Breastfeeding a premature baby is a topic that many expecting parents never explore. Everyone is naturally inclined to expect the birth of their child will carry on without intervention or unforeseen events. But the truth is that the unexpected does happen. Around one in 10 babies are born prematurely in the United States every year, the Centers for Disease Control and Prevention reports. Though the March of Dimes notes as many as half of premature births have no known cause, there are several things we do know that can cause premature births to occur, such as:
1. Maternal infection
2. Premature dilation and contractions
3. Multiple gestations
7. Kidney or heart disease in the mother
8. History of premature births
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The Challenges of Prematurity
When a child is born premature, he typically doesn’t have the developmental skills needed to breastfeed. Sucking isn’t second nature yet, and baby’s latch may also be hindered by a small mouth. New mothers often feel like failures at breastfeeding and give up shortly after starting. Sadly, even some doctors and hospital staff will encourage moms to forego their plans to nurse and give formula instead.
The biggest problem with this isn’t just the impairment of the mother-child bond that comes with breastfeeding, but breast milk is the very best form of nutrition any baby can receive, and premature infants may stand to benefit from it even more. When you deliver early, your body is aware and produces milk accordingly.
When a woman gives birth prematurely, not only does her milk still come in, but its composition is completely in tune with the baby being premature. Rather than delivering the same milk that she would have made for a term birth, mothers to premature babies produce milk that is specifically tailored to the needs of an early-birth infant, such as higher fat and mineral contents, La Leche League International states. This special milk is more easily absorbed by the baby’s system and is crucial for the continued optimal development of baby’s brain and body that it would have received in-utero.
Following birth, you’ll want to express milk as soon as you can. Ideally, trying to hand express or pump as often as baby eats is the best way to start producing milk and establish a good supply. That being said, caution should be used when using a pump that oversupply isn’t brought on by over-stimulation. The sooner you start pumping after birth, the better, but make sure to do so within six hours. Pump each time for 10 to 15 minutes initially if your baby isn’t nursing at all and increase to 30 minutes after your milk has come in.
The unfortunate side of many premature births is that these tiny babies end up in the NICU — the Neonatal Intensive Care Unit — and cannot be held often, nor can they room in with Mom. Parenting Magazine states premature birth is the leading reason for admissions to the NICU. These babies are often fed by tubes that must be inserted through the mouth or nose, but breastmilk can still be introduced into them via a bottle or small cup.
Moms may miss out on skin to skin time with babies for the same reason. Thus, baby isn’t present around the clock to let Mom know when it’s time to feed. Scheduling pumping or expression sessions via an alarm clock or timer on your phone is a great way to remind yourself during those early days or weeks that it’s time to work on establishing your supply.
Dispelling the Myths
Believe it or not, those same medical professionals that deter new mothers from trying to breastfeed premature infants also often propel the long-standing myth that their supply won’t come in because their body wasn’t actually ready to give birth. This couldn’t be farther from the truth. We could use the same example with mothers who are induced early or who deliver via scheduled cesareans. Their bodies weren’t pushed into labor or delivery on their own either and they can still breastfeed. Dr. Sears reports there is no difference in rates of success with breastfeeding between mothers who deliver vaginally and those who deliver via cesarean.
Another myth is that babies who are born prematurely won’t learn to nurse from the breast. This is true sometimes, not all the time, and it depends entirely on the individual baby’s temperament. Some infants will grow accustomed to the method of feeding they gain experience with during the initial days and weeks of their life. In some cases, getting a baby to go from the bottle to the breast can be very trying. In other cases, there’s no problem at all. A few things can be done to try and avoid this though.
1. Stick to using bottle nipples that are made for premature newborns, even as the infant ages.
2. Practice pace feeding.
3. Use a cup and small spoon to feed instead.
The slower flow of premature and newborn nipples means the baby gets less milk flowing freely from the bottle; they have to work for it, and that’s what you want. Pace feeding is based on the same premise. Spoon feeding or allowing the baby to take tiny sips from a small infant cup removes the potential for them to get used to the sucking relationship with a bottle nipple and later experience nipple confusion at the breast.
Alternative Ways to Breastfeed
A Supplementary Nursing System, or SNS for short, is one alternative way to breastfeed a premature baby. Those that have difficulty latching or transferring milk well can still stay on the breast and attempt to suckle while the SNS delivers the milk to them. However, if you use an SNS, be aware that you will still need to pump when you aren’t nursing to maintain supply. Thus, this process can be time consuming, but it’s a good way to get baby used to breastfeeding and give him or her the practice needed to get good at it.
Once your baby is able to attach to the breast, he may still need some help learning to suckle. A nipple shield may be the saving grace you’re looking for in these circumstances. This device is nothing more than a thin, molded piece of silicone. That goes over the nipple and covers most, if not all, of the areola. The protrusion overtop the nipple allows the infant to secure a deeper latch. Long-term use of nipple shields have been known to hinder milk supply, so they are best used as a temporary medium to get infants who are struggling to nurse onto the breast and a breastfeeding relationship established.
Some premature births are predictable. Scheduled cesareans and inductions do not automatically mean there will be issues with breastfeeding. Likewise, emergency c-sections and unforeseen preterm births may present roadblocks and can certainly be upsetting events for parents, but they don’t have to upset your plans to nurse. Remember, preemies need mom’s milk even more.