Breastfeeding a preemie
Premature babies – Transcript
If you’ve given birth to a baby prematurely, so your baby has been born before 37 weeks gestation, I’m sure that you will be feeling quite anxious and concerned about the next few weeks and months, and it really can be a roller coaster ride of emotions. Coupled with this you may also be recovering from surgery, as well as trying to work out what is going to happen in regard to breastfeeding and getting your milk supply established, (how breastfeeding works) with a baby who may or may not be latching (not latching)at the moment.
So I feel it’s wonderful for you to know that your breast milk is still really important for your baby – and yes, it is possible to provide that milk, even if your baby isn’t latching right now. Breast milk is specifically tailored to your baby, and it’s very easy to digest. It’s also going to provide, (even from the first drop of breast milk that your baby gets), a teflon coating for the inside of your baby’s gut, protecting your baby from allergens and pathogens, and even the first drops of breast milk could provide a huge amount of antibodies that will boost your baby’s immunity too.
So not only will breast milk strengthen your baby’s gut, it also causes less strain on your baby’s kidneys too, and as your baby has been born preterm, your breast milk is very much like colostrum – very low volume milk, packed full of high protein, an excellent source for your baby, and really helping your baby to develop health wise, and development wise too.
Of course breast milk provides fantastic resistance to infections and disease (benefits and how long video) so it’s great to know that in many many special care units, right across the country, where consultants are on board with this knowledge, you will be encouraged to pump your milk and give your fresh milk to your baby.
If you can’t give your fresh milk, the next best milk is your frozen breast milk. After that it’s donor milk, and after that formula. So in these special care units staff will encourage you to pump your milk with a really good quality pump, and many breastfeeding mums have told me over the years that they felt that was the ONE thing they could do. This was psychologically beneficial to them too.
And it’s also great to know that breastfeeding mothers who produce an oversupply, are donating their milk to the milk banks, and donor milk is then also available for babies – and please be encouraged to know that even the smallest amount of breast milk that you produce at the beginning is useful to your baby.
From 32 weeks gestation premature babies have the capacity to latch on at the breast and suckle and swallow, but not all of them will do that – and we know that some full term babies don’t latch initially, so it is variable what your baby will be able to do at the breast – but your baby can be given lots of practice – even just licking the breast and nuzzling in, is practice for your baby, preparing to be able to latch on and to suckle, however long that may take.
Meanwhile, pumping your milk will enable your baby to get the milk while he is practising too. If you are pumping your milk, your baby may be fed via a small nasogastric tube that will help your baby to get that milk, even although he is not attached to the breast and suckling. Some special care units encouraged soaking a cotton wool ball with breast milk and just having it in the isolette with the baby, so that your baby can smell that milk while being fed with the tube.
So if you are pumping your milk because your baby isn’t attaching right now, or maybe doing a little bit of suckling, but not enough to get all the milk that your baby needs, then ask the staff to help you, with a hospital grade double pump. You can pump every two to three hours (no more than 10 to 15 minutes at each pumping session). If you can pump once at night, that is ideal, to keep up that supply, and your body will start to make milk in the way that your baby WOULD have generated that milk, had your baby been feeding frequently from day one.
Another beneficial thing that you can do with your baby is to do what they call kangaroo care – that means skin to skin with your premature baby, as long as he’s stable. Even if he’s attached to monitors, the staff can help you to do this, keeping your baby very close. I’d encourage you to look at the video and gain knowledge around what skin to skin can do for your baby.
I do also want to mention that the skin to skin has great potential to increase your milk supply, because it boosts prolactin hormone. There are studies showing how much more milk can be made by pumping, after you’ve spent time in skin to skin.
Even if skin to skin isn’t routinely encouraged in the particular hospital where you and your baby are, you may still be able to ask the staff to enable you to spend some time in that close contact with your baby, however minimal that may be.
Many babies born preterm start to display those pre-feeding behaviours, and often latch on better and get more practice at it when they do in skin to skin. As your baby begins to breastfeed, little by little, we know from studies that premature babies are far more stable and less stressed when they’re at the breast, than they would be if getting milk from a bottle.
We also know that their temperature is more controlled, and their oxygen levels and their heart rate and breathing – all of these things are more stable. Try not to be discouraged if your baby is only taking only really short little feeds, as long as you’re pumping your milk, then you’re keeping that supply up, and giving your baby all the practice. So it is literally, little by little.
It may be that you help your baby by hand expressing a little bit of milk first of all, just to get that initial let down. This can really help. So it’s very likely that for quite some time you’ll be doing a mixture of bottle feeding and feeding at the breast (mixed feeding)– so it’s good to know how to feed your baby from a bottle (safe bottle feeding) in the most breastfeeding friendly way, to allow your baby to be more in control of that feed – and know that as your baby gets better at doing what he is doing, and that he is hard wired to do (this), he will improve and take more feeds over time.
While your baby has been in the special care unit, it’s very likely that you will have been on a schedule for bottle feeding, as well as offering the breast – and in some ways that can be a security, as you can know where you’re up to – and as you allow your baby to come to the breast more and more, that pattern does change dramatically.
And a lot of breast feeding mothers have found that when they are orientating their baby back to the breast again, with all of the different patterns that babies do at the breast, have found this to be quite difficult, even from a psychological point of view.
So prepare yourself, and know that it will take a bit of adjusting to get your baby back to the breast, totally, and to get away from that more regimented pattern – but it is possible, and seek out that skilled support from people who are skilled in lactation, who can support you.
As well as seeking out this skilled support, make sure that you do have people around you, friends and family who can support you in this, and give you as much rest and time with your baby as possible, and do seek out support at your local breastfeeding drop ins, and get alongside other parents who’ve been in similar circumstances to your own, as a means of added encouragement.
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Version 1.1 published in March 2019. Next review date: Jan 2022
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