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When Your Baby Is Born Preterm

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Giving birth early is a surprise and a worrisome situation. How is the baby? How is the mother? What just happened?

A baby who is born before 37 completed weeks is considered preterm. These little ones may look like a full term baby. They do, however, have different behaviors and needs. Please know that, amidst the many concerns, some of the most essential help for your baby comes from your skin warmth and your breast milk.

In fact, the World Health Organization promotes Kangaroo MotherCare and frequent breastfeeding as two critical components for improving a preterm baby’s survival. With that in mind, here are a few pieces of advice from parents and professionals.

Even for a preterm baby, your body has colostrum. It is specific to a preterm birth and provides the very best protection for your wee one.

While in the hospital, the sooner the better to start hand expressing and pumping. You can pump (maybe even breastfeed) and hold the baby skin-to-skin while in the Neonatal Intensive Care Unit (NICU). If your supply is ‘in’ yet, Pasteurized Donor Human Milk (PDHM) is an option that several hospital NICUs have. PDHM comes from the Mothers Milk Bank.

Preterm babies benefit from being at the breast, even if not actually feeding. Like all babies, they learn breastfeeding by smell and feel while the natural root and latch actions unfurl. However, preterm babies tire easily. Take it one step at a time. Meanwhile, your baby stays warm, conserving energy, in the cocoon of your body.

The World Health Organization promotes Kangaroo MotherCare for preterm babies.  That is “a baby being held in direct skin to skin contact with the mother 24 hours a day”. Kangaroo MotherCare also means rest for the recovering mother. Link here to a practical guide from the W.H.O.

Skin-to-skin time raises a mother’s prolactin levels, an essential hormone for milk production. This is especially important in the first hours and first two weeks. This is truly helping build your supply. Read this amazing story of preterm twins.

Unlike a full term baby, preterm babies don’t show obvious feeding cues. Parents need to keep a feeding schedule. Some mothers have said at least that gave them a plan. They could arrange their support (meals, child care) and visits to the N.I.C.U. around feedings.

Breast or bottle-feeding takes patience. When you leave the hospital, a home visit with an IBCLC can guide you in your endeavor. Talk with her about expressing and pumping, preterm sucking behaviors, bottle feeding and more. She’ll also send a review to your pediatrician after each visit.

As your baby gets stronger, he/she will be more capable of feeding. I’ve met mothers pumped regularly, did skin to skin and bottles for weeks. They despaired, at times, that their baby would never latch. How wonderful the first latch, then suckle, then suck and swallow a noticeable amount. It can happen.

A preterm birth is a surprise and a nexus of worry. The mother needs to recuperate and the whole family has to readjust. Here are three resources for support.

• Ten experienced IBCLCs who make home visits. Several insurance companies reimburse for home visits. Aetna has preferred providers who are in network.

Early Intervention, a free program run by the State of Massachusetts. Most N.I.C.U’s are connected with this program.

• JFCSBoston Fragile Beginnings Phone Support Group
Telephone support group for parents whose babies have spent time in the NICU.

In a list of ten, the United States comes in sixth place of the ten countries with the most number of preterm births.* Yet, all around the world, the low tech ‘therapies’ of skin to skin and breast milk makes an important difference in how preterm babies thrive. Isn’t it good to know that, essentially, you have what it takes to provide for your baby?

* Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional and worldwide estimates of preterm birth. The Lancet, June 2012. 9;379(9832):2162-72. Estimates from 2010.