If there has been no expression of milk during her ICU stay, you will do well to follow the guidelines for relactation, keeping in mind that it will likely take less time to get things going than if she were starting from scratch, i.e. without a pregnancy in the very recent past.  She should know how to hand express so she can do that whenever she has a moment, or when the baby is with her, to give the baby an extra hint of things to come.  She may want to use a pump in a systematic way to stimulate production, especially as the amounts increase, but be prepared for her to prefer hand expression and coaxing the baby to latch.

The basic steps are as always.  1) Feed the baby and 2) Protect the milk supply.  Encourage baby to help things along by spending as much time as humanly possible on mother's body; they both have a LOT of catching up to do.  Really, every moment that is not being used to do steps 1) and 2) can be an opportunity for mother to rest, lying down, with baby on her chest.

Her significant others can really help by relieving her of responsibility for other tasks, like cooking, shopping, laundry, and cleaning and washing milk containers and pump parts, etc.  They should all be made aware that it is counterproductive for anyone else to start feeding the baby, even when the baby is getting breastmilk substitutes.  The mother and the baby need to be together.

In my experience, things kind of toodle along slowly at the start and the mother may feel that breastfeeding is beyond her reach, but once the baby discovers how great it is to lie in her arms with a breast in its mouth, it gets much easier.  It seems like that often doesn't happen until production is up to a point where she can express a stream rather than individual drops of milk.  But this is one situation where you really *want* the baby to 'use mother as a pacifier' (I cringe as I write these words, but it's the only way you can explain it to a lot of Western parents).

There is no way to predict whether she will be able to exclusively breastfeed.  It might happen and it might not, but by following a plan that emphasizes mother and baby being physically in contact, both of them will enjoy the effort regardless of how much milk results.  I have yet to meet a mother who was sorry she tried.

Rachel Myr
Kristiansand, Norway

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