Pump Early, Often, and WellIf your baby was born early, then you may not be able to breastfeed right away. Until about 32 weeks, babies can’t coordinate sucking, swallowing, and breathing well enough to breast or bottle feed, and babies less than about 37 weeks aren’t strong enough to take enough nutrition by mouth to gain weight.
Because premature babies can’t always nurse effectively, moms who are breastfeeding a premature baby must often pump breast milk that will be fed to their babies via a feeding tube. Moms can establish a plentiful milk supply using a breast pump if they pump early, often, and well:
- Pump early: If your baby was born early, you may feel overwhelmed by your birth experience and by your baby’s condition. Pumping breast milk probably won’t be at the front of your brain! However, pumping breast milk as soon as possible helps moms establish a good milk supply and is associated with a better breastfeeding outcome. Ideally, your first pumping session should be within 6 hours of birth.
- Pump often: Healthy newborns breastfeed often, and preemie moms must pump often to establish their milk supply and to make plenty of milk. Plan to pump about 8 times per day. You should pump every 2 to 3 hours during the day, and every 3 to 4 hours at night or during work.
- Pump well: If you are breastfeeding a premature baby, your hospital should loan you a medical grade breast pump. If you purchase a supplemental pump, look for a quality full-size, fully electric pump. Have a lactation specialist work with you during early pumping sessions, and consider combining hand expressing with pumping to increase your milk supply.
Get InformedAlthough breastfeeding is entirely natural, it doesn’t always come naturally! Learn as much as you can about breastfeeding during your pregnancy. If you know that you are at risk for prematurity, then research breastfeeding a premature baby.
- Read up on breastfeeding: There are many great books out there on breastfeeding and on premature babies. The Premature Baby Book contains a lot of great information on breastfeeding a premature baby and is a great place to start.
- Spend time with a lactation consultant: Talk with your nurses about working with a lactation consultant. Lactation consultants are certified in breastfeeding support and are a wonderful source of information and advice. They are skilled at helping moms who are breastfeeding a premature baby increase their milk supplies and helping babies learn to breastfeed well.
- Join a support group: La Leche League is a free breastfeeding support group run by Leaders who are trained in breastfeeding support, including support for moms who are breastfeeding a premature baby. La Leche League meetings are a wonderful place for preemie moms to share their challenges and successes and hear great breastfeeding advice. Joining a NICU support group or a moms club dedicated to premature babies can also be great ways to connect with other moms who are breastfeeding preemies.
Spend Time With Your BabyBeing separated from your baby is upsetting, especially if the closest NICU is many miles away from home. Making the most out of the time you can spend with your baby can help to keep your milk supply up and help ease the transition from tube and bottle feeding to breastfeeding at the breast.
- Use kangaroo care: Kangaroo care, a method of holding baby skin to skin with mom or another loved one, can help make breastfeeding easier for mom and baby. Mothers who practice kangaroo care have increased milk supplies, and babies who benefit from kangaroo care with mom breastfeed better than babies who aren’t kangarooed.
- Visit during feedings or cares: Most premature babies need to sleep for most of the day in order to grow and develop. However, even the tiniest babies need baths and diaper changes. Ask your nurses what kind of schedule your baby is on, and try to visit during assessments and feeding times. Even if your baby is being tube fed, ask if you can hold him or her during feedings, so that your baby will associate being held by you with being fed.
- Ask about hospital resources: Many hospitals have special resources to help parents of premature babies, especially moms who are breastfeeding a premature baby, be closer to their infants. Some have special arrangements with local hotels or have places where parents of preemies can sleep so they may be closer to their babies. Others allow parents to stay with their babies for one night or throughout the entire NICU stay; ask your nurses if your hospital has any of these opportunities.
Callen, Jennifer RNC, MSc, and Pinelli, Janet RNC, MScN, DNS. “A Review of the Literature Examining the Benefits and Challenges, Incidence and Duration, and Barriers to Breastfeeding in Preterm Infants.” Advances in Neonatal Care April 2005: 5;72-88.
Ludington-Hoe, PhD, CNM, FAAN, Susan M, Morgan, BSN, CNNP, RN, Kathy, Abouelfettoh, PhD, RN, Amel. “Supplement: A Clinical Guideline for Implementation of Kangaroo Care With Premature Infants of 30 or More Weeks’ Postmenstrual Age.” Advances in Neonatal Care 21 May 2008 8:S3-S23.
Sears MD, William, Sears MD, Robert, Sears MD, James, Sears RN, Martha. The Premature Baby Book: Everything You Need to Know About Your Premature Baby from Birth to Age One. Little, Brown and Co., New York, 2004.
Boies, Eyla G., MD, FAAP “Breastfeeding the Late Term Preterm Infant. “ “The American Academy of Pediatrics Section on Breastfeeding Newsletter” Spring 2008; 2-3.