How can I breastfeed my preemie?

Breastfeeding NICU Preemies, Step 4: Getting Better at Breastfeeding (February 2019).


Can my premature baby be breastfed?

Yes. Breastfeeding is the most important thing you can do for your baby. Breastfeeding promotes the health and vitality of your premature baby, supports its development and protects it from infection (Bliss 2013, NHS 2014).

If your baby was born before the 34th week, it probably will not be strong enough to suck on your chest right from the start (Tommy's nd). But you can pump out breast milk that is important for your baby.

Pumping off also has the advantage that milk production starts (Bliss 2013, HSC PHA 2014). Your baby can take the breast milk by stomach tube or in the mouth dripped. If your child is strong enough, it can also be fed with a special cup.

If your baby is physically ready to be breastfed, it can work well with support and patience, especially at the beginning.

Whether you can breast-feed your baby or feed it with pumped-up milk, it does not matter when it comes to building a relationship with your baby and you want to deepen it (Bliss 2013).

How can breast milk help my premature baby?

Your baby can digest breast milk more easily than baby food (Bliss 2013). Breast milk protects your baby from infections, especially in the lungs and intestines. Infections that can be very dangerous for a premature baby (Johnson et al 2014, Quigley and McGuire 2013, Patel et al 2013).

For premature babies and low birthweight babies, the best option is to only receive breastmilk as food for the first 14 to 28 days (Bliss 2013). Most of these babies can be discharged from hospital earlier than babies fed baby food (Johnson et al 2015).

When your baby is strong enough to suck on the breast, you can really enjoy your baby's closeness to breastfeeding. Skin contact while breastfeeding helps your baby build a strong bond between the two of you.

Breastfeeding is good for you too! Women who breastfeed lose weight more quickly after birth (Baker et al 2008, Bliss 2013, Krause et al 2010) and produce feel-good hormones (Bell et al 2014).

Breastmilk supports your child's brain development (Thompson et al 2014). Your baby benefits from breast milk not only in his first few months of life, but also in his early years (Vohr et al 2007) until late childhood (Quigley et al 2011, Thompson et al 2014). Breastfeeding also brings you long-term health benefits.

How can I pump the breast milk for my premature baby?

Your midwife and nurses will give you guidance and help with the implementation. The milk flow must first be stimulated by manual stroking of the breast until the breast milk can ""shoot in"" and be pumped out. This happens until your child can drink independently from the breast. The first breast milk, called colostrum or foremilk, is particularly nutritious.

It is best, right after birth, within the first hour, when it is possible for you to start breast-spreading (Becker et al 2015, Parker et al 2012, 2015). The sooner you can use the first drops of this valuable milk, the faster the milk flow will be stimulated and the milk will start earlier (Becker et al 2015, Parker et al 2012, 2015).

Gently warm and massage your breasts before starting to prick your chest, which increases your productivity. Even if you think that only very little milk escapes from your nipples, it is enough for your newborn at the beginning completely (Becker et al 2015, Bliss 2013) and gives your child everything that it needs at this time. Colostrum contains concentrated high protein foods and your baby's stomach is tiny and therefore quickly saturated.

It may take a while for you to get the hang of pumping it out, especially since you have other things to do as well.

If the milk is not enough at the beginning, your baby will get extra food. Either fresh milk from other mothers of breast milk banks (Bliss 2013, Unicef ​​2012) or a special infant formula for premature babies.

If possible, keep your baby close to your body while pumping. Direct skin contact releases hormones that, among other things, also promote milk injection. Skin contact is the most important thing for you and your baby after birth, but even every touch contributes to his well-being.

Learn relaxation techniques, especially in pregnancy, to make it easier to pump out and increase the amount of milk (Becker et al 2015).

In the beginning, hand-pumping is usually easier than with a mechanical or electric pump. Find out what makes you feel most comfortable.

The hospital will provide you with a pump if needed. Over time, you also learn to pump both breasts simultaneously, which speeds up the process of breastfeeding.

Take care in good time to have a pump for your home too. You can borrow them in a pharmacy or buy them from a specialist drugstore with a prescription from your doctor or pediatrician.

