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As a parent of a premature or NICU baby, it’s exciting to finally bring your little one home from the hospital. You may have waited for days or even weeks to take your bundle of joy home. But for first-time parents, especially, it can be a nerve-wracking experience as you wonder how to take the best possible care of your preemie baby.
One of the major concerns on a mother’s mind is how she’ll go about breastfeeding her baby. This is a valid concern as breastmilk is the complete food source for a baby. It contains healthy enzymes and immunity-boosting antibodies that help fight off viruses and bacteria. Breastmilk is also rightly known as nature’s ideal baby food. Breastfeeding a premature baby is even more important because it reduces the odds of the child developing Necrotizing Enterocolitis (NEC) which could be a life threatening condition for premature babies. As the benefits of breastmilk are numerous, let’s take a look at the difficulties involved in breastfeeding a preterm baby, before diving into the ways to overcome these challenges.
The Challenges With Breastfeeding a Preemie Baby
1. Improper latching
NICU babies find it difficult to maintain a latch at the breast. As they keep suckling, it creates a vacuum at the breasts, which may cause pain in the nipple for the mother. This is a common difficulty experienced by most mothers.
2. Separation from the baby
Many mothers face unexpected separation from their babies in the hospital after delivery due to NICU stays that may be required if their baby has health issues. This separation interferes with the introduction of breastfeeding, leading to complications that cause significant stress in the mothers, anxiety and lack of sleep.
3. Lack of proper knowledge
A major challenge to the initiation and continuation of lactation in mothers whose babies are in the NICU is the inconsistency in the information received regarding the importance of human milk for their infants.
4. Successfully Breastfeeding a NICU Baby
Breastfeeding a preemie baby may be slightly difficult at least initially, but is not impossible. Dr. Jack Newman, a renowned paediatrician, shares a few truths about breastfeeding for mothers with premature babies that will help make breastfeeding a comfortable experience:
- Premature infants don’t need to learn to suck from a bottle before they can breastfeed. A bottle is not needed at all if breastfeeding is managed well.
- Kangaroo Mother Care can help infants get started with breastfeeding at an earlier stage. This implies skin-to-skin contact for most of the day, and even the baby’s father can get involved in the process.
- A nipple shield can be helpful when used occasionally, but efforts should also be taken to wean the baby off the nipple shield as soon as possible.
- Babies, especially premature infants, fall asleep while feeding when the milk flow becomes too slow to be worth staying awake for. Keep the milk flow going on at the breast and the infant will feed till he’s not hungry anymore.
Does Breast Milk Yield Better Outcomes for Preemie Babies?
It goes without saying that breastfeeding does miracles for a preemie baby! Let’s take the example of Shruthi Haridas, mom to a preemie baby girl of 30 weeks. Everyone was worried about the baby’s immunity and weight gain and kept telling Shruthi to try some other foods. But she knew she gave her little one the best as she exclusively breastfed her for seven months completely (including three months of pumped milk). From 1.2 kg to 8.2 kg, Shruthi’s baby is now doing really well!
And then there’s also Anubha Prakash Arun, mom to a preemie baby who was born at 32 weeks and weighed around 1.5 kgs. The nurses at the hospital helped her learn to feed her baby pumped milk through a paladai as the neonatologist had advised to wait and breastfeed the baby only once he crossed 2 kgs. Her baby was majorly fed breast milk, and a year later he was on track with his milestones, super active and had a steady weight gain!
Importance of the Mother’s Health and Wellbeing
As the mother of a NICU baby, it is important to look after oneself. The smoother the recovery goes, the stronger and energetic she will be to get involved in her baby’s care. This is the best time to say yes to every possible offer of help she may get. A simple offer of a lift, delivery of meals, babysitting the older child or helping out with the household chores will go a long way in making her comfortable and in a better position to take care of her baby. Don’t hesitate to ask for help from family, friends, and support groups. Ridhima Tandon whose preemie baby boy has just turned one expresses her gratitude to Breastfeeding Support For Indian Mothers which is a support group for expectant parents and breastfeeding mothers. It was through this group that she received all the information and support she needed via the posts and queries around breastfeeding a NICU baby.
FAQs on Breastfeeding a NICU Baby
Shruti Kanchan, a certified lactation consultant, answers some of the most common questions about breastfeeding a preemie baby.
1. Will I have enough milk if my baby is unexpectedly early?
A pregnant mother’s body already starts producing milk somewhere in the 2nd trimester. As soon as the mother’s placenta is removed post birthing, there is a rise in prolactin level, which triggers breast milk. So it is important that as soon as the baby is born, he/she is allowed to breastfeed immediately so that the mother’s body starts ejecting breastmilk.
2. I currently have a low milk supply. Are there any tips for expressing milk to increase output?
Breastmilk production primarily depends on demand and supply, so effective draining of breasts either via direct breastfeeding or by expressing milk can be helpful. If the supply is truly low (Always assess with a Lactation Consultant) then start emptying the breasts every two to three hours or simply breastfeed your baby on demand and let the baby decide the nursing duration and frequency.
3. How does one calculate how much to feed a preemie?
Preemies initially have anywhere between 15 to 20 ml every 2 hours. A little more may be needed if the baby is spoon-fed/tube-fed/paladai-fed.
4. How does one tackle nipple confusion in their baby?
Preferably bottles should not be introduced to premature babies because it could cause nipple confusion which may adversely affect the direct breastfeeding relationship. Other alternatives to bottles should be used such as a spoon/shot glass/small cup/syringe.
5. Should I wake my baby every couple of hours to feed him if he’s fast asleep?
Yes, it is important to do so for premature babies. Usually, the NICU recommends doing this until the baby reaches 1.8 kgs to 2 kgs. (It depends on recommendation from NICU to NICU).
In many ways, breastfeeding your premature baby may not be much different from how you would have imagined doing so with a new baby. With time and practice, you’ll soon learn how to provide the best possible care to your little one!
Note: Inputs taken from the ladies at Breastfeeding Support Group of India.