No matter how your breast milk is delivered to them, it provides the best nourishment possible at a time when it can make a big difference.

How premature breast milk is different and meets your baby's special needs

Mothers of Premature babies are known to produce breast milk that is slightly different in composition, at least for the first several weeks. This difference is designed to meet your baby's particular needs. Premature breast milk is higher in protein and minerals, such as salt, and contains different types of fat that your baby can more easily digest and absorb, amazing right?

The fat in human milk can help to enhance the development of a baby's brain and neurologic tissues, which is especially important for premature infants. Human milk is easier for them to digest than formula. It also avoids exposing their immature intestinal lining to the cow's milk proteins that are found in baby formula created for premature infants. Premature babies who are breastfed are less likely to develop intestinal infections than are babies who are formula-fed. The breast milk you produce in the first few days contains high concentrations of antibodies to help your baby fight infection Even if your baby cannot breastfeed yet, expressing breast milk from the beginning will ensure that your milk supply is kept up until your baby is able to nurse.

Breastfeeding support for you and your preemie

Your first step in providing your baby with breast milk is to enlist the support of professionals on the medical team who will care for your infant at the hospital. Notify your baby's paediatrician and neonatologist, if one is caring for your baby, that you want to breastfeed and to provide your expressed breast milk for your baby. Your doctors can arrange to have your expressed milk fed to your baby or for you to breastfeed your infant in the neonatal intensive care unit (NICU).

Many hospitals now provide private areas for nursing and trained specialists to assist breastfeeding mothers. These experienced members of your support team can show you how to assemble and use an electric breast pump, teach you to express milk efficiently, and give you advice on storing your breast milk. As your baby gets more mature, if you are able to directly breastfeed, they can help you adjust your nursing position to your infant's small size.

Many NICUs encourage parents to room-in continuously and keep the baby skin to skin, because this has been shown to be beneficial for stability and optimal growth and development of premature babies. Breast milk pumping, or expression, immediately after holding your baby skin-to-skin is a very effective way to increase your milk supply. Some mothers find pumping at their baby's bedside in the NICU very helpful as well.

Expressing breast milk

If your newborn is too small or ill to breastfeed at first, or if a birth condition prevents them from breastfeeding directly, an electric breast pump is an effective option to express milk and establish and maintain an adequate milk supply. Your hospital will provide you with a pump while you are there.

The pump you use should create a milking action and not simply be a sucking device (All of our Onatural pumps are designed with a 'Milking' like suction), Beginning as soon as possible after your baby's birth, express your milk at regular intervals, at approximately the times when your baby would usually feed. Aim to pump at least 6 to 8 times a day; this provides nipple stimulation and encourages milk production. You should pump at regular intervals throughout the night for the first few weeks, not going for more than 4 or 5 hours without pumping. If you wake up each morning and your breasts feel full, then you are sleeping too long through the night; this fullness will actually decrease your milk production.

Maintaining your breast milk supply

For mothers of preterm babies, the minimum amount of time to try to pump throughout a twenty-four-hour period is one hundred minutes. This much breast stimulation and milk expression is the minimum required to maintain breast milk supply over many weeks (if your baby is very small, premature, or ill).

Using a double-pump setup lets you express milk from both breasts at the same time. Most women find that the double pump produces the most milk in the least amount of time. When using the pump, continue to pump for several minutes after your milk has stopped flowing to stimulate increased milk production.

Breast massage before and during the use of the pump has been shown to improve your milk flow and may even boost your milk production. To do this, make small, circular motions with your fingertips, starting at the outer edges of your breast near the chest wall, and slowly make your way toward the center. The massage should always be gentle to avoid producing friction on the skin surface or massaging so deeply that it causes pain.

Feeding your premature baby at home

After your baby is home from the hospital, you may need to keep using your breast pump until your baby is exclusively breastfeeding (actually nursing) and growing well without the need for any supplemental bottles or formula. This lets you store breast milk for extra feedings and maintain an adequate milk supply, especially as your baby grows and their needs increase.

Try to nurse whenever your baby shows an interest—even if it's every hour or hour and a half during the early weeks. If your premature baby is exclusively breastfed, your pediatrician should recommend a multivitamin and iron supplement. Finally, have your breastfeeding technique rechecked by your pediatrician or a lactation specialist shortly after your baby's homecoming.

Remember

Caring for and learning to breastfeed / pump for a premature or ill newborn is emotionally taxing for any new mother. It's a good idea to contact support groups in your area that specialise in your baby's condition. Other mothers are often the most valuable sources of information. Make sure, too, that your partner and other family members understand the enormous advantages of offering breastmilk to a preterm baby or an ill newborn. The emotional and practical support of your loved ones will go a long way in helping you achieve your feeding goals.

 (Copyright © 2017 American Academy of Pediatrics)