Whether or not your premature baby is ready to nurse at your breast right away will depend on his gestational age and overall health. At many hospitals it’s standard practice to start off feeding very premature babies expressed breast milk through a nasogastric (NG) tube (known as gavage). This is to make sure the baby gets as much nourishment as possible if he’s too immature to suckle from breast or bottle.
You’ll work closely with the hospital staff overseeing your baby’s care on a plan to feed your pumped breast milk to your baby. Many premmies simply aren’t ready to start breastfeeding in the hospital right away, and won’t be released until they’ve started to gain weight from breast- and/or bottle-feeding.
Once your baby is able to start nursing at the breast, be prepared to nurse frequently, although premmies may not take in much milk at each feeding until they’re closer to term. For this reason, you’ll need to express after feedings to keep up your milk production as well as have milk for any necessary supplementary feedings. You may need to use different breastfeeding holds for your premmie. Hospital staff, including lactation professionals, may be helpful when you start breastfeeding.
Once your baby is ready to move on to the breast, learning how to latch on and suck can be difficult. Most babies don’t develop the suck-swallow-breathe reflex that’s critical for feeding until about week 32 in the womb, eight weeks before they’re considered full-term. It can also be challenging to figure out whether your baby is getting enough by breast alone if you’re used to supplementing feeding.
Aim for feeding your baby at least every three hours or so during the day. This schedule is flexible, and if he seems hungry only two hours after eating, by all means let him try again. It’s also okay to wake him up to nurse. In fact, disturbing a nap may actually trigger the suckling instinct.
Another method used by nurses in the NICU in the lead up to breastfeeding the baby is given a small dummy to suckle at each galvage feed to help the baby associate sucking with a full tummy. You are usually given this option by the doctors & nurses and it is your choice whether you wish to go down this path.
Photo courtesy of Lea Tidyman
The subject matter provided in these articles is strictly for informational purposes alone and should never be used in the place of a doctor’s advice. Please ALWAYS contact your doctor if you ever have questions or need advice in any area where medical advice is needed or medication is suggested.