Breastfeeding your premature baby

Breastfeeding can take extra time and practice if your baby is premmie, very small or has health concerns.

It can feel like a lot at first. With support, time and practice, many mums and their babies learn these skills together.

Breastmilk is the normal food for all babies. It supports growth and development. It’s especially important for babies born early, as their bodies are still developing.

Breastmilk for premature babies has some special qualities. It:

• has more protein, fat and important minerals to support growth
• contains immune factors that help protect your baby from infection
• protects premature babies from serious gut and blood illnesses including necrotising enterocolitis and sepsis
• is gentle on your baby’s tummy and easy to digest
• produces very little waste, which can help protect immature kidneys

Even small amounts of breastmilk are valuable. If you’re only making a little, your baby is still getting important nutrients and protection.

The first milk you make (colostrum) is very concentrated. Even tiny drops can support your baby’s immune system and gut development.

In most neonatal units, staff understand how important breastmilk is. They will usually encourage you to provide your own milk if you can.

Providing breastmilk can be one way to feel involved in your baby’s care.

Breastmilk is so important for premature babies that some hospitals have human milk banks. This makes sure that our most at-risk infants receive donor human milk  as the next best thing after their mother's milk. If you can’t breastfeed or express, ask if your hospital has a milk bank. 

Skin-to-skin contact (often called kangaroo care) means holding your baby against your bare chest. Many families find this helps them feel closer to their baby.

Your baby may be placed inside your clothing, wearing only a nappy and sometimes a hat. A wrap can help keep them secure.

Some hospitals support skin-to-skin even when a baby needs medical equipment. Staff can guide you on what’s possible for your baby.

Skin-to-skin contact may help your baby to:

• feel calm and cry less
• keep their temperature, breathing and heart rate steady
• practise feeding behaviours
• stay close to you and build connection

It may also help you increase your breastmilk supply.

If your hospital doesn’t routinely offer this, you could talk with staff about when and how you might be able to hold your baby. You, your baby and your milk supply will all benefit if you can have as much skin-to-skin contact with your premature baby as possible. 

Breastfeeding can be a gentle way for premature babies to feed. They can take their time at the breast, often with short bursts of sucking followed by rests.

Even very small babies may cope well with longer periods at the breast without becoming distressed. While they are there, they can stay warm and settled, and their breathing and oxygen levels can remain steady.

Time at the breast is also about more than feeding. Your baby is close to you, with touch, smell and eye contact. Many mums notice this helps them feel more connected.

Because of this stop–start way of feeding, your baby may need plenty of time at the breast. Unless there is a medical reason to limit feeds, you can let your baby take the time they need.

As your baby grows and becomes stronger, their sucking and feeding will usually become more effective.

• Start expressing milk as soon as you can after birth
• Spend time holding your baby in a feeding position, even before they are ready to breastfeed
• Try different ways of holding your baby to find what feels comfortable and supportive
• Encourage your milk to start flowing before a feed (for example with gentle hand expressing or warmth)

Hospital staff and a lactation consultant can help you work out what suits you and your baby.

Some babies need time before they can feed at the breast. In the meantime, your expressed breastmilk can be given in different ways. Some babies will be tube-fed. Others can be taught to suck using a lactation aid, finger feeding or a cup.

Talk with your baby’s care team about the options and what might work best for your baby.

Having a premature baby can feel overwhelming. Things may not be how you imagined. You might feel shock, worry, sadness or frustration. You may also feel separated from your baby or unsure of what’s happening. These feelings are common.

Some mums go home before their baby is ready. This can be especially hard. Travelling back and forth, or being far from the hospital, can add to the stress.

If you’re finding things difficult, you’re not alone. Support from family, other parents and trained counsellors can help.