Breastfeeding is the natural way of providing nutrition and nourishment to infants, and it is especially important for premature babies. Prematurity is defined as birth before 37 weeks of gestation, and it affects about 10% of all births worldwide (1). These tiny newborns are at higher risk for health complications and require specialized care in a neonatal intensive care unit (NICU). In this blog post, we will discuss the importance of breastfeeding for premature babies, the health benefits it provides, challenges and considerations, and tips for successful breastfeeding.
Importance of Breastfeeding for Premature Babies
Breast milk is known as “liquid gold” for its composition of antibodies, enzymes, hormones, and other immune-boosting components that protect babies from infections and diseases (2). For premature babies, breast milk is even more crucial due to their underdeveloped immune systems. Breast milk contains specific nutrients that are essential for their growth and development, such as proteins, fats, carbohydrates, vitamins, and minerals (3).
In addition to providing essential nutrients, breastfeeding has several other benefits for premature babies, including:
Enhanced Bonding and Attachment
Premature babies often require medical interventions and spend a significant amount of time in the NICU, which can make it challenging for parents to bond with their baby. However, breastfeeding offers a unique opportunity for skin-to-skin contact and promotes bonding and attachment between the mother and baby (4). The physical closeness and eye contact during breastfeeding help in establishing a strong emotional connection between the mother and her premature baby.
Improved Brain Development
Breast milk is rich in docosahexaenoic acid (DHA), an omega-3 fatty acid that plays a crucial role in brain development (5). Premature babies are at higher risk for neurodevelopmental delays, and studies have shown that those who are exclusively breastfed have better cognitive and motor development (6). The DHA in breast milk is especially important for premature babies as they need this nutrient to catch up on their brain development.
Reduced Risk of Infections
Premature babies are more vulnerable to infections due to their underdeveloped immune systems. Breast milk contains antibodies and other immune-boosting components that protect the baby from infections and reduce the risk of developing illnesses such as respiratory tract infections, ear infections, and meningitis (7). It is particularly crucial in the NICU setting where premature babies are surrounded by sick infants and are at higher risk of acquiring infections.
Health Benefits for Premature Babies
Breastfeeding offers numerous health benefits for premature babies, some of which are briefly discussed above. Let’s look at them in more detail:
Lower Incidence of Necrotizing Enterocolitis (NEC)
Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease that affects premature babies, with the highest incidence reported in those born before 30 weeks of gestation (8). NEC can lead to serious complications, including death, and it is one of the leading causes of mortality in the NICU. Exclusive breastfeeding has been shown to reduce the risk of NEC in premature babies (9).
Breast milk not only provides essential nutrients but also contains probiotics and prebiotics that promote the growth of beneficial bacteria in the gut, preventing the overgrowth of harmful bacteria that can cause NEC (10).
Improved Respiratory Health
Premature babies often have underdeveloped lungs, making them susceptible to respiratory problems such as bronchopulmonary dysplasia (BPD), a chronic lung disease that commonly affects preterm infants (11). Studies have shown that breastfeeding reduces the risk of BPD in premature babies (12). The antibodies and immune-boosting components in breast milk help prevent respiratory infections, and the DHA in breast milk also aids in lung development (13).
Better Growth and Development
Premature babies often have difficulty gaining weight and growing at the same rate as full-term babies. Breast milk provides all the necessary nutrients, including proteins, fats, carbohydrates, vitamins, and minerals, that are crucial for their growth and development (14). The composition of breast milk changes according to the needs of the baby, providing the perfect balance of nutrients for premature babies.
Breast milk is also easily digestible, which is important for preterm infants who may have immature digestive systems. This makes it easier for them to absorb the nutrients from breast milk and promote healthy growth and development (15).
Challenges and Considerations
While breastfeeding is highly beneficial for premature babies, it can also present some challenges and considerations. It is essential to address these issues to ensure successful breastfeeding and provide adequate support to mothers of premature babies.
Low Milk Supply
Mothers of premature babies may experience a delay in milk production due to the early birth of their baby. This can lead to a low milk supply, making it challenging to exclusively breastfeed their baby. In these cases, it is crucial to establish a good milk supply by pumping breast milk frequently, preferably within the first hour after birth, and maintaining a consistent pumping schedule (16). Mothers can also consult a lactation consultant for additional support and guidance.
Difficulty with Latching
Premature babies may have difficulty with latching onto the breast due to their underdeveloped sucking and swallowing reflexes. This can be frustrating for both the mother and the baby and may require the use of nipple shields or other techniques to help the baby latch on effectively (17). Working closely with a lactation consultant can also be helpful in addressing this issue.
Separation from Baby
In the NICU setting, premature babies often need to be cared for by medical professionals, and mothers may not have immediate access to their baby. This separation can make it challenging for mothers to establish and maintain a good milk supply and may also affect the bonding and attachment between the mother and her baby (18). It is essential to involve mothers in their baby’s care as much as possible and encourage skin-to-skin contact and breastfeeding whenever possible.
Tips for Successful Breastfeeding of Premature Babies
Breastfeeding premature babies comes with its own set of challenges, but with proper support and guidance, it is possible to overcome these obstacles and successfully breastfeed your baby. Here are some tips to help you navigate this journey:
Seek Support
The first step in successful breastfeeding is to seek support from healthcare professionals, lactation consultants, and other experienced mothers. They can provide guidance on how to establish and maintain a good milk supply, properly latch your baby, and address any concerns or challenges that may arise (19).
Practice Kangaroo Care
Kangaroo care, also known as skin-to-skin contact, involves holding your baby against your bare chest, providing warmth, comfort, and promoting bonding and attachment (20). This practice has shown to improve breastfeeding success and milk production in mothers of premature babies (21).
Use a Breast Pump
A breast pump can be a helpful tool for mothers of premature babies, especially those who experience a delay in milk production. Pumping breast milk frequently can stimulate milk production and maintain a good milk supply (22). Mothers can also use a hospital-grade pump that mimics a baby’s sucking rhythm and effectively empties the breasts.
Be Patient and Persistent
Breastfeeding premature babies may require more patience and persistence than breastfeeding full-term babies. It may take time for your baby to learn how to latch and effectively suckle, and it may also take time for your milk supply to increase (23). It is crucial to stay patient and persistent, and with time and practice, you and your baby will get the hang of it.
Be Prepared for Setbacks
Breastfeeding may not always go as planned, and there may be some setbacks along the way. It is essential to be prepared for these challenges and not be too hard on yourself. Seek support from healthcare professionals and other mothers who have gone through a similar experience, and remember that any amount of breast milk you can provide to your baby is beneficial for their health and well-being.
Conclusion
Breastfeeding is a vital aspect of caring for premature babies in the NICU setting. It provides numerous benefits for both the baby and the mother, including enhanced bonding, improved brain development, reduced risk of infections, better respiratory health, and healthy growth and development. While breastfeeding may present some challenges and considerations, with proper support and guidance, it is possible to overcome these obstacles and successfully breastfeed your premature baby. Remember to stay patient, seek support when needed, and be proud of the hard work you are putting in to provide the best nutrition and nourishment for your little one. Breast milk truly is the best gift you can give to your premature baby.