There’s no question that “breast is best,” but breast milk is particularly beneficial for the premature baby. However, infants born prematurely often have difficulty breastfeeding. This article will explore ways to overcome the challenges of breastfeeding premature baby and how to provide preemies with the valuable benefits of breast milk.
Why the Content of Breast Milk is Uniquely Tailored to Specific Infant’s Needs
As your child grows from newborn to toddler, the nutritional content of breast milk changes to accommodate her changing needs. Therefore, the fat, carbohydrate, protein, and caloric content of your breast milk will be different when your newborn is two weeks old than when your child is two years old. This is one of the many flaws of infant formula. The notion of feeding the same formula to a two-week-old and an eight-month-old fails to account for the different nutritional needs of infants at various stages of development and the differences between children of the same age. Obviously, the millions of babies who are formula fed do not all have same nutritional needs. Yet the infant formula is designed to be a one-size-fits-all solution. Baby formula simply fails to accommodate infant’s unique needs.
Breast Milk vs. Baby Formula
Despite millions of dollars spent by formula companies on research, scientists still aren’t able to replicate breast milk, which is made up of living tissue, nor do they understand all of its amazing qualities. For example, the baby formula does not provide the antibodies that breast milk contains. These antibodies help establish the infant’s immune system. This explains why breastfed babies get sick less and have fewer ear and respiratory infections. Incredibly, when your newborn is exposed to illness, your body immediately begins producing antibodies. These antibodies are passed to your body via breast milk to fight off those particular bacteria.
The well documented immunological benefits of breast milk are of particular importance for the premature infant whose immune system is especially immature. The infant formula also contains cow’s milk, which baby’s immature digestive systems are not designed to process. This can result in allergies and digestion problems. Cow’s milk also contains different ratios of protein, carbohydrates, and fats than breast milk. After all, cow’s milk was designed to feed calves, not human infants.
Benefits of Breast Milk to Premature Baby
Your body’s amazing ability to customize the milk you produce to your baby’s needs is particularly beneficial when your child happens to be born prematurely. Research has shown that the nutritional content of the breast milk of a mother who delivers a premature baby is significantly different than a woman who has given birth to a full-term baby. Your body knows that you have given birth early and that your child has special nutritional needs. Breastfeeding also offers the benefits of increased skin-to-skin contact, which is highly beneficial for all infants, especially preemies. Studies have shown that breastfeeding reduces the length of hospital stays for premature infants. Therefore, it is especially critical that moms should breastfeed their preemie baby at all possible.
However, premature infants, even those born “just a little early,” known as “late preterm” infants, often have difficulties initially with breastfeeding. Some of these babies simply do not have the strength to breastfeed efficiently yet. Others may expend more calories nursing than they can take in during the early days before mother’s milk comes in. While that is typically not problematic for the healthy, full-term baby, it can be dangerous for premature babies.
It is normal for it to take several days for mother’s milk to come in after giving birth. This is why newborn baby often loses a little weight in the first few days after birth. The body fat that the fetus puts on in the final weeks of pregnancy is nature’s way of equipping the full-term baby to withstand this weight loss.
For full-term infants, the small amount of colostrum produced until the milk comes in is sufficient to meet the baby’s needs. Supplementation is not necessary, and may even be contraindicated as it can interfere with establishing an abundant breast milk supply. This is why newborns often lose a little weight in the first few days after birth. However, premature babies have not had the chance to put on body fat in the womb and therefore do not have the body fat reserves to sustain them until mother’s milk comes in.
If your baby loses 10% or more of his or her body weight, your pediatrician will likely order that your breast milk is supplemented to help infant regain his or her birth weight. While short-term supplementation may be necessary for your baby’s health, the manner in which this is done can have a lasting impact on the future success of the breastfeeding relationship.
Alternatives to Bottle Feeding and Supplementing with Formula when Mother’s Milk Supply is Insufficient
One concern is how to administer supplemental feedings to the baby. The mother should avoid bottle feeding their baby as it can lead to nipple confusion. When this happen, the baby may prefer the bottle to the breast and refuse to breastfeed. The way the baby sucks at the breast is completely different and more challenging than sucking on an artificial nipple. Thus, the use of bottles and pacifiers is not advisable until the breastfeeding relationship becomes well established.
There are several options to avoid causing nipple confusion when administering supplemental feedings. You may use a cup, syringe, or spoon to feed the baby. These all allow baby to ingest the supplement while expending minimal effort and energy, which is important for preemies. If you choose to use one of these methods, it is critical that you continue to pump your breasts to provide the stimulation necessary to bring in your milk.
