Will I be able to breastfeed my preemie?
The gestation age, or number of weeks your newborn baby was at the time of birth, can make a significant difference when it comes to breastfeeding. Delivering your baby before full term of gestation (38-40 weeks) does NOT mean that you will be unable to nurse well. We want moms to know there are things about the preterm infant that may require more support from a lactation consultant; getting help early can improve the experience for you and the baby.
- Early preterm infants are born between 34 – 36 weeks gestation.
- Late preterm infants are born between 37 – 39 weeks gestation.
- Term infants are born between 40 – 42 weeks gestation and post-mature infants are born after 42 weeks gestation.
Early and late preterm infants need extra attention at the breast. A lactation consultant can evaluate baby’s ability to coordinate the suck-swallow breath sequence, as well as evaluate the oral anatomy including the palate, tongue and frenulum. This evaluation process can prevent feeding concerns by identifying any problems early on.
If you have a baby born between 34 and 36 weeks, you may be informed that your little one will be spending some additional time in the hospital, either in the newborn nursery or the Neonatal Intensive Care Unit. You’ll want to remind your nurses and physicians that you’ll be nursing as soon as the baby is showing signs of readiness, and you want to begin pumping as soon as you are able to.
Preterm babies have less energy to expend or waste, so feeding times at the breast may be limited initially to 5 – 10 minutes per side. The time at the breast will be increased by 2 – 3 minutes every few days depending on how the baby is doing with his/her weight gain.
Pumping after nursing sessions will help train the brain and the breasts to continue to produce increasing amounts of milk each week. Each pumping session should be about 10 – 15 minutes (double pump), and should occur at least every 3 hours through the day and evening. Mothers can take one 4 – 5 hour sleep break at night while the baby is growing. When the baby is nearing term of pregnancy (39 – 40 weeks), you will have go back to every three to four hours of feeding or pumping to maintain a robust supply.
Early preterm infants may have some additional concerns pertaining to breastfeeding; for example, their small size can make latch-on tricky, and these infants may need to use a nipple shield in order to get a deep latch. They may need help with milk transfer and require a supplemental nursing system (SNS). This allows for more milk to be available by nursing while getting a supplement of either breast milk, donor milk or formula.
Preterm infants usually need additional follow-up from a lactation consultant via in-person visit, telephone or virtual visits online. Preterm infants should be evaluated for weight gain weekly by the pediatrician or lactation consultant.
Mothers of preterm infants may have a delay in the arrival of a full milk supply by as much as 3 – 4 weeks after the birth and may need supportive care, including galactogogues. These may include some food sources, herbal supplements or medications prescribed by your physician. Mothers who deliver a baby or multiples prior to 38 weeks gestation may find a hospital grade breast pump is a more efficient way of maintaining a full milk supply over using a personal use pump.
Please take time to discuss all of your options pertaining to breastfeeding and using a breast pump after you deliver. We hope you’ll continue a good relationship with your lactation consultant and care team as baby grows and your breastfeeding relationship evolves.
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