Preemie Development & Breastfeeding


Breastfeeding a Preterm Baby

Breastfeeding a premature baby is even more important than breastfeeding a full term baby, and holds special advantages.

The notion that bottle feeding is easier for a preterm baby than breastfeeding is false, and intensive care units around the world, are starting to realise this and change their outlook on this matter.

A preemie baby that is in intensive care, may not be able to breastfeed directly from the breast, but can still benefit from breast milk via alternative feeding methods

When choosing whether to breastfeed your preemie

Please read…


What are the Benefits of Breastfeeding your Preemie?

  • Reduced infections via immunological defense: Breast milk contains Bioactive factors, enzymes, antioxidants and cellular components that formula does not. 
  • Allergy protection: Breast milk is easily digested, it protects the gut wall from infection and allergies, breastfed babies vomit less than their formula fed counterparts. 
  • Enhanced preemie development: Breastfed babies have higher intellectual scores than non-breastfed babies; their cognitive and motor development is also improved. 
  • Better vision: Preterm babies are at risk for a disease of the blood vessels in their eyes. Breast milk reduces this risk and may even prevent blindness. 
  • Improved oxygen saturation: Breastfed babies take in more oxygen while feeding and therefore their oxygen levels are higher than formula fed babies. 
  • Improved heart rate: Babies that breastfeed have been found to maintain normal breathing levels, while formula fed babies have a lower heart rate and more episodes of bradycardia. 
  • Improved temperature control: Breastfed babies regulate their temperature better than formula fed babies, this is especially helpful for preemies who struggle with temperature fluctuations. 


Encouraging your Preemie to Breastfeed

Kangaroo mother care is recommended especially for premature babies. It has many advantages, including the fact that it encourages a baby to spend more time at the breast.


Feeding Methods 

Oral feeding methods: 

  • Breastfeeding: Many preemies can feed at the breast from birth.
  • Bottle-feeding: There are special bottles that are available, that resemble the breast and the flow of the breast. These bottles will make the transition to the breast easier later on, when the baby can breastfeed. 
  • Supplemental nursing system: This device can be used while breastfeeding, to either supplement the mother’s breast milk with fortifier or expressed hind milk or to help increase the mother’s milk supply, if necessary. Read more in detail about SNS here.

Medela Supplemental Nursing System

Non-oral Feeding Methods:

  • Gastric nasal tube: This is used when a baby struggles to swallow. The milk is delivered to the stomach directly via a tube in the nose. A naso-jejeunal tube is a tube that is sent to the small intestine, this helps the baby hold food in the stomach longer; this type of tube delivers a constant supply of milk, rather than a once off large amount.
  • Enteral feeding: This is through an IV, rather than through the digestive tract. 


Preemie Development
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When is a Baby Ready to Breastfeed? 

  • It is a myth, that bottle feeding is the only transition before the baby can breastfeed.
  • Babies should also never be evaluated for readiness to breastfeed according to their weight or age; each baby is different. 
  • Babies can root, grasp for the areola and latch on as early as 28 weeks. 
  • Once a baby shows these signs of readiness, the mother can put her baby to a breast that has been pumped, so that the baby does not struggle with a fast milk flow while practicing to breastfeed. The mother can gradually start to pump less and less milk before a feeding, until it is not necessary anymore.
  • Wearing a premature baby, can help increase the time spent at the breast. 
  • Non nutritive sucking can also provide benefits to the premature baby, such as a calming effect, oral development, stimulating the mother’s supply and bonding. 
  • If the baby struggles with nipple confusion, the mother can use a nipple shield to provide a similar feel to the nipple. Weaning off of the nipple shield should be done gradually and as soon as possible. 


Developmental Milestones

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Tracy Behr,CBC,CLD (CBI)

Reference: Course information through childbirth International on the physiology of breastfeeding / preemie development.


Other pages on breastfeeding problems in connection with preemie development.

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