Everyone knows that premature babies need a lot of care and attention, but have you ever heard of late preterm babies who are also called near-term babies?
When is a baby considered late preterm?
Late preterm babies are those born between 34+0 and 36+6 weeks of pregnancy.
When they are born at 34-35 weeks, it is possible that they spend a few days in a neonatal unit, but many times, babies who are born close to 36 weeks of pregnancy are discharged and sent home, sometimes even without any further information.
And, of course, certain difficulties may arise because they are still babies who have been born a little early and who, when it comes to breastfeeding, need a little more attention than usual.
So, what aspects should be taken into account in these cases?
Difficulty latching on to the breast
Premature babies are physically immature, and so are their brains. They have small mouths and relatively little sucking strength. In addition, the brain is the center that regulates sucking and swallowing, and it must take care of the precise control of the more than 20 muscles that a baby uses to suckle.
Premature babies are also more tired, they have less energy, and the whole sucking and swallowing process is a major cardiorespiratory exercise for them.
Therefore, it is vital that when the baby latches on to the breast, it is enabled maximum access to the milk, and the sucking and swallowing process should be made easier for them.
To do this, you can make breastfeeding easier by performing active breast compressions. Breast compressions are when a mother squeezes her breast during the moments in the feed when the baby is not actively sucking. This makes it easier for the baby to maintain active sucking.
Can nipple shields help?
When a baby is unable to maintain the latch and constantly lets go of the breast, you can consider whether the use of a nipple shield (in your right size) might make it easier for your baby to maintain sucking and make the feed more effective.
Premature babies or babies with immature sucking may benefit from the use of nipple shields, as they generate a greater stimulus in the baby’s mouth, making it easier for them to maintain their latch and often facilitating better milk transfer. If you want to try using nipple shields, you need to look for the right size for you and learn how to position it correctly so it does not constantly move or fall out.
In the case of supplementing
Many babies leave the hospital with supplementing guidelines, with formula or breast milk. Some of these guidelines are with large volumes of milk: for a premature baby, 60ml is a very large amount, difficult to manage, and they often end up spitting it up.
Firstly, it’s clear that supplementing can be required and necessary for these babies, and it is not a matter of cutting them down; it is a matter of getting organized. It is often easier to divide the milk to supplement into smaller amounts throughout the day than to expect them to have large amounts of milk in one feed.
Whenever possible, the strategy should be: offer the breast first, perform breast compressions, complete the feed with pumped breast milk or, in its absence, formula milk, and finish at the breast again, so the baby understands that food and satiety come from the breast.
Once the baby gains weight and a few weeks have passed, it is more than likely that supplementing amounts of milk can be withdrawn if you wish to do so.
Breastfeeding only works on demand when babies are able to wake up on their own, are not sick, and are not premature. So, with all premature and late preterm babies, it is important to follow a regular feeding schedule to make sure that they get 8 to 12 feeds every 24 hours. Once they are able to be proactive and ask for feeds by themselves, breastfeeding will finally become on demand.
Keep an eye on sleeping times
This point comes hand in hand with what we have said before. Sleeping does not nourish; sleeping does not help premature babies gain weight, and on the contrary, a baby who sleeps too much is a baby who eats less than they would need to. In the case of premature babies, sleeping too much happens very often, and it is crucial to watch out for their sleeping times.
Sometimes, it can be very difficult to wake these babies up. You have to spend a lot of time waking them up: take off their clothes, change their diapers, move the baby a little, leave them with your partner, and wait for them to wake up a little to start the feed at the breast. And remember the first thing: if your baby latches on, then breast compressions will help them to get the maximum amount of milk possible.
Check on weight gain
Weight gain in preemies is key; the heavier they are, the stronger they will be, and the more effective the sucking will be. Weight gain in these late preemies can happen in different ways:
- Some babies do a catch-up, which is more or less a very rapid and sudden weight gain, and then they slow down and follow a normal growth rate.
- And then there are babies who take it easy and gain weight gradually and more slowly, from 18 to 20 grams per week, which always makes both professionals and families quite nervous. In any case, it is very important to get support from a breastfeeding expert to see if the growth is slow but in accordance with the size or if you need to do something else.
As you can see, there are many aspects to consider if your baby was born late preterm. Remember that you can find all this and more information in our app, LactApp, which is free to download on Android and iPhone.