Tips for Breastfeeding a Premature Baby

Breast pump next to baby
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Breastfeeding a premature baby is one of a preemie mom’s most important jobs. Although breastfeeding a premature baby is not always easy, following these tips can help you get your preemie breastfeeding experience off to a good start.

Pump Early, Often, and Well

You may not be able to breastfeed right away if your baby is born early. Premature babies can’t always nurse effectively. Moms breastfeeding a premature baby often need to pump breast milk that can be fed to their babies via a feeding tube.

Until about 32 weeks, babies can’t coordinate sucking, swallowing, and breathing well enough to breast or ​bottle-feed. Babies less than about 37 weeks will not be strong enough to take enough nutrition by mouth to gain weight.

Breastfeeding moms can establish a plentiful milk supply using a breast pump if they pump early, often, and well.

  • Pump early. If your baby was born early, you may feel overwhelmed by your birth experience and your baby’s condition. Pumping breast milk is not likely to be at the forefront of your thoughts during this time, pumping as soon as possible will help you establish a good milk supply. It's also associated with a better breastfeeding outcome. Ideally, your first pumping session should be within 6 hours of birth.
  • Pump often. Healthy newborns breastfeed often. Therefore, preemie moms will need to pump often to establish their milk supply and ensure they are producing plenty of milk. You'll want to plan on pumping about 8 times per day. You should pump every 2 to 3 hours during the day, and every 3 to 4 hours at night (or during work).
  • Pump well. If you are breastfeeding a premature baby, your hospital should loan you a medical-grade breast pump. If you purchase a supplemental pump, look for a quality, full-size, and fully electric pump. Have a lactation specialist work with you during your early pumping sessions. You might also want to consider combining hand expressing with pumping to increase your milk supply.

While a medical-grade pump is needed to establish your milk supply, the early antibody-rich colostrum may stick inside the tubing.

To get this precious early breastmilk to your premie, start pumping sessions by hand expressing your milk into a medicine cup (you'll only get a few drops). Then, switch to using the pump to stimulate your supply. A lactation consultant can help with this process.

Get Informed

Although breastfeeding is entirely natural, it doesn’t always come naturally! It can help to learn as much as you can about breastfeeding during your pregnancy.

If you know that your baby is at risk for prematurity, you might want to start by specifically researching breastfeeding a premature infant.

  • Read up on breastfeeding. There are many books on breastfeeding as well as on caring for premature babies. You might want to start with a resource like "The Premature Baby Book", which contains a great deal of helpful information on breastfeeding a premature baby.
  • Spend time with a lactation consultant. You might want to ask your nurse if you can meet with a lactation consultant. Lactation consultants are certified in breastfeeding support and can be a wonderful source of information and advice. They are skilled at helping moms who are breastfeeding a premature baby increase their milk supplies. They can also help premature babies learn to breastfeed.
  • Join a support group. La Leche League is a free international breastfeeding support group. It is run by leaders who are trained in breastfeeding support, including for moms who are breastfeeding a premature baby. The meetings can be a wonderful place for preemie moms to share their challenges and successes as well as get breastfeeding advice. Joining a NICU support group or a moms club for parents of premature babies can also be a great way to connect with other moms who are breastfeeding preemies.

Spend Time With Your Baby

Being separated from your baby is upsetting, especially if the closest NICU is many miles away from home. Making the most out of the time you can spend with your baby can help to keep your milk supply up. It can also help ease the transition from tube feeding and bottle-feeding to breastfeeding at the breast.

  • Use kangaroo care. Kangaroo care, a method of holding baby skin to skin with mom or another loved one, can help make breastfeeding easier for mom and baby. Mothers who practice kangaroo care have increased milk supplies, and babies who get kangaroo care with mom tend to breastfeed better than babies who aren’t kangarooed.
  • Visit during feedings or care. Most premature babies will need to sleep for most of the day to grow and develop. However, even the tiniest babies still need baths and diaper changes. Ask your nurses what kind of schedule your baby is on, and try to visit during assessments and feeding times. Even if your baby is being tube fed, ask if you can hold them during feedings. This will help your baby associate being held by you with being fed.
  • Ask about hospital resources. Many hospitals have dedicated resources for parents of premature babies, especially moms who are breastfeeding a premature baby. The goal is to help parents be closer to their infants. Some hospitals have special arrangements with local hotels or places in the facility where parents of preemies can sleep. Others allow parents to stay with their babies for one night or throughout the entire NICU stay. Ask your health care team if your hospital has any of these opportunities.
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  1. Bonet M, Forcella E, Blondel B, et al. Approaches to supporting lactation and breastfeeding for very preterm infants in the NICU: a qualitative study in three European regionsBMJ Open. 2015;5(6):e006973. doi:10.1136/bmjopen-2014-006973

  2. Spatz DL, Froh EB, Schwarz J, et al. Pump Early, Pump Often: A Continuous Quality Improvement ProjectJ Perinat Educ. 2015;24(3):160-170. doi:10.1891/1058-1243.24.3.160

  3. Buckley KM, Charles GE. Benefits and challenges of transitioning preterm infants to at-breast feedingsInt Breastfeed J. 2006;1:13. doi:10.1186/1746-4358-1-13

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