photo used with permission of K Bartle

BREASTFEEDING YOUR PREMMIE IN NICU

You may be grieving losses, feel guilty, fatigued, overwhelmed, worrying, feel angry, helpless and exhausted. It is a really difficult time.

Providing your milk is extra important for babies born prematurely but comes with extra challenges.

5 OF THE REWARDS OF BREASTFEEDING YOUR PREMMIE

1.     give them a good start in life (after a rough beginning)

2.      health benefits of your milk

3.      enjoyment of physical closeness and perception infant prefers breastfeeding

4.      making your unique contribution

5.      even with extra effort involved, BF is still “convenient”, rewards outweighing efforts

BENEFITS OF HUMAN MILK FEEDING FOR PRETERM INFANTS

MILK CONTENT

·         macro and micronutrients designed for humans

·         nutrients more readily absorbed with less energy expenditure

·         probiotics

·         less risk of zinc deficiency syndrome

·         greater gut feeding tolerance

LESS ILLNESSES

·         reduced risk and severity of infections, especially in hospital setting

·         reduced risk and severity of necrotising enterocolitis

·         less risk of ear, gut and bladder infections

·         less late-onset sepsis

·         reduced risk of allergy

INFANT MATURATION

·         enhanced retinal maturation and visual acuity (better eyesight)

·         enhanced developmental and neurocognitive outcome (higher IQ)

·         greater physiological stability during breastfeeding than bottle-feeding

·         comfort and bonding with their mothers

·         shorter hospital stay

ANTENATAL ACTION PLAN

Learn all you can about breastfeeding especially if you may deliver prematurely

Human milk is especially important for premature infants

Donor human milk may be an option if you are not able to express enough

IMMEDIATE POST PARTUM

Skin to skin as much as possible

Establish expressing early to optimise your milk supply

start expressing by hand ASAP after birth if baby can’t feed for himself, at least 8 times a day

Value every drop of your precious expressed milk

Anticipate and overcome obstacles

Avoid bottles, use cup or syringe instead

Ask the NICU staff about “trophic feeds” of very small amounts (drops) of EBM to prime gut initially and while your prem baby is receiving IV (parenteral) feeds

GET THE HELP OF A LACTATION CONSULTANT

early, effective help makes the world of difference in breastfeeding your little baby

EXPRESSING MILK TO ENSURE ADEQUATE MILK SUPPLY

Hand express or use breast milk pump frequently, especially in first month to maximise prolactin response

increase frequency of expressing not duration to increase supply

collect EBM in glass container with airtight lid

store milk in esky with frozen ice block/s and use fresh preferably within 12 hours or freeze

or in frig up to 48 hours or freeze

express by baby’s bedside if possible

skin to skin care (kangaroo care) can increase milk yields

KANGAROO CARE

promotes physiological stability in infants

increases prolactin and oxytocin in mother

aids longer duration of breastfeeding

may enhance maternal antibody production from close proximity to her baby

aids milk production and milk ejection reflex

improves exposure to mother’s skin flora and development of the infant’s own microbiome (instead of being colonised with the hospital germs)

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