Breastfeeding can be challenging. But if when we have a healthy full-term baby we can find difficulties, when we have a premature baby they multiply.
And so the statistics indicate: breastfeeding rates are even lower in premature babies . We already know that breastfeeding is the ideal food for babies during the first six months of life, and this includes premature infants, as it also offers great advantages in them.
What are the benefits of breastfeeding in premature babies?
Breast milk is an exceptional food. And it is that among its many properties is that of being able to change its composition depending on the moment. Thus, the breast milk of mothers who have given birth to premature babies has a different composition than that of mothers who give birth to full-term babies.
It is richer in proteins and defense elements (such as immunoglobulin A or lactoferrin). Breast milk is essential for the development and maturation of premature babies, it protects them from infections and serious intestinal diseases and shortens their hospital stay. So much so that if the mother is not able to breastfeed her baby or cannot do it exclusively, we try to give that baby donated breast milk.
What difficulties can we have to breastfeed a premature baby?
Some 28,000 premature babies are born in Spain each year. Premature babies are those born before week 37 . Fortunately, 70% of these are late preterm (born between weeks 34 and 36 + 6).
Many premature babies will have no difficulty feeding and will be perfectly capable of feeding from their mother’s breast. However, the most immature (born before 30-34 weeks of gestational age) need time to develop their muscles as well as to be able to coordinate sucking, swallowing and breathing during lactation .
In some cases they will not be able to breastfeed from the beginning and they will be fed through a tube that goes from the mouth or from the nose to the stomach (orogastric or nasogastric tube).
Seven Tips for Successful Breastfeeding for the Premature
Kangaroo method
Kangaroo care is proven to be beneficial for premature babies (and their parents). In addition to achieving better control of their temperature, that they are calmer and more stable at the respiratory level, it favors the bond and favors breastfeeding, since it increases the stimulus of oxytocin.
So whenever possible and for as long as you can, babysit and stay in skin-to-skin contact with your baby.
Breast stimulation as soon as possible
If our baby still cannot breastfeed directly, we need to stimulate him and begin to extract colostrum (for the baby to take when he is ready). Ideally, do it within the first hour after delivery; if not possible in the first six hours after delivery .
About eight extractions a day are recommended, some should be at night. We will have to do them at regular intervals and try to ensure that no more than four or five hours pass without extracting ourselves.
The first two or three days, manual extraction is preferable, as we will obtain small amounts of colostrum (which is liquid gold). Later we can use a double electric breast pump in the Neonatology unit. Being in contact with our baby or seeing him (through the incubator, a photograph …) or performing a massage prior to the extraction are some tricks that can help to obtain more milk.
Non-nutritive suction
Even if the baby is not ready to breastfeed yet, it is recommended that he be in contact with the breast. Non-nutritive sucking (latching on to the breast when it is empty, as an affective rather than a nutritional method) can be done in many cases from week 28.
Position does matter
You must be comfortable to breastfeed your baby. Put on a breastfeeding pillow or cushion if you need to. Each mother and baby finds the position that best suits them, but the rugby position , which allows a good support for the baby’s chin, as well as the inverted crib position , are especially useful in premature babies.
Supplements
Some of these babies require supplements at the beginning, which may be expressed breast milk or formula . The bottle is not the only way to administer it, as we can also do it using the finger-feedig technique (finger-probe), with a syringe or with the help of a cup. The different options are very well explained in the Clinical Practice Guide (Annex 10).
Nipple shields, sometimes necessary
In some cases, nipple shields may be necessary, since there are premature babies who achieve a better latch on and a greater milk extraction with them. When they mature, we can remove them.
Ask for help
Breastfeeding in premature babies has added difficulties. Don’t be afraid to ask for help. Find out and ask all your questions to the professionals of the neonatology unit: IBCLCs, pediatricians, nurses … who are trained in breastfeeding. Also, having a premature baby is something unexpected, and sometimes we find ourselves overwhelmed with mixed feelings. Be patient; delegate tasks, seek support. And do not hesitate, you can achieve it .
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