Breastfeeding Premature Babies

All babies need breastmilk for optimal growth and development but there are numerous reasons why premature babies need breastmilk even more than full term infants. The breastmilk of a mother who has given birth to a preterm infant is specially formulated for preterm growth needs, with extra calories, vitamins, and protein. What's more, the live cells in breast milk that protect babies from infection can be even more important for premature babies: preemies face a higher risk of infection because their immune systems are particularly immature. Artificial formulas and supplements made just for preemies cannot provide the antibodies and other protective factors that are in your breast milk and are so beneficial to a fragile premature infant. Even small amounts of breast milk can provide premature babies with health benefits that last through childhood and potentially their entire life.

Giving Breastmilk to my Premature Baby

Whether or not your baby is ready to nurse at your breast right away will depend on his gestational age and overall health. At many hospitals it is standard practice to start off feeding very premature babies expressed breast milk through a nasogastric (NG) tube (also referred to as a gavage), in order to make sure the baby gets as much nourishment as possible if he's too immature to suckle from breast or bottle.

You'll work closely with the hospital staff overseeing your baby's care on a plan to feed your pumped breast milk to your baby. Many preemies simply aren't ready to start breastfeeding in the hospital right away, and won't be released until they've started to gain weight from breast- and/or bottle-feeding. Once your baby is able to start nursing at the breast, be prepared to nurse frequently, although preemies may not take in much milk at each feeding until they're closer to term. For this reason, you'll need to pump after feedings to keep up your milk production as well as have milk for any necessary supplementary feedings. You may need to use different breastfeeding holds for your preemie. Hospital staff, including lactation professionals, may be helpful when you start breastfeeding.

Breastfeeding Premature Baby Challenges

If your baby is too immature to breastfeed right after birth, your initial challenge will be to stimulate and maintain your milk supply. The most efficient and convenient way to do this is to use a hospital-grade pump with a double collection kit (a hospital nurse or lactation consultant will get one for you and show you how to use it). You'll also eventually want to rent one to use for the first several weeks at home, until you're sure your baby is feeding well at your breast.

Until you are able to participate in breastfeeding, you may feel upset, or angry and sad that nursing was "taken" away from her. However, when the news is shared about pumping breastmilk, your outlook is likely to change. If you choose to try pumping, you can be an active participant in mothering, even if you can't yet hold or care for your baby. Seeing your baby drink your breast milk can be very reassuring and comforting.

Breastpumping to feed a premature baby is not easy. Breastmilk supply can be very difficult to build up and maintain. Here are some basic questions and answers to help get you started while your baby is still in hospital:

Q: When can my premature baby begin to breastfeed?

Answer: If your baby is stable and relatively well, breastfeeding can be gradually introduced from about 32-33 weeks. Before this stage, expressed breastmilk can be given to your baby via a gavage tube, and baby's interest in breastfeeding encouraged by the skin-to-skin contact of kangaroo care.

Q: How do I get started breast pumping or expressing breast milk for my baby?

Answer: You'll need to begin pumping expressing by the day after your baby's birth, and even earlier if possible. Some mothers prefer to begin with hand expressing. A nurse or lactation counsellor should show you the proper way to express either by hand or with a breastpump. Once your milk has come in, you'll need to begin using a good breastpump. The pump may feel uncomfortable at first, so try to use a low setting. In time, you will be able to increase the speed and the suction setting of the pump. Read our articles on How to Use a Breast Pump and Expressing Breast Milk By Hand

Q: How often and for how long do I need to express or pump milk?

Answer: For the first day or two, before your own breastmilk comes in, you'll should pump for about 5 minutes every three hours during the day, and once during the night. Once your milk comes in (no matter how small the amount produced ), you should try to express at least 6-8 times in each 24 hour period, for as long as it takes to completely empty your breasts. You'll need to rent or buy a hospital grade electric breastpump to use at home. Frequent pumping can be difficult to manage with a sick baby but will help to build and maintain your supply. If your baby is in hospital for a long time, you may decide that it would be better for you to sleep through the night, but try to never go longer than 8 hours without expressing. When you know your baby will soon be coming home, you can begin begin expressing during the night again. Read our articles on How to Use a Breast Pump and Expressing Breast Milk By Hand

Q: What is the best way to store and freeze and thaw Milk?

Answer: Some hospitals don't allow the use of frozen milk. Your NICU will be able to guide you on their practices and procedures. Read our articles on Freezing and Thawing Breast Milk and Breast Milk Storage

Q: Is there anything I can do to increase my breast milk supply?

Answer: Maintaining a breastmilk supply without a nursing infant is very difficult.

Read our articles on Increasing Your Breast Milk Supply and Maintaining Breastmilk Production