“Breastfeeding a preemie is possible but the exclusive breastfeeding of a baby, especially the earlier premature babies, is not always nutritionally appropriate,” says Dr. Christine Bixby, a CHOC Children’s neonatologist who specializes in caring for premature infants.
There’s rarely a case where a premature baby can’t get some breast milk, she says. For example, in CHOC’s neonatal intensive care unit (NICU), nurses add powdered formula to breast milk to increase the nutrient levels.
“The breast milk is the best base, so we add some nutrients and that helps the baby grow,” says Dr. Bixby, who is involved in research studies focusing on issues related to breast milk, establishing a milk supply and using breast milk for premature babies.
Mothers of premature babies often have difficulty producing milk or sustaining production, Dr. Bixby says.
“Oftentimes moms are unable to make milk early in the process or sustain it, which given the prematurity of their baby, isn’t surprising,” Dr. Bixby says.
So, while the baby is at CHOC, lactation consultants and other specialists are available to help and encourage a mother to pump, if possible. The best way for a mother of a premature baby to establish a milk supply is to begin pumping as early as possible, ideally within six hours of delivery, she says. The mother should attempt to pump regularly, which physicians understand can be challenging when her baby is in the NICU.
For early feedings, donor human milk is an excellent alternative to a mother’s breast milk. CHOC purchases breast milk from a milk bank to offer babies whose mothers cannot produce milk, Dr. Bixby says. Milk donors are tested and the banked milk is completely safe, she adds.
Specialized formulas are also available for later feedings and following discharge. These both provide extra nutrients to help older premature babies grow, Dr. Bixby says.
“If the milk doesn’t come, regardless of why, it’s not worth dwelling on it,” she says. “Parents should ask their doctor about the best formula available and focus on creating a nurturing and loving environment for their baby.”