Babies born between 34 and 38 weeks are immature and often have a hard time feeding on their own. They are both with reflexes that help them feed but they often need help to effectively feed until they reach their due date. Working closely with your Lactation Consultant will help you have a healthy baby and reach your feeding goals.
· Feed your baby when they are quiet and alert. This awake state is doesn’t last as long for preterm babies. Holding your baby skin-to-skin with just a hat and diaper is a great way to turn on feeding reflexes.
· You will start to see baby’s eyes move rapidly under their eyelids, they may make sucking movement with their mouth and hands, and start to wiggle around. These are signs baby is getting ready to eat.
· Baby needs to eat every 2-3hrs and will feed at least 10 times per 24hrs. If baby is too sleepy to feed try changing their diaper and holding them against your chest while you speak softly to them. You can give drops of your milk on a clean finger for baby to lick or suckle on.
· Preterm babies get sleepy while feeding. They may take a lot of breaks to catch their breath and organize their feeding. If baby has wide open eyes, a furrowed brow, has milk spilling out of their mouth, or has their fingers splayed apart they are telling you they need a break. Remove the nipple from their mouth and watch for their signals that they are ready to start again.
· Holding your baby skin-to-skin turns on feeding reflexes, you may try leaning back and having baby lay across your chest. You may need some help at first especially if you are recovering from a c-section. You can also try football hold. Make sure to support the weight of your breast.
· You can try doing breast compression later in the feed to keep milk flowing. Hold your breast with a “C” shaped hand and gently squeeze your thumb and index finger towards one another. You should see baby begin to swallow when they are getting milk. Hold this 4-5 seconds then release and repeat. Move your hand around your breast to empty all the areas. This is a great technique for pumping, too.
· Nipples shields may help baby latch but they reduce how much milk baby can take. Breast compression is important if you are using a shield.
· Mostly we are just waiting for baby to mature. Giving your baby only breastmilk is the best way to help their brains grow and to reduce their stress. Sometimes this means we need to feed babies with bottles and pumped milk. You should pump or hand express each time baby does not effectively feed on both breasts. You can tell that baby has fed well if your breasts feel softer after the feeding and you’ve been able to hear swallowing (sounds like a soft ‘kuh’).
· Just like with breastfeeding, baby will need breaks. Follow paced feeding and give baby a break with stress signs.
· It’s easy for preterm babies to be overwhelmed by noise, lights, and handling from visitors. They may shut down and go into a deep sleep. Keeping the home environment calm will help avoid this.
· Keep a feeding log of how many breastfeeds, amount pumped, supplement given to baby, wet diapers, and stools. This will help you to keep track and also can be shared with your providers.
Once baby is closer to their due date feeding problems usually resolve on their own. Continue working with your Lactation Consultant and Provider and contact them if you have any concerns.
Red Flags: baby is very difficult to wake or sleeps more than 4hrs more than once per day, baby has had less than 8 feeds in 24hrs, baby has a significant decrease in wet and dirty diapers.
