward at first. But with practice, pumping becomes easier and more comfortable. Your nurse or lactation consultant in the NICU can show you how to use the pump and create a pumping schedule. It’s best to use a hospital-grade electric pump. It gets the most milk from your breasts in the shortest amount of time.

Pumping breast milk provides your baby with something only you can give. It also allows you to feed your baby at a later time. To store your breast milk safely, after you pump, put your breast milk in bottles or bags. Put just the amount of milk your baby needs for each feeding in the bottle or bag. Be sure to write the date on the bottle or bag before you store it in the refrigerator or freezer.

What can you do if you’re not making enough breast milk?

Some moms may have trouble making breast milk. It can be really hard for those who had health problems before, during, or after their baby was born. If you’re having problems or are worried that you’re not making enough milk, talk with your nurse or lactation consultant.

You may be able to build up your milk supply by:

• Getting rest. Your body produces more milk when it’s rested.
• Eating well and drinking a lot of fluid, like water or milk. When you breastfeed, your body loses fluid. It’s important that you get that fluid back through what you drink.
• Using a breast pump after or between feedings. When you pump your breasts often, they make more breast milk.
• Pumping your breasts until they’re empty each time you pump.
• Doing kangaroo care (skin-to-skin care). This is when you put your baby, dressed only in a diaper, on your bare chest.

How can you feed more than one baby?

When you have more than one baby, feeding can be a challenge. You may find that one baby feeds better from the breast and another from the bottle. Or one baby may do better on breast milk and the other on formula. You may decide to pump milk for all your babies and only use formula when needed. Ask your nurse or lactation consultant for help.

Last reviewed: April 2025

See also: Breastfeeding is best, Feeding your baby formula, Keeping breast milk safe and healthy, Using a breast pump