Preemie Parents: What To Know About Breastfeeding Premature Infants

Babies who arrive early have very special needs. If your baby was preterm or you know your baby will be coming before your 37th week, there’s essential information you should know about feeding your newborn breast milk. Rest assured, mama; we’re here for you. The following should give you a clear picture of what to expect breastfeeding premature infants and how you can best nourish your precious new baby to support their health, wellness, and development.

Is Breast Milk Better Than Formula for a Preemie?

Yes! Breast milk offers many significant advantages to full-term babies and is even more beneficial to preemies. Babies who receive breast milk have:

• Fewer infections.
• Reduced risk of allergies.
• Improved development.
• Lower risk of Necrotizing Enterocolitis (NEC).
• Reduced risk of retinopathy of prematurity, which can lead to vision loss.
• Less chance of developing bronchopulmonary dysplasia, a chronic lung disease.

Even more importantly, preemies fed breast milk are often discharged from the hospital two weeks earlier on average than babies fed formula.1 And we know how much you want your baby to thrive so they can come home sooner!

The breast milk of mothers who deliver early contains more protein, sodium, calcium, and other nutrients than moms of full-term babies. There’s no question that your little one will benefit tremendously from your breast milk because it’s made just for them and their unique needs as a preemie – That’s pretty amazing!

Breastfeeding Premature Babies in NICU

The suckling instinct is often not well-developed in a preemie, which means you will administer feedings via a tube while your baby is in the neonatal intensive care unit (NICU). You can pump your breast milk using a hospital-grade (multi-user) breast pump and provide it to hospital staff for the baby’s feedings.

Between 32- and 34-weeks gestation, your baby will develop the suck-swallow-breathe pattern needed to feed at your breast. Your healthcare providers will closely monitor your little one and recognize when they are ready, so you can begin that joyful process and celebrate an exciting milestone!

When Will I Need To Begin Pumping?

You should begin pumping as soon as possible after your baby’s birth, ideally within the first hour. This will help you establish your milk supply and provide your preemie with your breast milk and all the vitamins, nutrients, and minerals needed for protection and to start strong.

Even if your baby is taking in very little, you can still pump, store and freeze your milk for future feedings to ensure they receive every drop of your liquid gold.

It is critical to pump 8 – 12 times per 24 hours, with no longer than 5 hours between your pump sessions. Frequent, consistent pumping tells your body to continue producing milk so that you can build an ample supply for your little one.

Breastfeeding Premature Babies at Home

Every baby’s feeding pattern is different and can change daily. Preemies are generally fed every two to four hours. Not all preemies will cry when they’re hungry, so look for cues that your baby is ready to eat, including restlessness, opening their mouth, moving the arms and legs, and bringing their hands to the mouth.

Before your baby is discharged home, be sure you have a detailed discussion with your baby’s physician about how often and how much you should feed them. It will be essential to have a clear plan to increase the number of nursing sessions per day if your little one is not taking all feedings by breast before their discharge from the NICU.

Once you get going, pumping 25 ounces per day is optimal to establish a good breastfeeding routine while building up your milk supply. Depending on your preemie’s unique needs, they may not be taking that amount just yet. However, it is crucial to build and maintain a strong milk supply that will meet your baby’s long-term needs.

What Is Kangaroo Care?

Your healthcare provider may recommend administering “kangaroo care” to your baby. This term refers to holding your baby skin-to-skin against your bare chest for extended periods. Kangaroo care is beneficial to both you and your little one. Close contact with you is soothing for a baby and can help your little one regulate their breathing and heartbeat.

Even if your preemie is not yet able to breastfeed, you can hold them to your emptied or pumped breast so they can begin learning how to suckle. This is called non-nutritive breastfeeding and can ease your baby into actual breastfeeding when ready.

Just be sure that your breasts have been pumped or emptied before offering it to your preemie. If they are not mature enough to suck, swallow, and breathe safely at the breast, offering a full breast to suckle may cause aspiration. Ensuring that your milk has been pumped or expressed before allowing your preemie to nurse and latch for non-nutritive sucking will keep everyone safe while encouraging the benefits of this development.

Studies have shown that the benefit of kangaroo care for moms is higher volumes of expressed milk and a longer duration of the breastfeeding journey. It’s best to practice kangaroo care about 30 to 60 minutes before feeding so that baby is awake and hungry when it’s time to feed.

Breast Milk for Healthier Outcomes

Being a new mama to a preemie can feel stressful and worrisome. Rest assured that by providing your sweet little one with your nutritious breast milk, you’re helping your baby thrive and giving them exactly what they need.

Breastfeeding premature infants will increase your baby's chances of healthier outcomes in both the short and long term. You’ve got this!

Resources

1. Schanler RJ et al. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics. 2005;116(2):400-406.
2. Chang SR, Chen KH. Demand feeding for healthy premature newborns: a randomized crossover study. J Formos Med Assoc. 2004 Feb;103(2):112-7. PMID: 15083241.
3. 26 Acuña-Muga J et al. Volume of milk obtained in relation to location and circumstances of expression in mothers of very low birth weight infants. J Hum Lact. 2014;30(1):41-46.
4. 27 Nyqvist KH et al. Towards universal kangaroo mother care: recommendations and report from the first European conference and seventh international workshop on kangaroo mother care. Acta Paediatr. 2010;99(6):820-826.

Can you share any tips on breastfeeding premature babies at home with us?