Finding it hard to breastfeed your premature baby? Try these tips for help

It isn’t easy for a new mom to breastfeed her premature baby, but guess what? It isn’t impossible. Here’s all that you need to know.
postpartum health issues
Don't fret over weight woes after pregnancy. Image courtesy: Shutterstock
Dr Kishore Kumar Published: 12 Aug 2021, 08:00 am IST
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Providing breast milk for a premature or seriously ill newborn may be a challenge, purely because of the state of the mind of mothers at that stage. It is also difficult because babies are unable to suck at the breast, but it is possible and it is certainly an effective way to enhance your baby’s health, growth, and development. Even if your baby is unable to breastfeed at first, you can begin expressing your milk immediately after giving birth. 

As a practicing neonatologist, I have seen many new parents who have experienced premature birth, and are anxious and worried about how they can breastfeed their child. My simple answer to them and everyone reading is yes, breastfeeding a premature baby is possible and new parents should accept, prematurity is NOT their fault. We advise all mothers to start expressing the breast milk from the day the baby is born and whenever the baby is stable, the mother can give the milk to their baby – fed to via a tube or by letting the baby sip the milk from a tiny cup or bottle. No matter how your breast milk is delivered to him/her, it provides the best nourishment possible at a time when such an advantage makes a big difference.

Also, read: Worried about breastfeeding amidst the pandemic? Here’s all you need to know

If you give birth prematurely, your milk will be slightly different from full-term milk. This is because your baby’s needs are different from those of a full-term baby. Because premature babies need more protein for growth than full-term babies. That’s why your colostrum will have more protein than the colostrum of full-term mothers.

breastfeed a premature baby
You need to be very careful while breastfeeding a premature baby. Image courtesy: Shutterstock
Some handy tips for new parents
    • Have positive thoughts; avoid negative feelings and thoughts 
    • You are one in many and prematurity is not your fault 
    • Choose to read about prematurity and understand what’s going on
    • Start expressing breast milk from day 1; even a few drops on day 1 is very useful 
    • Seek support from a lactation consultant, other mothers & support groups who have gone through this.  Talk to the nurses in NICU, Talk to the doctor for any clarifications
    • Pump early, often, and well
    • Use kangaroo care wherever possible. It is a method of holding the baby skin to skin with mom or another loved one. This can help to make breastfeeding easier for mom and baby.

Take this quiz: Think you know everything about breastfeeding? Find out with this quiz

Expressing breast milk
  • If your newborn is too small or ill to breastfeed at first, or if a birth condition prevents the baby from breastfeeding directly, use a breast pump which is an effective way to express milk and establish and maintain an adequate milk supply. 
  • Beginning as soon as possible after your baby’s birth, express your milk at regular intervals, at approximately the times when your baby would usually feed. 
  • Aim to pump at least six to eight times a day; this provides nipple stimulation and encourages milk production. You should pump at regular intervals throughout the night for the first few weeks, and that encourages milk production. If you wake up in the morning and your breasts feel full, then it means that you are sleeping too long through the night. 
  • Breast massage before and during the use of the pump has been shown to improve your milk flow and may even boost your milk production. To do this, make small, circular motions with your fingertips, starting at the outer edges of your breast near the chest wall, and slowly make your way toward the center. The massage should always be gentle to avoid producing friction on the skin surface or massaging so deeply that it causes pain.
breastfeed a premature baby
Premature babies often do not latch on well. Image courtesy: Shutterstock
  • Keep in mind that you will express only small amounts of colostrum at first, but this immune-boosting substance is extremely beneficial for your baby. Some mothers find that expressing the colostrum by hand massage into a small cup or spoon is easier than using an electric pump in the first few days. Hand expression into a cup also allows you to save each drop, instead of losing milk that is trapped within the tubing of the pump. Once your milk supply increases, the amount of milk you can express will probably fluctuate from day to day. 
  • As a result, you will need to increase the number of times per day you express milk to maintain an optimal milk supply. These fluctuations are normal—just more easily observed when expressing milk than when breastfeeding. Once your baby begins breastfeeding, your milk production is likely to increase as direct breastfeeding is always more pleasurable than expressing the hormones that certainly help to increase the milk production. To maximize your milk production, try to get as much rest as possible, take your prescribed pain medication, drink adequate fluids, and minimize stress.
  • Direct breast feeding is possible after the baby reaches a corrected age of 34 or 35 weeks, a bit earlier in some babies.
  • Expressed breast milk is given by palada or a bottle, once the baby is just over 32 weeks. It is around this time that the sucking reflex comes in and gradually gets better. Before that, your baby is fed your expressed milk by a tube inserted into their stomach.
  • After your baby is home from the hospital, you may need to keep using your breast pump until your baby is exclusively breastfeeding (actually nursing) and growing well without the need for any other supplemental feeds.

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About the Author

Dr R. Kishore Kumar is a neonatologist who has worked across North America, the UK, Asia and Australia. After spending nearly 18 years overseas, Dr Kishore, along with three other founders, established Cloudnine Group of Hospitals in 2006. The genesis of the hospital was rooted in his belief that pregnancy is a wellness, not an illness. Through Cloudnine, he was determined to raise quality and service standards in maternal and neonatal care in India. As the Founding Chairman of Cloudnine Group of Hospitals and senior neonatologist at Cloudnine Hospital, Jayanagar, Dr Kishore has been instrumental in propelling Cloudnine Group of Hospitals to the pinnacle of the maternity and neonatal landscape today. He has received an array of honours for his achievements in neonatology, the most significant being a felicitation for his contribution to the field of neonatology by former US President Bill Clinton. ...Read More

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