Guide to Feeding Your Premature Baby Breast Milk

Babies who arrive early have very special feeding needs and often require some extra care to help them adjust to life outside of your cozy belly. If your baby was preterm or you know your baby will be coming before your 37th week, there’s essential information you should know about feeding your newborn breast milk. Rest assured, mama, we’re here for you – and we understand this can be an overwhelming and even stressful time. To start, here’s what to expect and how you can best nourish your precious new baby to support their health, wellness, and development.

Is Breast Milk Preferred Over Formula for Preemies?

Yes! Feeding your baby with breast milk offers many great advantages to full-term babies and makes an even bigger difference for preemies. Babies are provided with mother’s own milk either through breastfeeding or by receiving pumped milk also:

• Get fewer infections.
• Experience a reduced risk of allergies.
• Show improved overall growth and brain development.
• See a lower risk of Necrotizing Enterocolitis (NEC).
• Have a reduced risk of retinopathy of prematurity, which can lead to vision loss.
• Are less likely to develop bronchopulmonary dysplasia, a chronic lung disease.

Even more importantly, preemies who are fed breast milk are often discharged from the hospital two weeks earlier on average than babies who are fed formula. And we know how much you want your baby to thrive, so they can come home sooner!

The breast milk of mothers who deliver early contains elevated levels of protein, sodium, calcium, and other important nutrients for your preemie. There’s no question that your little one will benefit tremendously from your breast milk, because it’s made just for them and their unique needs – That’s pretty amazing!

How Soon After Delivery Can I Nurse My Preemie?

Babies born earlier than 32 – 34 weeks often do not yet have a well-developed suck-swallow-breathe instinct, which means feedings will be administered via a tube while your baby is in the neonatal intensive care unit (NICU). You can pump your breast milk using a hospital-grade (multi-user) breast pump and provide it to hospital staff to ensure your baby is fed with your milk.

Between 32-34-weeks’ gestation, your baby will likely develop the suck-swallow-breathe pattern needed to safely feed at your breast. Your healthcare providers will closely monitor your little one and recognize when he or she is ready, so you can begin that joyful process and celebrate an exciting milestone.

When Should I Start Pumping?

Pumping helps establish your milk supply and provides your baby with all the vitamins and nutrients he or she needs for protection and to begin life strong. You should begin pumping as soon as possible after your baby’s birth, ideally within the first hour if possible. This helps ensure that you’re stimulating your milk-producing cells for long-term milk production. Even if your baby is taking in very little, you can still pump, store and freeze your milk for future feedings to ensure he or she receives every drop of your liquid gold.

It is important to ensure that you’re pumping 8 – 12 times every 24 hours, with no longer than 5 hours between your pump sessions. Frequent, consistent pumping helps stimulate milk production and tells your body to continue making milk, so you can build an ample supply for your little one.

How Often Should I Feed My Preemie at Home?

As a general guideline, preemies should be fed every 2 – 4 hours. That said, every baby’s feeding pattern is different and can change on a daily basis. Not all preemies will cry when they’re hungry, so look for cues that your baby is ready to eat, including restlessness, opening their mouth, moving the arms and legs, and bringing their hands to the mouth. Before your baby is discharged home, be sure you have a detailed discussion with your pediatrician about how often and how much you should feed him or her. It will be important to have a clear plan to increase the amount of nursing sessions per day if your little one is not taking all feedings by breast prior to their discharge from the NICU.

Once you get going, pumping 25 ounces per day is optimal to establish a good breastfeeding routine while building up your milk supply. Depending on your preemie’s unique needs, they may not be taking that amount just yet. It is important, however, to build and maintain a strong milk supply that will meet your baby’s long-term needs too. 

What is Kangaroo Care and Why is it Important?

Kangaroo care is a way of holding your baby skin-to-skin against your bare chest for extended periods of time. Your baby will usually be naked, except for their diaper. Kangaroo care is beneficial to both you and your little one – and, best of all, both parents can individually do skin-to-skin with their baby. In fact, for your little one, the close contact is soothing and can help them regulate their breathing and heartbeat.

Kangaroo care can also play a role in teaching preemies to suckle. Even if he or she is not yet able to nurse, you can hold him or her to your breast after pumping. This is called non-nutritive breastfeeding and can ease your baby into actual breastfeeding when ready. Just be sure that your breasts have been pumped or emptied prior to offering it to your preemie – If he or she is not mature enough to suck, swallow, and/or breathe safely at the breast, offering a full breast to suckle may cause aspiration. Ensuring that your milk has been pumped or expressed before allowing your preemie to suckle and latch for non-nutritive sucking will keep everyone safe while encouraging the benefits of this development.

Studies have shown that the benefit of kangaroo care for moms is higher volumes of expressed milk and longer duration of the breastfeeding journey. It’s best to practice kangaroo care about 30 to 60 minutes before feeding so that baby is awake and hungry when it’s time to feed.

Breast Milk Can Support Healthier Outcomes

We know that being a new mama to a preemie can feel stressful at times. Remember, by providing your new little one with your nutritious breast milk, you’re helping your baby thrive. You’re giving them exactly what they need for healthier outcomes both now and in the future. You’ve got this!

References

1. Schanler RJ et al. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics. 2005;116(2):400-406.
2. Chang SR, Chen KH. Demand feeding for healthy premature newborns: a randomized crossover study. J Formos Med Assoc. 2004 Feb;103(2):112-7. PMID: 15083241.
3. 26 Acuña-Muga J et al. Volume of milk obtained in relation to location and circumstances of expression in mothers of very low birth weight infants. J Hum Lact. 2014;30(1):41-46.
4. 27 Nyqvist KH et al. Towards universal kangaroo mother care: recommendations and report from the first European conference and seventh international workshop on kangaroo mother care. Acta Paediatr. 2010;99(6):820-826.