Breast-feeding your premature infant

Breast milk has proven benefits, especially for the fragile premature infant. Benefits of breast milk over formula include better immunity to dangerous infections, nutrient absorption, digestive function, and nervous system development.1 Therefore, your hospital is likely to strongly encourage you to provide breast milk for your infant during the first weeks of life, at a minimum. Your hospital's lactation consultant can be very helpful with pumping and breast-feeding questions and problems, both before and after the birth.

You may have to start by pumping your milk to tube-feed to your premature infant. Regular pumping keeps up your milk production for when your infant is ready to breast-feed. (Your premature infant may not be able to feed by mouth right after birth. If your infant can't digest milk yet and requires intravenous feedings, your milk will be frozen for future use.)

If you are undecided about breast-feeding, consider keeping your options open. You can pump to keep your milk supply going until you've had time to decide. Any amount of breast milk offers your premature infant greater protection from infection than no breast milk at all. But keep in mind that anything you put in your body can be passed to your baby in breast milk. Do not drink alcohol, take drugs, or smoke if you are breast-feeding. And before you take any kind of medicine, herb, or vitamin, ask your doctor if it is safe.

Pumping

While you are still in the hospital, talk to a lactation consultant and become familiar with the double electric breast pump.

Like anything new, pumping for your infant will get easier with practice. Pump as often as your infant feeds, about every 2 to 3 hours, and at least once at night. Bring your labeled bags of milk with you to the NICU to feed your infant or to freeze for later use.

Breast-feeding

Your infant will probably need to start slowly with breast-feeding. Usually, one or two breast-feedings per day are enough to start. As he or she gains strength and weight, you can gradually replace more tube feedings with breast-feedings.

Premature infants can have trouble learning to breast-feed. If you find yourself feeling frustrated or worried about it, get help. Both the NICU nurses and your lactation consultant have years of experience with preemie feeding problems.

As your infant feeds more by mouth, you may not be able to be present for all oral feedings, and your infant will probably be bottle-fed. Among newly breast-fed infants who are bottle-fed in their mothers' absence, a small number develop nipple confusion. Because the sucking action is different in breast-feeding and bottle-feeding, an infant given a bottle may no longer feed well from the breast. To avoid such a problem, plan ahead with the NICU nurses and lactation consultant. Decide whether and when to introduce a bottle. Alternative methods, such as cup feedings, work well for some infants.

For more information about pumping and breast-feeding, see the topic Breast-Feeding.



Author: Debby Golonka, MPHLast Updated: May 8, 2007
Medical Review: Michael J. Sexton, MD - Pediatrics
Jennifer Merchant, MD - Neonatal-Perinatal Medicine

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