Why breast milk is the best option for premature babies

Feeding baby exclusively with breast milk is recommended for the first 6 months of their life, whether or not they are premature. 

Breast milk provides the ideal nutrition for newborn babies. It has the right balance of fats, proteins and hormones to support their development and is packed with antibodies that help babies fight off illness and infection. So, it’s especially important that premature babies get the benefit of breast milk, if possible

Mum’s bodies do some amazing things during pregnancy and birth and that includes really stepping up if your baby is premature. The content of your breast milk changes in response to your baby’s needs, so with a premature baby, it will be even more nutritious than breast milk from a full-term mum. Every drop will help strengthen and boost their immune system and help give your baby what they need to grow. 

Breast milk is also easier for a small baby to digest than baby formula. And when your preemie baby can feed directly from your breast, you will get regular skin-to-skin contact with them, which helps you to create a special bond.

Ensuring weight gain and growth through breastfeeding

It’s essential that your premature baby puts on weight so that they grow and develop. Premature babies may gain weight slowly because they’re using their energy for healing as well as growing. The people caring for your baby will discuss with you how to give your baby the best nutrition for growth and will measure how much weight they gain.

Breast milk is the best source of nutrition for any baby and you may be able to supply this yourself through pumping, if your baby isn’t able to feed directly from your breast.

Some neonatal units will have access to donor breastmilk. They will talk to you if they feel that baby needs extra feed supplements or formula. Smaller or weaker babies may need to be fed milk through a tube into their tummy.

Your baby’s healthcare team will monitor your baby's weight very carefully. If they are not gaining weight as expected, they will discuss ways to improve baby’s calorie intake.

Common concerns

Will I have milk if my baby is unexpectedly early?

Yes. Mums are ready to produce milk in mid-pregnancy. From about 16-22 weeks into your pregnancy your breasts will start producing an early, concentrated form of breast milk, packed with nutrients and disease-beating antibodies, called colostrum.

When the placenta is delivered after your baby’s birth, your levels of the pregnancy hormone progesterone drop, allowing your breasts to start producing this antibody rich colostrum. 

Often your milk supply will be triggered by baby latching onto your breast. If your premature baby is unable to breastfeed directly at first, this doesn’t mean you can’t produce breast milk or breastfeed them later.

You can mimic baby’s actions to encourage your breast milk to come in by gently massaging your breasts, or by using a breast pump. You can also collect small amounts of colostrum in a syringe to give to your baby. You may not produce very much, but your baby only has a tiny tummy, so every drop helps.

Most mums’ milk ‘comes in’ around two to four days after baby is born, but if the delivery was premature this may take a little longer. Your breast milk won’t come unless it’s asked for, so by expressing you help to give your body the signal that it needs to produce milk to help feed your baby.

How can I prepare if I know my baby will be premature?

If you know your baby is likely to arrive before they are full term, you could prepare to give them their first feeds by starting to express and collect your colostrum. But make sure you speak to your doctor or midwife as harvesting colostrum can bring on labor.

You can hand pump some of this thick, creamy first milk into a sterile container such as a syringe and store ready to feed your baby. Don’t expect to produce much, just a few drops at a time, but it’s full of nutrients and antibodies that can give your baby a real boost when they’re born.

Preterm babies are at higher risk of low blood sugar than babies born at term, so having some colostrum ready means that this is available instead of formula or donor milk.

Always consult your healthcare professionals before starting antenatal expression as it may increase your risk of going into labor.

If there is time before your baby arrives, someone from your healthcare team should discuss how you plan to feed your baby and what options are available from expressed colostrum and donor milk to formula.

What if my preemie can’t feed from the breast?

Some babies born before 34 weeks will find it difficult to suck, swallow and breathe which will make breastfeeding directly too difficult for them. But they can still get the benefits of breast milk by being fed through a tube into their tummy through their nose or mouth.

A baby who is born very prematurely may need feeding through an IV line - a thin tube that carries the nutrients they need directly into their blood supply. They may need this for anything from a few hours after birth to days or weeks, depending on how premature they are.

Once babies are well enough to breathe on their own unaided, you can start introducing them to breastfeeding. Just because you haven’t been able to breastfeed right away, doesn’t mean that you can’t learn together.

How will my baby feed if they are too weak to breastfeed?

If your baby is unable to stay latched on to your breast and feed, you can use a breast pump to express your breast milk and may be able to feed your baby using a bottle or syringe.

If your baby is born prematurely it’s best to start expressing as soon as possible after giving birth, ideally within six hours of delivering your baby. You can hand express or use a pump. You may only produce a few drops of milk at first, but don’t let this put you off. The amount of breast milk you produce will gradually increase the more that you encourage it. You may also find that having baby, a photo or a piece of their clothing nearby as you express helps to stimulate your milk flow as this encourages the release of the love hormone oxytocin.

You'll need to pump around eight to ten times a day, including once during the night to help establish your milk flow and build up a supply for your baby.

How looking after your own health and wellbeing is just as important

Hey mama, you’ll be recovering from the physical and emotional rollercoaster of pregnancy and birth and trying to deal with all the extra challenges that come with having a preemie baby. So give yourself a break, please. It’s important to look after yourself, as the more energy you have the better you can care for your precious little one.

Mums of premature babies often have to leave hospital before their baby is ready to come home, and that can be really tough as you juggle life at home with hospital visits and your own recovery. Accept any offers of help and ask for it when you need it. Little things like asking for a lift, having a home-cooked meal delivered, getting a friend to clean and tidy up, or just talk to you over a cup of tea can help make life a little easier at a difficult time.

Sleep, eat, and look after yourself. You’re awesome and deserve all the love and care that you’ll give your baby.