Breastfeeding Preterm Infants, with midwife and IBCLC Katie James

Breastfeeding preterm infants can present unique challenges, but with the right support and knowledge, these obstacles can be managed. In this episode of the Pregnancy, Birth, and Recovery podcast, I had the pleasure of chatting with Katie James, an experienced lactation consultant and midwife, who offered incredible insights on how parents can navigate breastfeeding with preterm babies. Here’s a summary of what I learned from Katie, including some practical tips and answers to common concerns.

Common Challenges for Parents Who Are Breastfeeding Preterm Infants

Breastfeeding is challenging for many parents, and when a baby is born preterm, those challenges are often amplified. Preterm infants, particularly those born before 37 weeks, may struggle with breastfeeding due to their underdeveloped neurological and physical functions. Some of the most common issues Katie mentioned include:

• Sleepiness and fatigue: Preterm babies are typically sleepier and tire more quickly during feeding, making it difficult for them to take in enough milk.
• Difficulty showing feeding cues: Unlike full-term babies, preterm infants might not give clear signals when they’re hungry, leading to missed feeding opportunities.
• Sucking, swallowing, and breathing coordination: These reflexes are still developing in preterm babies, which can make breastfeeding particularly difficult for both mother and baby.

Tips to Help Facilitate Breastfeeding Preterm Infants

Thankfully, Katie offered some fantastic advice for supporting both preterm babies and their mothers through breastfeeding challenges. Here are a few of the key tips we discussed:

• Skin-to-skin contact: Katie emphasised the incredible benefits of skin-to-skin contact, also known as kangaroo care. This practice helps regulate a baby’s body temperature, improves their breathing, and can even lead to earlier breastfeeding success. Katie explained that holding your baby against your chest for extended periods can have a profound impact on their overall health and breastfeeding journey.
• Expressing milk: For mothers whose preterm babies are too sleepy or not yet able to feed effectively, expressing milk is a crucial part of building up their supply. This can help bridge the gap until the baby is ready to breastfeed, ensuring that the mother’s milk production keeps pace with her baby’s needs.
• Patience and support: Preterm infants often take longer to develop a consistent breastfeeding pattern, so it’s essential to be patient and give yourself and your baby time to adjust. Katie highlighted the importance of seeking out support from lactation consultants and other professionals who can provide guidance tailored to your situation.

How Long Does It Take for the Milk to Come In for Preterm Infants?

One of the questions I often hear from mothers of preterm babies is about milk supply—will their milk come in on time? Katie explained that while preterm births can sometimes cause a delay in milk production, with the right support, many mothers find their milk comes in within the typical 72-hour window. The key is to start expressing milk as early and as often as possible—around eight times in 24 hours—to ensure a good supply for when the baby is ready to breastfeed effectively.

Skin-to-Skin Contact, Expressing, and Feeding Sleepy Babies

Katie couldn’t stress enough the importance of skin-to-skin contact for preterm infants. This practice isn’t just about bonding—it’s also a vital part of helping preterm babies regulate their temperature, breathing, and heartbeat. Skin-to-skin can also encourage early feeding cues, prompting the baby to nuzzle and latch onto the breast more easily. Katie shared that even if a baby is too sleepy to breastfeed right away, keeping them close to the breast during skin-to-skin time can make a big difference in their breastfeeding journey.

If a baby is struggling to feed or is too sleepy, expressing milk becomes even more essential. Katie recommended using a hospital-grade electric pump and combining pumping with gentle breast massage to stimulate milk production. She also explained that preterm babies often make gradual progress—starting with nuzzling the breast or touching the nipple, before eventually developing the ability to latch and feed effectively. These small steps are important milestones in a preterm baby’s development, so it’s important to celebrate each one.

Breastfeeding preterm infants may feel daunting, but with the right knowledge and support, it is possible to overcome these challenges. By incorporating skin-to-skin contact, expressing milk, and being patient with your baby’s progress, you can help set both you and your baby up for a successful breastfeeding experience. And remember, you don’t have to go through it alone—professionals like Katie James, along with lactation consultants, midwives, and support groups, are here to help.

If you’re looking for more advice on breastfeeding preterm infants, be sure to check out Katie James’ podcasts, The Midwives Cauldron and The Feeding Couch. These resources provide helpful guidance and stories from other parents to remind you that you’re not alone on this journey.

** This podcast has general information only. Always seek the guidance of your doctor or other qualified health professional with any questions or concerns you may have regarding your health or medical condition. 

Links

Preparing for birth Pelvic health checklist
Free 7 Day Trial Pregnancy Workouts
Free 7 Day Trial Postnatal Workouts
FitNest Mama Website
Instagram @fitnestmama
Katie James website: https://www.katiejames.site/The Feeding Couch Podcast: https://www.katiejames.site/the-feeding-couch