A preemie baby usually needs additional support, of the neck and jaw during feeding, compared to their full term, larger counterparts.
The mother will need to find a nursing position that allows for good support and visibility of her baby’s head and mouth. The cross cradle hold and football hold are commonly used to breastfeed premature babies.
The mother needs to support her baby’s head, neck and trunk, by propping the baby up with pillows, so that the baby is at her nipples level.
The mother can place her palm on her baby’s upper back and support her baby’s neck with
her fingers and her thumb behind her baby’s ears. Some infants do not like
to be touched on their heads, but in this position, the baby’s head is not
Breastfeeding a Preterm Baby ~ Tips
When latching preemies, expression of a few drops of milk just before a baby latches on, can entice the baby to the breast. The milk can be placed on the baby's lips or on the mother's nipple.
Sometimes a chin first latch can be helpful in
getting a baby to latch on, this will ensure that more of the areola is
taken into the mouth.
The mother can use a U-hold to support her breast.
A deep latch is very important, because not only will the
baby get more milk, if the baby is latched on deeply, but the mother will less
likely have sore nipples. So, in most cases, if the mother will follow a few
simple steps, she and her baby can achieve a deep, comfortable latch fairly
quickly and easily.
Firstly, the mother will need to tilt the baby’s head back.
Babies are born with a recessed lower jaw. Just think about it, we need to tilt
our heads back when we take a bite out of a sandwich and the same applies when
a baby breastfeeds.
The mother should not be leaning forward, she needs to bring
her baby to the breast not bring the breast down to the baby. This will prevent
back ache. It is also best to have your baby at the level of your breast. The
mother should preferably have a backrest behind their back and have her feet up
on a stool, so that her lap is lifted slightly. Some mothers use special breast
feeding pillows, others find it enough to use a normal bed pillow.
The mother needs to place her hand at the base of her baby’s
head, with her thumb behind her baby’s ear. The other hand needs to be rested
in the centre of her baby’s back, so that the baby’s head can fall back
slightly and be supported by her fingers. The heel of your hand should be between
the baby’s shoulder blades. This allows the baby a bit of freedom to extend
Once the baby’s head is slightly tilted back, the mother can
rest her nipple just above the baby’s lip. This allows the baby to open their
mouth widely. Only then, when the baby’s mouth is open wide, should the mother
bring the baby’s bottom jaw in for the latch. Remember lower jaw first, then
upper jaw. The baby has to have a large part of the areola as well as the whole
nipple in his/her mouth.
Try to be patient with yourself and your baby, this is a
learnt skill. You’ll have to be patient as you learn. If you have latched on
and the pain seems to be less than usual, or you feel no pain at all, then you know
that you have latched your little one on well.
A good, deep latch will create a pull and tug sensation, not
a painful sensation. The first few seconds of a latch might cause some
discomfort, but this should improve during the feed, if the latch is correct.
When latching preemies, the nipple should be round and extended after a feeding,
not compressed or flat or bent over.
During a feeding, your baby’s mouth should look wide open
and not pursed. The baby’s jaw should be well behind the areola. Your baby
should be sucking and swallowing.
Tracy Behr, CBC, CLD (CBI)
Reference: Course information through childbirth International on the physiology of breastfeeding / latching preterm babies.