Breastfeeding Your Premature Infant
When can my premature baby begin to breastfeed?
If your baby was born early, then you may not be able to breastfeed right away.
Whether or not your baby is ready to nurse at your breast right away will depend on
their gestational age and overall health.
At many hospitals it's standard practice to start off feeding very premature babies
expressed breast milk through a nasogastric (NG) tube (known as gavage). This is to
make sure the baby gets as much nourishment as possible since the infant may be too
immature to suckle from breast or bottle.
 Gavage feeding is a way to provide breastmilk or formula directly to your baby’s
stomach. A tube placed through your baby’s nose, called a nasogastric or NG
tube, carries breast milk/formula to the stomach.
If your baby is stable and relatively well, breastfeeding can be gradually introduced from
about 32 weeks. Until about 32 weeks, babies can’t coordinate sucking, swallowing, and
breathing well enough to breast or bottle feed, and babies less than about 37 weeks aren’t
strong enough to take enough nutrition by mouth to gain weight.
Beginning to Breastfeed Your Baby2
Generally, babies who are 1200-1500 grams (3 -3 1/2 lbs.) and around 32-34 weeks gestation are
good candidates for breastfeeding.
Signs that your baby is ready to be breast fed
 Sucking around a gavage feeding tube
 Hand to mouth activity
 Nuzzling, turning head inward with mouth open
 Ability to maintain body temperature
 Can manage his own saliva (does not require suctioning)
 Seems to need more sucking satisfaction
Pump Early, Often, and Well3
Because premature babies can’t always nurse effectively, moms who are breastfeeding a
premature baby must often pump breast milk that will be fed to their babies via a feeding tube.
Moms can establish a plentiful milk supply using a breast pump if they pump early, often, and
well:
Pump early: It is important to start pumping breast milk as soon as possible. This will
help you create a good milk supply which will in return result with a better
breastfeeding outcome.
 Ideally, your first pumping session should be within 6 hours of birth.
Pump often: Healthy newborns breastfeed often, and preemie moms must pump often
to establish their milk supply and to make plenty of milk.
 Plan to pump about 8 times per day.
 You should pump every 2 to 3 hours during the day, and every 3 to 4 hours at
night or during work.3
Pump well: If you are breastfeeding a premature baby, your hospital should loan you a
medical grade breast pump. If you purchase a supplemental pump, look for a quality fullsize, fully electric pump.


Have a lactation specialist work with you during early pumping sessions, and
consider combining hand expression with pumping to increase your milk supply.
It is also recommend to applying heat and massage your breasts during pumping
sessions
Tips for using a Breast Pump4
If your baby is not able to breast feed right now, you should still begin to pump your breasts as
soon as possible. By doing so, it will keep your hormone level up and stimulate your milk to
come in.
After delivery begin pumping as soon as possible. While in the hospital, use the pump
they have provided.
Pump on a regular schedule to keep your hormone levels up and trigger your body to
produce milk. Without regular pumping, your milk supply will dry up
When first starting to breast fed it is recommended to pump every 3 hours.
 Pump at least 10 to 15 minutes on each breast if pumping one breast at a time.
 Pump a total of 10 to 15 minutes if double pumping.
 Pumping at least 8 times in 24 hours is recommended.
 At night, you can plan to sleep without pumping for up to 5 hours.
Using the double pumping method is best because it cuts pumping time in half, which
raises hormone levels and improves milk supply.
If you have trouble getting milk with a pump, try pumping for 5 minutes, stop, drink an
8-ounce glass of fluid, and resume pumping.
Resources
Books:
Breastfeeding Your Premature Baby By: Gwen Gotsch. 2002
The Premature Baby Book: Everything You Need to Know About Your Premature Baby from Birth to
Age One By: William Sears, Robert Sears, James Sears, and Martha Sears. 2004
Websites:
http://abbottnutrition.com/Downloads/Breastfeeding_Your_Premature-Baby.pdf
http://www.mynursingwear.com/html/BreastfeedingInfo/English/premie_BF.pdf
http://www.breastfeedingbasics.com/articles/returning-to-work
1
http://www.preemie-l.org/bfaq.html
http://www.mynursingwear.com/html/BreastfeedingInfo/English/premie_BF.pdf
3
http://preemies.about.com/od/parentingyourpreemie/a/breastfeedingtips.htm
4
http://www.breastfeedingbasics.org/pi/pi-166.pdf
2