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Breast milk for your premature baby

The benefits of breast milk for your premature baby – making the right decision for your baby

Having a baby prematurely can be very overwhelming and a lot for you to process. The midwives, neonatal nurses and feeding specialists are all available to help support you.

You may not have decided how you want to feed your baby long term, but if your baby is born prematurely, you will be encouraged to express your milk very soon after birth. Your midwife, neonatal nurse or infant feeding team will help with expressing, storing and delivering milk to your baby (although this is a good job for birth partners too). This parent advice sheet will provide you with information to get your breastfeeding journey started.

Evidence suggests your breast milk is the most important and effective nutrition for your premature baby. Mother’s breast milk is always the first choice of nutrition for your baby. Your breast milk plays a vital role in protecting your premature baby. Colostrum (the first milk produced) has many benefits for your baby such as helping fight infection.

Every drop counts

Breast milk …

  • helps protect your baby from infections, particularly their gut – premature babies are more prone to infections and your milk contains antibodies that help their gut develop to help fight infections.
  • contains hormones, nutrients and growth factors that help your baby to grow and develop including their brain development.
  • is easier for your baby to digest than formula milk, because it is human milk specially designed by your body for your baby and will help protect their immune system.
    expressing your breastmilk and giving it to your baby will help build a strong bond between you both at this stressful and worrying time.

In brief the benefits of early breast milk include:

Necrotising enterocolitis 

A serious gut condition – Your milk is specifically designed for your baby and optimises gut health

It helps their brain development

each millilitre of breast milk has a positive influence on outcomes for premature babies

Protects their immune system, eyes and lungs

all babies no matter how early can receive their mother’s colostrum

Breast milk is more than food and nutrition

Being born early your baby may have missed out on microbe transfer. Your milk will provide these microbes (flora and friendly bacteria) for your baby. This flora and friendly bacteria crosses the gut/blood barrier and kick starts your baby’s immature defence and immune system and has a protective effect against gut immaturity. Your milk is made specially for your baby at the right times. When you express your milk, it is very important to give your milk in the right order for the first 14 days. Your milk should be labelled with times and dates, and a provided number sticker ensuring your milk is given in the correct sequence.

When can I start expressing breast milk for my baby?

Although you have given birth early, your body will still be able to make breastmilk. Your breasts will need stimulation of regular expressing to start and maintain breast milk production.

Expressing before your baby is born

At times you can start to express your milk before your baby is born. You must discuss this with your doctor or midwife before you start. Antenatal expressing should only be done when it is certain you will give birth in the next few hours.

Antenatal expressing can be done by hand only. Expressing before delivery will ensure one of the first treatments your baby receives will be your milk.

Expressing after your baby is born

Evidence shows that if you express within the first 1-2 hrs after giving birth your milk volumes will more than double by day 7 compared to if you wait after 2 hrs of giving birth to express. The difference will continue until baby is at least 4 weeks old.

Please see the video link on how to hand express and the supporting leaflet.

Frequency of expressing

  • If possible, have as much skin to skin contact with your baby.
  • Express 8-10 times every 24 hrs.
  • Express at night, hormone receptors are most ready to stimulate milk production at night. You may need to set your alarm at night to wake you up as expressing at night  helps stimulate milk production.
  • It may be frustrating when very little milk comes out initially, but continued stimulation will be important to get breast milk established. Every single drop counts and is very precious to your baby.

Increasing breast milk supply

If you are having trouble with milk supply, please feel free to talk to the neonatal infant feeding champions or the infant feeding team on maternity.

Some top tips:

  • If possible, increase skin to skin contact you have with your baby.
  • Express near your baby, think about your baby, look at photos whilst you express.
  • Exchange a muslin cloth, bonding squares or clothing with your baby. They can then smell you and in turn you can smell them and feel closer to your baby.
  • Look after yourself, get plenty of rest, stay hydrated and eat well.
  • Increase the amount you are pumping, try both hand expressing as well as using the pump.
  • Check your equipment, is the pump a good fit? There are different size shields available, ask a member of staff to help.
  • Consider that not all pumps suit every person, if possible, try a different make.

Donor breast milk

We will encourage and support you to produce your own milk, but when necessary we can offer donor breast milk if your baby meets criteria; this will be discussed with you by the staff caring for your baby.  Donor breast milk is the preferred alternative to infant formula (or artificial milk). This is because donor breast milk still contains many of the protective factors which help protect premature babies from infection and are not present in formula which is prepared from cow’s milk. We will discuss this with you before ever giving donor milk and ask for your consent.

If you require further support with feeding or expressing please ask your midwife or your baby’s nurse. They can refer you onto the infant feeding specialists if necessary.