Breast Milk

Establishing Breastmilk for your premature or sick baby  

Evidence  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177123/  

Ragnhild Maastrup, Bo Moelholm Hansen, Hanne Kronborg, Susanne Norby Bojesen, Karin Hallum, Annemi Frandsen, Anne Kyhnaeb,  Inge Svarer, and Inger Hallström  

Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. 

Education 

Breast milk is important for all babies but for premature and sick newborns, it provides vitally important health benefits and acts like a protective medicine that only a mother can provide. Research has shown that the composition of a mother’s breast milk is different if her baby is born premature than if her baby was born full-term. It is tailored to the needs of a premature gut and is highly beneficial for your baby.    

Although at times it can be exhausting and challenging, most mothers find that providing breast milk for their baby is one of the more beneficial and rewarding things they can do. It is important to check in regularly with the lactation team in the NICU. They will be able to give you help and support tailored to your individual needs, which often change over time. 

So, whether you’ve decided to express milk for a short time or plan to transition to feeding at the breast later, your milk is an important part of your baby’s treatment plan.  

Why is breast milk so important?  

• Breast milk provides the right nutrient absorption, digestive functioning, and nervous system development.  

• Colostrum (first milk) is rich in antibodies called ‘immunoglobins’ and coats the GI tract, stomach and intestines, providing protection from viruses and bacteria.  

• Mothers of premature babies produce milk that is higher in nitrogen, protein, lipids, fatty acids, vitamins, calcium, and other vital elements that are important to the development of Pre-term infants.  

• Breast milk antibodies protect from viruses and infections such as gastroenteritis or sepsis.  

• Premature infants receiving human milk have a lower incidence of NEC (Necrotizing enterocolitis) than those fed preterm formula. 

• Research shows that breast milk reduces the risk of conditions such as allergies, asthma, and eczema.  

• The varying composition of breast milk keeps pace with the baby’s changing nutritional needs.  
• Breast milk has vital long-chain polyunsaturated fatty acids, which are essential to brain development.  

Expressing milk for your premature baby starts almost immediately after you give birth.  

You will be shown the technique of hand expressing and then use of a hand or electric pump.  

If you are unwell, seeking support from the lactation team can help provide the necessary guidance and emotional support for successful breastfeeding. 

There are simple and effective things that you can do to establish and increase your milk supply. Most of the time milk making is  

• Many mothers find that being close to their babies while they are expressing can help to increase the amount that they are able to express.  

• Kangaroo Care is a crucial part of your time together and also helps to establish and increase your milk supply.  

• If you are separated, looking at photos of your baby can help or smelling something that has been close them.  

• Hospitals are breast feeding friendly and will provide you with all the support and tools needed to be successful. Having privacy like using a scarf or a screen may help you relax which will help to make milk as well as flow better.  

• Listening to music may help you to relax and increase your milk production.  

• Once babies are well enough to breathe unassisted (off ventilation or CPAP), they can be offered the breast.  

• Giving your milk via tube feeds while holding your baby allows you and your baby to learn to breastfeed together without a feeling of pressure. Your baby can feel that full feeling while in your arms and or when near the breast.  
• Gentle breast compressions –smoothing down your breast towards the nipple – can help your baby stay alert and actively feeding. It helps the milk flow more easily for your baby, especially the fatty milk towards the end of the feed.   

Empowerment  

Before your baby was born, you may have spent time imagining their birth and how you would care for them. You may have even spent time thinking about how you planned to feed after their arrival. When your baby is born premature or sick and admitted to a NICU or SCN, you may find yourself needing to adjust your dreams and expectations.  

For parents and their new baby, feeding can be a time when relationships are formed, and bonds are forged. However, for parents of premature babies, it can also be a great source of anxiety and concern. In the womb, your baby received all their nutrients via the placenta and umbilical cord. When your baby is born prematurely or sick, he or she will need to receive these vital nutrients in a variety of different ways.  

Breast milk composition is unique for each baby. The milk that you are making for your premature or sick baby is produced depending on the gestational week they were born.  Some mothers feel that providing milk for their babies is the unique way they can care for their babies. It may be an important part of bonding with a new and fragile baby.   Your baby will benefit from your milk for as long as you provide it.  

Useful Links 

Australian Breastfeeding Association  

https://www.breastfeeding.asn.au/resources/breastfeeding-your-premature-baby 

Australian Government – Department of Health and Aged Care 

https://www.health.gov.au/topics/pregnancy-birth-and-baby/breastfeeding-infant-nutrition 

Raising Children 

https://raisingchildren.net.au/newborns/premature-babies-sick-babies/breastfeeding/breastfeeding-premature-babies 

The Royal Women’s Hospital, Melbourne  

https://www.thewomens.org.au/health-information/breastfeeding/breastfeeding-sick-and-premature-babies/an-early-start 

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