Breastfeeding a Premmie Baby

Babies learn and mature their sucking and swallowing reflexes usually in the womb. In the last trimester of pregnancy, a baby is swallowing around 700ml of amniotic fluid per day! Perfect practice for when a full-term baby is born, as by the time they are two weeks old they are drinking about that much milk each day. But what about the baby who is born too soon and is premature? How can we help enhance their sucking skills if they missed out on a lot of this practice in the womb?

There are many ways a mum can help her premmie baby learn to breastfeed. The best way is to start off slow and gentle. There’s no need to rush anything with these bubs, keeping it relaxed is what it’s all about.

Non-nutritive sucking:

You have probably heard this being mentioned in the neonatal unit, but what non-nutritive sucking means is sucking without any milk flow. All babies do this; usually they suck quickly and non-nutritively at the beginning of a breastfeed to send messages to the mum’s brain to release the hormone Oxytocin which helps the breasts have a let-down or flow of milk.

Babies who are born prematurely and are not able to fully breastfeed yet, find this type of sucking really soothing and calming, that’s why it is one of the reasons the nurses may have given your baby a dummy to suck on when you are not able to be in the neonatal unit. But when you are with your baby in the neonatal unit and holding baby in skin to skin contact, then it is really good to allow baby to non-nutritively suck on your breast.

Non-nutritive sucking benefits:

• Enhances baby’s ability to develop their feeding skills
• Eases baby’s transition onto full breastfeeding
• Studies show babies who have lots of non-nutritive sucking whilst they are learning, go on to breastfeed for more months
• It improves baby’s weight gain whilst in the neonatal unit
• Babies should be allowed to non-nutritively suck for as long as they want at mums breast – do not set time limits

Watching baby’s instincts:

Babies who have been born early and especially those born before 32 weeks of gestation may appear to not be showing many or any signs to breastfeed yet. But just watch your baby when you hold them in skin to skin contact. Every move they make will be their instincts and reflexes already working to show them how to move to the breast. Babies born as early as 27 weeks gestation have been seen to move down to the breast by themselves and latch on to their mother’s breast and suck, after having had long periods held in skin to skin contact! They may not be swallowing much milk at this stage but they are still learning and creating positive neural pathways in their brains every time they are near the breast.

It takes time:

Sometimes I think we see preterm babies lying in skin to skin contact with their parent and we automatically think it is beautiful, but what we may not think about is that every moment that your baby spends next to you they are actually learning to breastfeed!

One day you may see your baby bob their head towards your nipple, after a few movements they are exhausted and off to sleep they go! The next week they may move themselves all the way down to your nipple and you’ve guessed it, then fall asleep, well why not the breast is an extra comfy, warm pillow! The following week they bob down again to the nipple, but this time they have a nuzzle and a lick, they may even have a taste of your milk but then, just like before, fall asleep!

Eventually they will have remembered all those times of bobbing down toward the breast, having a nuzzle, learning to open their mouth wide and taking the breast into their mouth, and then one day, hey presto, they start sucking and the milk flows for them…and they never look back!

Never be disheartened by the time it takes for your baby to start breastfeeding and never compare yourself and your baby to anyone else, we are of course all at different stages.

Having a preterm baby means that it will likely take weeks or months to get to the actual point where baby is fully breastfeeding (sucking and swallowing with milk flowing). This is normal but can be hard when all we want to do is see and feel our baby feed from our breasts.

Small steps, huge progress:

Remember, when breastfeeding a premmie baby, every little step your baby makes is actually huge progress for your baby right now. Through all of these new discoveries, each and every day, your baby is learning, your baby is laying down the foundations in their brain so that they can eventually fully breastfeed, once their sucking, swallowing and breathing reflexes are strong enough.

Be patient, there will be good days where everything seems to be progressing along perfectly, and then all of a sudden baby doesn’t breastfeed very well for a few days. This is normal, babies are just like adults, we all have good and bad days too when we are learning a new skill, our brains can only take in and absorb so much information. Give yourselves time together to work it out, and never be afraid to ask for more help and support from your nurse or lactation consultant, as you and bub learn to get breastfeeding off to a good start.

If you are looking for a support group, Life’s Little Treasures Foundation, Australia’s foremost charity dedicated to providing support, friendship and information, specifically tailored for families of premature or sick babies can be contacted via their 24hr support line on 1300 697 736 or visit the website.