If your baby is born early (before 37 completed weeks of gestation) and is small, you may find feeding a challenge. Your baby may be able to breastfeed or bottle-feed, or suckling and swallowing may be difficult. Your baby may be sleepy, even during a feeding. It is important that preterm babies experience steady weight gain.

Your participation in the feeding plan is important, and your care provider wants to help you with the feeding method of your choice. Here are the answers to some questions you might have:

1. Is breast milk beneficial for my baby?

Breast milk has the same benefits for your baby as any baby. The American Academy of Pediatrics says that breast milk is the best for all babies for the first year. Breast milk has the following special benefits for preterm babies:

    • Fewer infections

 

  • Specific substances (growth factors) in human milk help to mature the baby’s gut

 

 

  • Increased ability to use iron and zinc

 

 

  • Better development of areas of the baby’s brain

 

 

  • Better absorption of the milk

 

 

2. My baby is not ready to feed at the breast yet (not able to latch on). How often should I pump? Any specific pumping instructions?
    • As often as you would be breastfeeding: at least eight times in 24 hours, or approximately every three hours

 

  • Use a hospital-grade pump and double-pump if possible as they saves time

 

 

  • Label and freeze/refrigerate your milk so that when your baby is ready, it will be available

 

 

3. How will my baby be fed if he/she is not able to breastfeed?

There are several ways that your baby may be fed, including:

    • feeding of expressed breast milk by a tube put down the nose into the stomach

 

  • intravenous feedings of glucose or other solutions

 

 

  • alternating bottle-feeding/breastfeeding with tube feedings

 

 

Your baby may have developed his/her ability to latch on, suckle, and swallow. Or your baby may still have to grow and develop enough to do the “work” of feeding. Your nurse and other healthcare providers will work with you and your baby to ensure that feeding goes well, and that your baby receives the calorie intake he/she needs.

4. My baby gets tired easily and falls asleep at the breast? Is my baby getting enough?

If your baby feeds from only one breast, you can pump the other to ensure that you keep up your milk supply. Other things you might do in the hospital to ensure that your baby is getting enough include:

    • keeping track of the number of wet and dirty diapers that you change

 

  • feeding at least eight times in 24 hours

 

 

  • listening for swallowing with every one to three sucks at the breast

 

 

While you are in the hospital, your baby may be weighed before and after feedings to ensure that he/she is doing well.

5. When I go home, how do I make sure my baby is getting enough and growing?

After you go home, some steps you may take to make sure you are making enough milk and that your baby is feeding well include:

    • follow up with your health care provider within 24 to 48 hours to have your baby checked and weighed

 

  • keep track of feedings and diaper changes

 

 

  • use a breast pump to pump after feeds if the baby falls asleep

 

 

  • make sure you eat well, drink lots of fluids, and sleep when the baby sleeps

 

 

Author

The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) promotes the health of women and newborns.

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