Three Empowering Practices for NICU Parents
Breastfeeding Literacy Project Module 7.4
Three Empowering Practices
Practice 1 - Reframe Pumping as Milk Expression
“Milk expression is about getting milk out of your breasts for your baby “
- Language matters
- “Pumping” sounds mechanical and has to include a breast pump
- “Milk Expression” is more inclusive of multiple ways to get milk out of the breast
- The reframe changes how parents experience the work
Language matters.
When we say “pumping,” it sounds mechanical and like it has to involve the breast pump. When we call it milk expression, they have choices on how they get their milk out of their breasts and it can look a little different at each session.
They might hand express and then use their pump, pump first and then use hands-on pumping to finish, or they might only hand express, or they might only use their pump.
That reframe changes how parents experience the work. There’s agency and choice there that allows them to learn what works best for them in which situations - whether they are at home or at the bedside, have access to the hospital pump or not, feel like being plugged into the wall or prefer to use their hands to gently express milk.
Practice 2 — Explain the “Why”
Frequent milk expression tells the body to keep making plenty of milk
- The pump is sending signals while the baby is unable to do it
- Frequent milk removal in the early days is linked to better long-term milk production
- Understanding “why” helps parents feel connected to their baby through their milk
Many parents say that they weren’t really told why frequency of milk expression matters. It’s logical to assume it’s about emptying the breast, or “getting more out.” When we explain that the breast is waiting for a signal—that frequent milk removal tells the body “keep making plenty of milk”—they can easily understand how the pump is standing in for their baby and sending the signals instead of the baby.
We don’t even have to get deep into the biology with families. The simple message is: your body is asking, “Does anyone need this milk?” and every time you pump or take milk out by hand, you’re answering “yes.” That’s a concept we can all hold onto, and it helps with motivation and positivity when volumes are small, the baby isn’t eating or is only taking small amounts, and the whole NICU situation feels overwhelming.
Practice 3 — Give Specific, Time-Bound Goals
“Pump as much as you can” is not a goal.
Give parents structure:
- 7–8 milk expressions every 24 hours
- No interval longer than 5 hours—even overnight
- Concrete, achievable, something to troubleshoot together
“Pump as much as you can” is not really a goal. It’s a recipe for guilt and confusion. When we say “seven to eight times in 24 hours, and don’t go longer than five hours between sessions—even overnight,” we’re giving parents a structure they can hold onto.
It’s concrete. It’s achievable. And it gives them something to troubleshoot with us if they feel like they are falling short—not a vague sense that they’re “not doing enough.”
About The Breastfeeding Literacy Project
Breastfeeding Literacy is a free, evidence-based curriculum for anyone who supports breastfeeding families.
Built on the First 100 Hours framework, this curriculum covers the physiology of lactation, clinical assessment and intervention, ethics and industry influence, and support for special populations including late preterm infants and NICU families.
It’s designed for lactation professionals, nurses, midwives, doulas, medical students, peer counselors — and parents who want to understand how breastfeeding actually works.
Why free? Because access to accurate lactation education shouldn’t depend on what you can pay. No paywall. No sponsors. No industry influence.
About Christine Staricka
Christine Staricka is an IBCLC with 25 years of experience, an international speaker, and founder of Evolve Lactation Media. She is the author of Evolving the Modern Breastfeeding Experience: Holistic Lactation Care in the First 100 Hours.