Giving birth to a premature baby is an experience for which parents are not prepared. The dreamed and desired baby disappears, happiness is postponed, and the future is too big and unknown. Parents often feel lost in the fragility of their babies. It seems that nothing is in their hands, that they cannot do much for them, and that they can only trust doctors and medicines. But is that so? What about breastfeeding in premature babies?

Although there are no specific causes for premature birth, in Western countries, several factors are pointed out as the cause of premature birth: assisted reproduction techniques, multiple births, work-related stress, health problems in the mother, and delayed motherhood. In developing countries, on the other hand, prematurity is due to a lack of medical follow-up during pregnancy and childbirth.

About 15 million premature babies are born worldwide each year, and this number is rising inexorably. More than one million premature infants die from complications, making it the leading cause of death among children under five worldwide.

For many of the premature babies who manage to survive, it is not going to be easy because many premature babies can suffer long-term conditions throughout their lives: blindness, cataracts, retinopathy, myopia, deafness, cerebral palsy, bronchopulmonary dysplasia.

The survival rate of babies born prematurely worldwide is very uneven, depending on the economic situation in each country. But more than three-quarters of premature babies can be saved with simple and cost-effective care, including a range of essential health services during delivery and the postnatal period for all mothers and all infants: prenatal steroid injections; “Kangaroo Mothercare Method”; promotion of breastfeeding; and antibiotics to treat newborn infections.

Premature babies do not have reserves of body fat. They cannot regulate their temperature, so they lose body heat more easily, which could lead to hypothermia, putting their lives at risk. They need more energy and care to conserve heat. More and more hospitals are encouraging open units that allow unrestricted access to small children. In this way, when the baby is stable, the more hours, the better the skin-to-skin contact with the parents can be.

Premature babies may have difficulty feeding because their reflex coordination is not yet mature, and they are not able to suck, swallow and breathe at the same time. Therefore, babies born before 30-34 weeks of gestation may need additional help to feed. They may need a nasogastric or orogastric tube for a while until sucking is effective, and they do not make respiratory desaturations when breastfeeding.  Many premature infants begin breathing autonomously from birth, but others need resuscitation. If the lungs have not finished developing, they also have a higher incidence of apneas. Then, they may need to wear a CPAP (continuous positive airway pressure) mask or nasal goggles until their lungs are ready.

“My milk is more than food; it’s your medicine. I can do something real to help my baby. Finally, something is in my hands.”

Breastmilk is the ideal food for any premature baby. The milk of a mother of a premature baby has a different composition than that of a mother of a full-term baby. It is known as preterm milk and maintains this unique composition until the baby is between 4 and 6 months old. For a premature baby, breastfeeding and skin-to-skin contact with the mother can make the difference between life and death. Breast milk has multiple advantages for them:

• It is easier to digest, better tolerated, and easier to assimilate.
• The lipase present only in breast milk helps fragment the fat in the milk and makes it easier to digest.
• Antibodies and other elements in breast milk protect the baby and are less likely to have necrotizing enterocolitis (NEC).
• Breast milk helps improve the baby’s vision with all the fatty acids and lactose it contains.
• Breast milk contains growth factors that promote intestinal and nervous system maturation.
• Breast milk needs an approach between mother and child, which makes the mother participate in the care of the baby, which promotes attachment and bonding.

The results of research conducted by Brigham and Women’s Hospital in Boston and published in The Journal of Pediatrics show the follow-up and development of 180 children born prematurely. The conclusions are that infants who were breastfed for at least the first month of life had better IQ and better motor skills development outcomes.

Knowing all of this, it’s hard to believe that most studies show that the rate of breastfeeding among premature infants is lower than among full-term infants. For premature babies, breastfeeding is much more than just food; it gives them the opportunity to grow properly. But mothers don’t have it easy to do it, to get to pump and maintain their milk production. This is why mothers of premature babies need more support in their decision to breastfeed, more information, and motivation to achieve it.

Do you have any other questions?

You can find more information about all things breastfeeding in our free app, LactApp, for iPhone or Android. In the contact section of the app, you can find an in-app consultation channel where our experts will answer your questions.