Supplemental Nutrition System
Another option with significant benefits for the breastfeeding relationship is to use a Supplemental Nutrition System (SNS). This device works similarly to an IV by using a rubber tube to dispense milk or formula from a container held up in the air. The tube ideally can be taped to mother’s nipple. This way, baby can nurse at mother’s breast and receive small amounts of colostrum or milk from the breast in addition to milk or formula dripping from the tube taped to the nipple. This technique avoids nipple confusion and allows baby to consume more milk with less effort than breastfeeding alone. It also provides the opportunity for skin-to-skin contact and nurturing that is inherent in nursing. Furthermore, this method provides the nipple stimulation that is critical to bring in mother’s milk supply.
However, if supplementing with SNS at the breast is too difficult or otherwise not possible, the tube can be taped to mother or father’s finger instead. The baby sucks on the finger while he dripped the milk or formula into his mouth through the SNS tube. This method provides husbands with the opportunity to take part in feeding the premature baby. It can be very gratifying for a new father and can help with early bonding. If the mother used finger feeding method, it is again critical for her to pump her breasts as well. Your lactation consultant may also recommend pumping even if you can use the SNS at the breast, to provide extra stimulation to signal your breasts to produce milk.
Besides deciding how to administer the supplemental feeding, you must decide what to supplement. If your breast milk has come in and the reason for supplementation is that nursing is too difficult for your premature infant, the best option is to pump your breasts and administer your breast milk to your baby via one of the methods discussed above. This is the ideal scenario because your milk is uniquely suited to your baby’s specific needs.
Breast Milk Banks
If mothers don’t have breast milk supply yet, there is an alternative to a formula that still provides many of the benefits of breast milk. Many urban communities now have breast milk banks, similar to blood banks. This is where you can obtain donor breast milk from healthy mothers.
Volunteer breastfeeding mothers who have an abundant milk supply that exceeds their own baby’s needs and mothers whose children have passed away donate their pumped breast milk to these banks. The people working on these banks screened donors more carefully than blood donors. Donors must meet strict criteria to ensure the safety of donor breast milk. Milk banks also pasteurized the breast milk to ensure safety. They try to match your baby with the most appropriate donor to meet his or her needs. An example would be a donor with a child of the same age who would likely have similar nutritional needs to your baby. Most milk banks require a prescription from your baby’s pediatrician for breast milk. Mothers can easily obtain the prescription when they have a premature infant.
The cost varies by locale, but in Denver, banked breast milk costs $3.50 per ounce. This is a small price to pay for the many benefits of breast milk over formula, which is itself expensive. However, you will only need to supplement for a short period until you can exclusively breastfeed your premature baby. Therefore, you may only need to purchase a small quantity of milk.
Supplementing with donor milk is preferable to supplementing with infant formula. Many benefits of breast milk are still provided to your premature baby, although the breast milk is not your own. For example, the donor mother’s antibodies will be passed to the infant. Also, your baby will not be exposed to the potential allergies and digestive upset caused by the inability to digest formula made with cow’s milk. Donor milk is the next best thing if you are temporarily unable to breastfeed your newborn.
Again, be sure to pump your breasts to establish and maintain your milk supply while supplementing with banked breast milk. You may find that you are nursing your baby at the breast while using the SNS to deliver additional donor breast milk, as well as pumping your breasts after each feeding. This can be daunting and exhausting. However, this is just a temporary situation with immeasurable, life-long benefits for your premature baby.
The single most important thing you can do if you or your baby is experiencing breastfeeding difficulties is to consult a lactation consultant. Most hospitals have a nurse who is a Certified Lactation Consultant on staff. Typically, insurance companies covered these services. Another resource is your local La Leche League leader. They can provide support, information, advice, and resources to the breastfeeding mother. Reach out for help immediately to avoid potential pitfalls as you navigate your way through the challenges of breastfeeding.
Don’t let the challenges of breastfeeding a premature baby deter you. After all, your child stands to benefit tremendously from your efforts. Stick with it and eventually, you will be able to breastfeed your baby exclusively. You can do it – just as generations of women before you have. In return for your diligent efforts, you will enjoy one of the most rewarding experiences of motherhood. You will experience the joy of breastfeeding and confidence in the knowledge that you are providing your baby with the best possible start in life.