Can I Breastfeed My Preemie?

Premature babies can breastfeed even if they are born very early and need special care. While human milk is important to the health of all newborns, preemies benefit most from the infection protection human milk provides. All babies, including those born premature, have immature digestive systems making human milk the ideal food. Human milk also adjusts to the individual needs babies regardless of when they are born (preterm, near term, or full term). So there is no need to worry about meeting your baby’s nutritional needs.

Breastfeeding a healthy, full-term baby can be challenging for many new moms. And breastfeeding a preemie, especially one who may need intensive care, can feel overwhelming. Your medical team at the hospital, your health care provider, your baby’s health care provider, and your family can help you develop realistic breastfeeding goals.

Here are some tips from Amy Spangler’s BREASTFEEDING: A Parent’s Guide for feeding a baby who can’t breastfeed—yet:

• If your baby is unable to breastfeed, you should begin pumping your milk as soon as possible after delivery, ideally within 24–48 hours after giving birth.
• Use a fully automatic electric pump with double collection kit that allows you to pump both breasts at the same time.
• Babies who are unable to be fed orally during their earliest days can still receive the health-promoting benefits of their mothers’ milk through “oral care” procedures (swabbing the inside of the baby’s mouth with their mother’s expressed milk). The immune components of colostrum (a mother’s first milk) are especially protective when preemies are the most vulnerable, and so many hospitals encourage mothers and their care providers to express and collect their colostrum and apply it to the inside of their baby’s mouth using cotton swabs. (Connecticut Children’s Medical Center makes its oral care procedure available online.)
• Once your baby is able accept oral feedings, your expressed milk can be fed to your baby through a small tube that is passed though this his nose and into his stomach (gavage feeding).
• You will want to pump your breasts about 8–12 times in each 24-hour period. You may get only enough milk to cover the bottom of the collection container at first. Don’t panic! The amount of milk expressed will increase over time. Expect to get about 1 ounce from each breast during each pumping session after the first week.
• Pump whenever your breasts feel full to avoid engorgement. If you are making more milk than your newborn needs, freeze and store extra milk.
• Freezing milk can affect the anti-infective proprieties of breast milk so it is best to provide fresh milk to your preemie each day, if possible.
• Store your milk in single-serving clean containers; label each container with your baby’s name, the date and time the milk was collected, and be sure to include the name of any medication you are taking on the label itself.
• Your milk can be stored at room temperature for up to 5 hours but can be stored in a refrigerator (which is preferable) for up to 5 days.
• As soon as your baby is stable enough to be held, hold him each day skin-to-skin against your chest for at least one hour at a time. Kangaroo care has been shown to improve a baby’s weight gain. It also gives your baby a chance to feel safe and secure at your breast. And mothers often find that they are able to pump more milk after holding their babies skin-to-skin.

Once your baby is ready to start breastfeeding, you will want to try a variety of positions to see which ones work best. Regardless of which positions you choose, make sure your baby’s back, shoulders, and head are well supported. For babies with weak muscles, you may want to support his chin with your thumb and forefinger forming a u-shape called the “dancer hand.”

At first, your baby may just lick and swallow the milk (as opposed to suckle and swallow). Eventually, all babies will learn to suckle and swallow as their muscles get stronger and they become more accustomed to breastfeeding. As your baby’s suckling slows down, you can massage or compress your breast to increase the flow of milk . This will also ensure that your baby gets the high fat hindmilk and the calories he needs to grow.

It is important to give your baby a chance to breastfeed, but if you don’t hear him swallow, the nurse will give him your milk through his feeding tube, while you pump to maintain your milk supply.

At first, your baby is likely to be able to breastfeed only once a day; the rest of his feedings will be through his feeding tube. As your baby grows, so will his ability to handle more feedings at the breast.

Learn more about breastfeeding your preemie in BREASTFEEDING: A Parent’s Guide.