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Breastfeeding a Premature Baby

December 10, 2012

Can you breastfeed a premature baby? Yes, even if your baby has spent time in the NICU and was given bottles.  Sara Chana Silverstein, a New York based, international board certified lactation consultant (IBCLC), classical homeopath, herbalist, lecturer, author, wife and mother of seven children (yes, she really is superwoman!), wrote an article for us that explains how.

Breastfeeding your premature baby By Sara Chana Silverstein, IBCLC, RH (AHG)

If you give birth to a premature baby you can breastfeed. It may take some time for you and your baby to master the skill of breastfeeding but with some patience and, most importantly, proper guidance you can be successful.

In fact, the prevailing thought is that breast-milk is even more important for premature babies than it is for full-term babies, because the nutrients in breast-milk will help the internal organs, which did not have as much time to form without the full nine months of gestation, develop to their fullest potential.

The other vital component of breastfeeding is the act of the mother touching and caressing her child.  Breastfeeding moms, who normally nurse their babies at least eight times a day, end up touching their babies more often than formula feed babies are touched. It’s not that bottle-feeding mothers do not want to touch their babies; however, once the breastfeeding baby is properly latched onto the breast, these moms tend to stroke their babies throughout the nursing event. This motherly nurturing in turn helps stimulate proper growth.
Researcher Dr. Schanberg, from Duke University, found in his extensive research with animals that, “when mother rats licked their babies, the action produced a cascade of much needed compounds, in fact, the growth hormones that produce normal body development.  Remove the mother—(but keep giving the rats the needed nutrients), remove the touch of her tongue, and the baby rats became stunted beings.”  Furthermore, he states that this need for touch also transfers to humans, especially premature babies, and that encouraging the mother to touch and hold her baby, “led to better health and shorter hospital stays.”

Ashley Montagu writes in his book called “Touching, The Human Significance of the Skin” that, “gestation in the human being continues for as long outside the womb as it does inside the womb and places the end of gestation at the age at child a child begins to crawl on all fours, about nine months old”.  He also states “that touching and coddling a baby is needed all the time to help build the child’s immune system and their emotional health”.

Below are some guidelines and suggestions for breastfeeding premature (premie) babies:

  • Premies have smaller mouths so it is imperative that you latch your baby onto your breast as deeply as possible.  If the premie is not on the breast deeply enough, it is impossible for the baby‘s tongue to reach the mother’s milk cavities that are located deep within the breast.
  • Almost all of the premies that I have treated required breast compression in order to keep up the proper nursing rhythm on the breast.
  • Although I am a fan of nursing on only one breast during a feed with a term-baby, I encourage moms to use both breasts during a single feed with premies.
  • Often premies do best when a mother uses a nipple shield, (even if the mother has protruding nipples).  It appears that these small critters like to experience a firm shape in their mouths.
  • Some premies who are having endurance problems—an inability to stay awake on the breast, will require the use of an SNS (supplemental nursing system) in order to breastfeed.
  • If your child has nipple confusion as a result of feeding from bottles in the NICU, finger-feeding for a few days will teach the baby how to eat with a flat tongue, which will allow transfer back onto the breast.
  • If your baby is taking the breast, but is not putting on enough weight, the recommended procedure is to nurse the baby for 20 minutes, followed by 20 minutes of finger feeding.
  • Premature babies can fall asleep very easily on the breast, so it is important to watch carefully and listen for swallowing during nursing.  If the baby appears to be drifting off, take the baby off the breast before the sleep becomes too deep and reawakening becomes increasingly difficult.

Although all babies are different, I have recognized two distinct nursing patterns used by premies.  The first pattern is employed by those babies who need to eat uninterrupted for twenty minutes with lots of breast compressions.  Babies in the second pattern group need to eat from five to seven minutes, then require burping, and repeat this eat-burp pattern for a total of three times.
Most moms are not warned by their care-providers about the ‘premie-grunt’—a grunting noise these children make in between their times of nursing.  You should know that it is not a sign of danger, and this deep, guttural sound leaves as the child grows.
If you feel frustrated with your new “little package”, get help from a lactation consultant.  From my experience, these little guys become great nursers when they are given the proper guidance.

Other articles by Sara: