Author Name:
Liz Jones, Breastfeeding Specialist

Biography:
Elizabeth Jones has spent many years working as a breastfeeding specialist on a Neonatal Intensive Care Unit and also work as a Research Fellow in a team that focuses on breastfeeding research.

Article:
As soon as your baby is stable skin-to-skin contact (kangaroo care) is important. Your baby will love to be close to you and to hear your heartbeat and voice. Skin-to-skin contact will also enable you to trigger your body to make antibodies to the germs that are around in the environment and your milk will contain extra protection. You can also tempt your baby to feed by hand expression. Tiny babies love to lap dribbles of milk even when they are too weak to establish breastfeeding. Remember tiny babies are only able to tolerate limited sensory stimulation and the desire to sleep may over-ride the ability to feed. You will have to be very patient during this transitional phase.

When your baby is ready to start breastfeeding chose a moment when your baby is awake and alert. It is helpful to stimulate your milk flow first, either by hand expression or a breast pump, so that your baby does not have to work very hard. An under-arm position works very well, since the baby’s body is in a position of flexion while his head is slightly extended. By using a combination of hand expression and gentle facial massage you can stimulate your baby to root and open his mouth widely. Ensure that your breast is not too full of milk so that the disparity between breast and mouth is not a significant problem. Nipple tissue is very elastic, and even when very tiny a baby is able to draw the nipple deep into his mouth, so that it is wedged between the tongue and the palate. What can take time to develop is a rhythmic suckling pattern. Initially due to poor suck / swallow / breathe co-ordination, sucks may appear in isolation. Later, there may be long pauses between bursts of sucks.


The use of cup feeding can be a very useful tool to promote early feeding. Cup feeding appears to accelerate the transition from nasogastric to established breastfeeding. Cups should only be offered when you are not available to put baby to the breast. Babies vary enormously in their ability to feed. Some babies are very sleepy and it might take awhile until you can coax your baby to feed. Others acquire the skills necessary for feeding earlier and demand to be fed often. These differences occur whether or not your baby is born early. Another point to remember is that in the early stage feeds will vary from day to day and from feed to feed. Your baby will not be able to be demand fed until the part of the brain that regulates feeding is mature. This might not happen until your baby is 34 –36 weeks gestation. Don’t worry poor breastfeeds can be supplemented by tube or by cup.


It is a challenge to breastfeed following preterm delivery. However, it is worth all the effort when you see your baby growing and developing. Breastfeeding your baby will also help to provide a special closeness between you and your baby, which will help to make up for the time that you have been separated following birth. If you need help and advice do ask the nurses that are caring for your baby. A leaflet about breastfeeding preterm babies is also available from BLISS.