As a Certified Breastfeeding Counselor, you will provide support to many families. Sometimes, this support might include families with premature babies. Can these premature babies breastfeed?
The short answer is that many premature babies are in fact able to breastfeed. However, it is not as simple as baby born, baby goes to breast, and working out typical breastfeeding initiation. Providing lactation support for premature babies will often extend beyond the scope of practice for a CBC.
However, it is still important you understand what premature babies breastfeeding can look like. Families may reach out to you for education and support. While they will likely need to work with an IBCLC to establish breastfeeding, you can still play a role in support and education.
Can Premature Babies Breastfeed? Often, Yes!
There are many variables which come into play with premature babies breastfeeding. Premature means a baby is born prior to 37 weeks gestation. A 23-week baby is very different from a 35-week baby. Their feeding journeys will look very different.
Prior to 33-34 weeks, most babies cannot safely coordinate their suck, swallow, breath reflex. This makes oral feeding unlikely prior to that gestation. Babies born prior to that 33-34 week will have mostly or exclusively feeding tube feeds.
This means there is no feeding at the breast initially. The parent would need to pump so the milk can be fed to the baby via a feeding tube. Pumping also maintains their milk supply so once baby can attempt feeds at the breast, the supply is there.
For babies born 33-36 weeks, some can practice or even effectively transfer milk right from birth. Many will still need feeding support if they are born less than 34-35 weeks. This may look like a feeding tube, cup, or bottle.
Once babies can safely practice suck, swallow, breath, they can have time at the breast using their feeding instincts. Some preemies will need time to navigate latching. Other preemies have little difficulty latching.
What is A Certified Breastfeeding Counselor’s Role Support Preemie Parents?
As supporting premature breastfeeding initiation is outside our scope, our role is a bit different than with typical breastfeeding initiation. However, we can still be a source of support and education for parents of premature babies.
While the journey is a lot more difficult for premature babies, it is possible for many preemies to breastfeed.
As a CBC, you can help parents navigate pumping schedules, provide encouragement about typical pumping output, and give them tips and tricks. Things such as:
- Keeping a handpump in their bag so they are never without a pump
- Have a car adapter to pump in car
- Sterilizing bags can make things easier for some
- Pump wipes can be great for on the go
- Breast milk storage information
- Pumping after skin-to-skin
- Reinforce non-nutritive suckling as being beneficial for supply
Are There Situations Where Premature Babies Cannot Breastfeed?
In some cases, a premature baby may have issues preventing them from feeding orally. This can include, but is not limited to:
- Severe reflux with aspiration
- Oral aversions and not showing feeding cues
- Needing high level oxygen support
- Certain congenital craniofacial abnormalities
- Galactosemia
- GI related abnormalities
In some cases, special equipment such as a nipple shield can aid in a preemie being able to feed when they would otherwise struggle too much. However, these should only be recommended by an IBCLC.