Are premature babies getting good help to breastfeed in our NICUs?

Can’t breastfeed yet because your baby is premature? There are many obstacles put in the way of breastfeeding premature babies.

The attached photo shows a premature baby born at 28 weeks gestation and breastfeeding at the age of 10 days.

Myth #1: premature babies need to live in incubators.

Premature babies are more stable skin to skin with the mother than in an incubator https://ibconline.ca/premature1/ In fact, the sicker the baby the more this is true because skin to skin is what supports the physiological function of every system in the baby's body. The link https://ibconline.ca/premature1/lists several articles how Kangaroo Mother Care supports the physiological function of every system in the baby's body. Breastfeeding is much more likely to work well when the baby is in Kangaroo Mother Care.

Myth #2: premature babies cannot breastfeed until they are at least 34 weeks gestation.

Many premature babies can latch on and breastfeed (and receive milk) even by 28 weeks gestation and most well before 34 weeks gestation https://ibconline.ca/premature2/ See the attached photo.

Myth #3: “non-nutritive sucking” is a good way to teach premature babies to breastfeed

How does this make sense? There seem to be two reasons for some neonatal special care units to ask mothers to “empty” their breasts and only then put the baby to the breast. 1. To prevent the baby from “accidentally getting milk” before he is ready to suck and swallow, and thus aspirating milk. Why is a baby more likely to aspirate at the breast than from a bottle or nasogastric tube? And 2. So that the staff can measure how much the baby gets from the breast. Oh, we love to measure, but this process often results in mothers and babies never really breastfeeding successfully.

This notion also “supports” the notion that premature babies need to use pacifiers to learn to suck “before they are ready to swallow”.

Myth #4: Breastfeeding tires out premature babies (the same is said about term babies and babies with cardiac problems)

This notion seems to come from the idea that “babies transfer milk”. But babies do not transfer milk . Mothers transfer milk https://ibconline.ca/who-transfers/. But starting with the notion that “babies transfer milk”, essentially, that babies “suck milk out of the breast”, breastfeeding is felt to be “hard work” and babies fall asleep at the breast because they tire out. Babies tend to fall asleep at the breast when the flow of milk slows down.

Myth #5: Premature babies need to learn how to bottle feed before they can breastfeed

This one is still around. Never made sense and still doesn’t.

The use of bottles in NICUs usually results in very few premature babies leaving hospital exclusively breastfeeding.

Myth #6: Most premature babies need “human milk” fortifier.

“Human milk” fortifier is misnamed and is formula milk, and makes many, even health professionals, think that it’s made from breastmilk. Most such products are made from cow’s milk. “Human milk fortifier” has been associated with an increased risk of necrotizing enterocolitis (NEC). If a premature baby needs extra nutrients and/or volume, these can be given with banked breastmilk, which is used more and more in some, but not all, special care units.

Want more information on breastfeeding the premature baby? See our eBook "Breastfeeding: Empowering Parents". The eBook contains videos, links to scholarly articles and more: https://ibconline.ca/ebook/.

New! An audiobook of my book Dr Jack Newman’s Guide to Breastfeeding. https://www.audible.ca/…/Dr-Jack-Newmans-Guide-…/1515933490…