Breastfeeding a premature baby

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We always picture our pregnancy going to 40 weeks but what happens when you deliver at 25 weeks, 35 weeks or any other earlier than expected gestation, can you still breastfeed?

Yes you can! Not directly at first as many prems have what is called a Nasal Gastric Tube which is inserted  into the nose or mouth and your pumped colostrum and then breastmilk is fed via this tube until baby is stable enough and strong enough to learn to suck.

I read a lot of articles about breastfeeding prems written by people who have never had prems and some of the information is so incorrect that many parents maybe misinformed.

Feeding my son expressed breastmilk through his NGT

The photos in this post are of my own children and our experiences with breastfeeding premature babies. Above my son is being fed my expressed milk via his NGT.

Normally with a term baby you would hold off on expressing and pumping to let baby establish your supply for you, here you can't so it is important to start expressing as soon as you can, a nurse will usually help you hand express into a syringe and take the colostrum to your baby or babies.

Having to pump can often leave you feel very deflated (I know that's how I felt!) you're using this machine to feed your baby not holding them and nursing them as you had always pictured, not to mention constantly looking at how many oz or ml your are pumping and worrying about that. Many women myself included found it hard at first to establish a relationship with the pump and struggled with my letdown. Ways of overcoming this are:

♥ Pumping with a photo of your baby or whilst touching your baby

♥ If baby is able to wear clothes holding and smelling some he/she has worn

♥ Closing your eyes, forgetting the pump and imagining your baby feeding from your breast

♥ Nipple stimulation before pumping

♥ Hand express to get your milk flowing first (some women respond to human touch better than a pump)

♥Massage your breasts with your hand as you pump

My premature son (twin A) on CPAP to help him breathe. An example of a NGT inserted via the mouth instead of nose

It is never easy leaving the hospital without your babies, I have left without 4 so far and no matter the circumstance neither was easier than the other.

I strongly recommend finding a good hospital grade breastpump (I found the double electric by Medela amazing), many places hire out breastpumps so you don't have to worry about spending hundreds on a pump that doesn't suit you,  spend the time to find one that does work for you.

Many lactation consultants will recommend pumping every 2 hours  including overnight (overnight can be spaced out to 3-4 hours if you wish) whilst you are in NICU or until your milk is established for 20 minutes at a time to a) establish your supply and b) build a good stockpile for your baby.

Kangaroo Care

If baby is stable enough for Kangaroo Care this is something that is beneficial to you, your milk supply and your baby. Kangaroo care is where your baby is undressed down to his/her diaper and placed on your bare chest with a blanket over the baby to keep them warm. It is great for bonding and has also been proven to help babies breathe better independently, gain weight and regulate temperatures better. Having this skin to skin contact will also be great for increasing milk supply because of the hormones released as you hold your baby.

Breastfeeding a prem baby is no easy road, babies do not even have a suck reflex until around 32 weeks and many will be fed via a NGT for quite some time before you can even attempt breastfeeding but when you do attempt it for the first time and baby latches you will have the most overwhelming sense of joy fill your whole body.

One of our first breastfeeds in Special Care Nursery

The main thing is to relax! Nobody plans a prem baby but it does happen and that does not mean you cannot breastfeed. With support and determination you can give your baby the best start to life possible.

Before long you will be counting how many suck feeds per 24 hours and shortly after that counting how many days you haven't had to use the nasal gastric tube.

One thing to make note of with a premature baby is that they are very sleepy babies which can also make breastfeeding harder but again not impossible baby will eventually become more awake and willing to feed.

Having 3 premature babies myself and still here to tell the tale and share my premature twins breastfeeding photos is amazing and proof it can be done, these boys were on ventilators and at one point Twin A was on life support yet when we left the hospital as a family we were fully breastfed and loving it!

If you have any questions please do ask me. We will have more posts coming about premature babies and feeding and care so your questions will help me know what you want to know.

Our first 24 hours with no feeds from the NGT just breast