When Your Baby Is Born Preterm

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. It will change as your baby grows.

While in the hospital, the sooner the better to start hand expressing and pumping. You can hand express and pump, maybe even breastfeed, and hold the baby skin-to-skin while in the Neonatal Intensive Care Unit (NICU). If your supply is not ‘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. It may take some time for their natural root and latch actions to develop. Because preterm babies tire easily, take it one step at a time. Holding your baby skin-to-skin helps him/her to stay warm and conserve energy in the cocoon of your body.

Especially for preterm babies, the World Health Organization promotes Kangaroo MotherCare.  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. Click here for 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 to 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 that at least that scheduling 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 who pumped regularly, did skin to skin and bottles for many weeks. They despaired, at times, that their baby would never latch. How wonderful it was when the baby first latched, then suckled, then sucked and swallowed a noticeable amount. Step by step, 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. Give yourself and your family time, patience and honest, accurate support. This is why, as an IBCLC, I make home visits. That can take the stress out of getting to another appointment. Some insurance companies reimburse for home visits. Aetna has preferred providers who are in network.

In a list of ten, the United States comes in sixth place of 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.

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