Pump between eight and ten times a day, one night at a time (Bliss 2013, NHS 2014). Breaks in between should not be longer than three hours during the day, and no longer than four to six hours during the night (Bliss 2013).Regular pumping guarantees a regular milk flow and counteracts a stagnation.

It is also important that you drink a lot: about 2, 5 to 3 liters should be in 24 hours. This also supports milk production. In addition, for example, geyser tea and Bockhorn clover seed capsules help.

This phase is not easy and requires a lot of work, but it's worth it. Regular pumping in the first two to three weeks will help you to promote and regulate milk flow (Meier et al 2010, Unicef ​​2012).

You can freeze pumped milk for later use (Bliss 2013). Label the bags of milk being pumped with your baby's name and the date and possibly time (Bliss 2013, HSC PHA 2014). This allows you to store the bags chronologically in the freezer and use them later (Bliss 2013, HSC PHA 2014). Breast milk changes in consistency over time, adapting to your baby's needs.

When will my premature baby be ready to breastfeed?

For most premature babies, it is a gradual, sometimes very slow, process until they can drink from the breast. It depends primarily on how early your child was born and on his overall health (Bliss 2013).

With the so-called kangaroo method, you can particularly promote your preemie and support his chances of breastfeeding enormously (Bliss 2013, HSC PHA 2014).

Put your baby under your shirt on top of your torso just under a diaper, like a kangaroo carrying a baby in its pouch. The nurses will show you how to properly position your baby so it can feel your warmth and skin.

There are mostly breastfeeding experts at the preterm stations. They stand by your side during the first breastfeeding attempts and continue to accompany you.

Your baby may not be able to drink from the chest right from the start. Do not let that discourage you. The sucking reflex must first develop to full strength, and perhaps other health problems prevent your baby from drinking from the breast (Bliss 2013, NHS 2014).

In the first few days, it may be necessary for your baby to get extra help with food intake. So the food z. B. administered intravenously or via a nasogastric tube (Bliss 2013).

I can not breastfeed my baby yet. What can I do?

There's a lot they can do. If your child can not yet drink from the breast, then you can still pump out the breast milk and thereby start your milk flow. Your partner can take care of the equipment and make sure that you eat enough during this stressful time.

The kangaroo method is suitable for both parents. This technique has positive effects on parents and children (Bliss 2013, Conde-Agudelo and Diaz-Rossello 2014).It deepens the bond with your baby and helps him to slow his heartbeat, regulate his body temperature and relax.

The kangaroo method helps you to be aware of yourself as a parent (Bliss 2013, NHS 2014). The deep relationship between you causes oxytocin to be released, the harmony hormone that is also very important for the nursing phase.

Many mothers offer their babies their nipples before and during artificial feeding (Bliss 2013). So your baby can practice sucking without stress. This ""dry training"" can lead to your baby sucking more vigorously sooner and therefore leaving the hospital sooner.

Sometimes nurses offer babies special teat cups to practice sucking. Do not worry, it does not disturb the natural sucking reflex on the chest. On the contrary, it helps your premature baby to drink earlier, sleep easier, and leave the hospital earlier (Pinelli and Symington 2005).

When your baby starts to suck on her breast, maybe just a few drops or her baby licks the nipple and just tastes a drop of milk.

Babies born too soon tire easily. So do not be disappointed if your baby sucks for a moment and then falls asleep. This tiring phase will be easier if you support the hospital staff and help you to set up.

Experts have also had good experiences with supporting the breast-sucking baby with a tiny, soft little tube, so that the milk can be delivered a little easier via ""Brustfeeding"".

Even if your baby is strong enough to drink from the breast, it can be very tedious to properly grasp the nipple. Your child has to open his mouth wide to get the nipple and areola in his mouth, and that can be very tiring for such a tiny creature. If this happens, then you can also feed your baby with your breast milk from a special cup. Nevertheless, put on your baby as often as possible. Consult with the Stillexpertin the premature birth ward about further help.

