A premature baby's path to breastfeeding
If a baby is born prematurely, the path to breastfeeding can sometimes be described as a "Breastfeeding wheel". The path to breastfeeding can go forward and, at times, take a backward step depending on how the baby is feeling.
The different steps can take varying lengths of time depending on the baby, follow your baby's signals and let your baby determine the pace. Feel free to avail of the support from the staff to interpret the baby's signals and consult them as to whether the baby is ready to take the next step.
The first step to breastfeeding begins with skin-to-skin contact with you. Skin-to-skin contact has many benefits for you as a parent, for breast milk production and for your baby. It is also easier for you to interpret your baby's behaviour when it starts to show signs of being ready to breastfeed.
The next step comes when the baby starts to show signs of wanting to suck, by licking, smacking its lips and searching. You can then, based on how the baby is feeling and what the baby is capable of, lay the baby next to your breast. At first, the baby may fall asleep immediately and that is perfectly normal. In the beginning, the length of time the baby is able to stay in this position at the breast varies. Be guided by the baby's behaviour and let the baby decide how much it can handle. A premature baby needs support in order to remain in the right position at the breast for breastfeeding, and you may also need support for your arms in order to find a comfortable position.
When the baby is ready for the next step, it will begin to search for the breast by trying to latch onto the breast and suck occasionally or a few times in succession. Initially, the baby may only be able to latch on for very short periods, and will often take long breaks between attempts. The baby may sometimes even swallow some milk.
Eventually, the baby will be able to latch on and suck for longer periods. The baby then sometimes swallows more milk. Offer the baby the breast as soon as it shows signs of wanting to breastfeed, even if this is done before planned tube feeding.
The baby can then start breastfeeding for longer periods of time with shorter breaks in between sucking, and can often take in large amounts of milk. It may now be time to reduce the amount of feeds given via tube feeding in order to increasingly switch to breastfeeding, this will be done in consultation with the staff.
When the baby is ready, you can gradually switch exclusively to breastfeeding. Many infants then want to breastfeed at frequent intervals. Offer the baby the breast when it shows signs of wanting to breastfeed, and in the beginning approximately every 3 to 4 hours at least.
You can facilitate the transition to breastfeeding by stimulating your milk production by expressing milk by hand or using a pump. Sometimes it can be difficult to produce large amounts of milk when expressing milk by hand or using a pump, as this does not stimulate the breasts as well as the baby's sucking. Even though it can sometimes be difficult to increase your milk production when expressing milk by hand or when using a pump, it is beneficial to try to maintain the production that exists. Then when the baby is ready to go to the breast and start stimulating milk production, the amount of milk can often increase. Sometimes this may only happen once you go home and are in a familiar environment.