When baby comes too soon: what this means for the nursing mother

November 2, 8:47 AMFresno Breastfeeding ExaminerTess Johnson

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This preterm baby needs the many benefits of breast milk even more than if she were born full term

Ken Johnson

November is National Prematurity Awareness Month. Even with the technological advantages available in the United States, premature births account for over 10% of all California births. The causes of premature delivery range from the mother catching one of many common infections to the onset of more rare disorders which cause uterine contractions. Regardless of the underlying cause for a baby’s premature arrival, there is one consistent need that preterm babies share: having entered the world before their immune systems were well developed, they are in great need of the protective factors found in their mother’s breast milk.

The challenge is that many preterm babies will take a considerable amount of time to reach the level of maturity where they are capable of taking the breast efficiently. Oftentimes, with help, they will reach this ability around their due date, but some may still not be ready to perform independently even at a full term adjusted age. For these mothers, establishing and maintaining adequate milk supply can be a real challenge, because much of what is known about lactation indicates that a baby’s contact at breast is the best stimulation to the hormones of milk production. When the baby is unable to provide reliable stimulation through sucking, it is up to the mother to find strategies to make this happen.

The primary tool that comes to mind when a mother must establish her milk supply without efficient stimulation from the baby is a breast pump. Ideally, it is wise to obtain a hospital-grade pump, which often can be rented from a lactation consultant. New research has shown, however, that the breast pump may be further enhanced by a technique called “hands-on pumping.” In this method, a combination of hand expression and pumping is used to facilitate the best emptying of the breasts. Not only does this provide more milk to store for the baby, but it also shows a remarkable benefit to the long term milk production in the mother. In fact, the most effective way to establish and maintain milk supply for a premature baby includes hand expression and pumping within the first 3 days, followed by frequent use of the hands-on pumping method after that period. To really maximize the process, any opportunities for skin-to-skin contact with baby should be utilized. This is often referred to as Kangaroo Mother Care, and it too shows great promise in the goal of achieving full lactation for a preemie.

As the baby’s physical maturity and stamina improve over time, the next step is to begin putting baby to breast for latch-on training. It is extremely advisable to have a board certified lactation consultant helping with this step, because the learning process takes many twists and turns. Ultimately, with some help along the way, combined with mom’s dedication to these goals, most premature babies can go on to become happy and independent breastfeeders in time.