If you can not get along with breastfeeding or are not sure if you want to make it through, then try it for a while. Breastfeed once a day. Or give yourself a deadline, a month for example. Watch the progress. Even if you switch to baby food afterwards, your baby has already benefited from breast milk.

Who can help me breastfeed when I'm back home?

You can get tips and help from your midwife, gynecologist, maternal counselor (Bliss 2012), and certainly from nurse station nurses.

Most importantly, contact the midwife who will be taking care of you right from the start.Then you can ask them for advice at this stage.

Prenatal Parent Counseling Centers are also a good source for hands-on help and tips.

You can also interact with parents in our community.

breastfeeding and lactation consultants are represented throughout Germany. The costs can be covered by the health insurance companies.

Breastfeeding groups and cafes provide support and helpful entertainment.


Baker JL, Gamborg M, Heitmann BL, et al. 2008. Breastfeeding reduces postpartum weight retention. At J Clin Nutr 88 (6): 1543-51

Becker GE, Smith HA, Cooney F. 2015. Methods of milk expression for lactating women. Cochrane Database of Systematic Reviews (2): CD006170.

Bell AF, Erickson EN, Carter CS. 2014. Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood. J Midwifery Womens Health 59 (1): 35-42.

Bliss. 2011. The Bliss baby charter standards.

Bliss. 2012. Going home: the next big step.

Bliss. 2013. The best start: a guide to expressing and breastfeeding your premature baby.

Conde-Agudelo A, Diaz-Rossello JL. 2014. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database of Systematic Reviews (3): CD002771.

HSC PHA. 2014. Breastfeeding your ill or premature baby. Health and Social Care, Public Health Agency, Northern Ireland.

Johnson TJ, Patel AL, Bigger HR, et al. 2014. Economic benefits and costs of human milk feedings: a strategy to reduce the risk of prematurity-related morbidities in very-low-birth-weight infants. Adv Nutrition 5 (2): 207-12

Johnson T, Patel AL, Bigger HR, et al. 2015. Cost savings of human milk as a strategy to reduce the incidence of necrotizing enterocolitis in very low birthweight infants. Neonatalogy 107 (4): 271-6

Krause KM, Lovelady CA, Peterson BL, et al. 2010. Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC programs. Public Health Nutr 13 (12): 2019-26

Meier PP, Engstrom JL, Patel AL, et al. 2010. Improving the use of human milk during and after the NICU stay. Clin Perinatol 37 (1): 217-45

NHS. 2014. Breastfeeding a premature baby. NHS, Health A-Z.

Parker LA, Sullivan S, Krueger C, et al. 2012. Effect of Early Breast Milk Volume and Timing of Lactogenesis Stage II among Mothers of Very Low Birth Weight Infants: A Pilot Study. J Perinatol 32: 205-9.

Parker LA, Sullivan S, Krueger C, et al. 2015. Association of timing of breastmilk expression on milk volume and timing of lactogenesis stage II among mothers of very low-birth-weight infants. Breastfeed Med 10 (2): 84-91

Patel AL, Johnson TJ, Engstrom JL, et al. 2013. Impact of early human milk on sepsis and health care costs in very low birthweight infants. J Perinatal 33 (7): 514-9

Pinelli J, Symington AJ. 2005. Non-nutritive sucking for physiological stability and nutrition in preterm infants. Cochrane Database of Systematic Reviews (4): CD001071

Quigley MA, Hockley C, Carson C et al. 2011. Breastfeeding is associated with improved child cognitive development: A population-based cohort study. J Paediatr 160 (1): 25-32

Quigley M, McGuire W. 2013. Formula versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database of Systematic Reviews (4): CD002971.

Tommy's. nd. Feeding your premature baby.

Thompson DK, Lee KJ, Egan GF, et al. 2014. Regional white matter microstructure in very early infants: predictors and 7 year outcomes. Cortex 52: 60-74.

Unicef. 2012. Guide to the Baby Friendly Initiative standards.

Vohr BR, Poindexter BB, Dusick AM et al. 2007. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birthweight infants at 30 months of age. Pediatrics. 120 (4): e953-9

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