Q&A Breastfeeding

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If I have a prem baby, will I still be able to breastfeed? Of course, I’ll express so the baby can get colostrum, but will he be able to latch once he doesn’t need to be in the Nicu anymore? Does he get a bottle to drink there, or is it all through a tube?

SISTER BRITZ ANSWERS:

Being pregnant, giving birth to a baby and becoming a new parent is a big change in life. There is no certainty in the progression of these stages, and often expectations are met with the reality of the situation. Having an open mind, a good support system, and a humble heart helps you get through these different moments with the best outcome. It is a learning experience, and putting as much as is possible in place will ensure that you can prepare for any eventuality.

When a baby is born earlier than the stated term period of gestation of pregnancy, for any reason, it will require assessment, planning and decision making on the part of the team involved.

It can be a very challenging time, as Baby’s special needs are met to ensure his growth and development, and allow him to reach maturity.

Your breast milk is tailored to meet baby-specific requirements, according to his age and development, so it is important to start expressing early, often and effectively to ensure a good supply for your baby.

Many babies born before 34 weeks struggle to coordinate their sucking, swallowing and breathing rhythm. A tube will gently be placed into his tummy through his nose or mouth to feed him. All his feeds can be given this way until he is ready to breastfeed. Preemies have the rooting and sucking reflex in place from 24-28 weeks gestation. But they don’t have the stamina, strength and endurance to remove milk form the breast. He will need time to mature. The rooting reflex helps him find the breast and sucking removes the milk he needs.

Once your baby is stable, you can hold him to your bare chest, between your breasts. This is called kangaroo care. Kangarooing makes up for the weeks lost in pregnancy. And dads can do it too! Your baby will start to recognise you from your body odour, the smell of your breastmilk and your voice as you talk to him. This builds your self confidence and baby’s security, as you get to know each other and connect.

This form of holding him for long durations helps calm and regulate your baby’s breathing and heart rate.

You are a natural incubator for him. He will keep warm against you as your chest regulates your temperature in response to his.

He may also seek your breasts as he loves the smell of your breast milk. Hand express a few drops onto your nipple. This will help him find your nipple and make him want to suck and practise what is called ”non-nutritive” suckling.

His tongue will explore the nipple, lick some milk or suckle a bit at the breast. His mouth is his most important means of exploration, and he learns to recognise his future source of food.

Every one of these is an important learning step. He will gradually build strength to maintain a longer latch and take more milk over time. Tube feeds can even be done while you hold him close to your breast. This will help him associate a full tummy with your breasts.

Once your baby is strong enough and stable in his breathing, he will be offered a bottle feed.

He will tire at the breast and often finish a feed with a bottle or be given an amount through the tube, to complete the feed. When your baby is ready for his first breastfeed, massage your breasts before the feed time. Breast care helps the milk flow well and drain through the breast easier. It will also help stimulate a letdown of milk, so your baby receives milk shortly after latching and sucking. Quite a few babies respond well when the drinking muscles around the lips are gently massaged and stimulated just before feeding.

A speech therapist can be requested to guide you with these.

Make use of the service of a lactation consultant who can help you position baby well at your breast to obtain a deep latch. This makes breastfeeding more comfortable and successful, avoiding sore nipples and ensuring optimal milk flow. Other supportive measures can be put in place like a supplemental nursing system, which encourages both breastfeeding and supplementing a volume of milk at the same time to reduce the energy your baby uses to feed. Be patient, and give your baby time to learn to breastfeed. ●