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Importance of Breastmilk
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How much should I be getting?
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How to Increase Milk Supply
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Medication and Breastfeeding
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Breastmilk and added calories
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Why is breast milk so important?
Breast milk helps to prevent infections.
When you are exposed to infections your body produces something called immunoglobulins, proteins that function as antibodies, which help to protect you from getting that infection again. These infection-fighting immunoglobulins are passed to the fetus through the placenta in the last three months of pregnancy. Babies born prematurely miss out on some of this, but the good news is your breast milk also contains these infection fighters! By providing your milk you are helping to protect your baby and lowering the risk of them getting an infection, including the risk of developing a serious intestinal infection called necrotizing enterocolitis (NEC).
Oral Immune Therapy (OIT)
Oral immune therapy (OIT for short) is given to premature infants who are not ready to feed by mouth. This is done by taking a small amount (usually about 0.5mL) of your breastmilk and putting it onto the inside of each cheek in your baby’s mouth. The breast milk gets easily absorbed and has been shown in studies to be safe and well tolerated. Giving OIT to premature infants has many helpful properties including decreasing the chance of your baby developing necrotising enterocolitis (NEC) which is a serious intestinal infection that premature infants can have.
Breast milk is easier to digest for all babies but especially for premature babies.
Your body knows your baby was born early and the milk you produce is made specifically for your preterm baby. Premature babies have an immature gastrointestinal system and your milk is easier to digest than traditional formula. In addition your milk contains more protein, fat and minerals than it would have if your baby had been born at term. Your baby needs these additional calories and minerals to help them grow!
Improved neurodevelopmental outcomes
Breast milk helps your baby's brain to grow and leads to improved neurodevelopmental outcomes. Your baby's brain is growing at a very rapid rate during the first two years of life. Studies have shown that the more breast milk a baby receives compared to formula, the better their brain growth and developmental outcomes.
These are just a few reasons why providing your breastmilk is strongly encouraged for preterm babies. If you have any questions regarding pumping or putting your baby to breast for the first time when they are ready, make sure to ask to speak with a lactation consultant.
Breast milk helps to prevent infections.
When you are exposed to infections your body produces something called immunoglobulins, proteins that function as antibodies, which help to protect you from getting that infection again. These infection-fighting immunoglobulins are passed to the fetus through the placenta in the last three months of pregnancy. Babies born prematurely miss out on some of this, but the good news is your breast milk also contains these infection fighters! By providing your milk you are helping to protect your baby and lowering the risk of them getting an infection, including the risk of developing a serious intestinal infection called necrotizing enterocolitis (NEC).
Oral Immune Therapy (OIT)
Oral immune therapy (OIT for short) is given to premature infants who are not ready to feed by mouth. This is done by taking a small amount (usually about 0.5mL) of your breastmilk and putting it onto the inside of each cheek in your baby’s mouth. The breast milk gets easily absorbed and has been shown in studies to be safe and well tolerated. Giving OIT to premature infants has many helpful properties including decreasing the chance of your baby developing necrotising enterocolitis (NEC) which is a serious intestinal infection that premature infants can have.
Breast milk is easier to digest for all babies but especially for premature babies.
Your body knows your baby was born early and the milk you produce is made specifically for your preterm baby. Premature babies have an immature gastrointestinal system and your milk is easier to digest than traditional formula. In addition your milk contains more protein, fat and minerals than it would have if your baby had been born at term. Your baby needs these additional calories and minerals to help them grow!
Improved neurodevelopmental outcomes
Breast milk helps your baby's brain to grow and leads to improved neurodevelopmental outcomes. Your baby's brain is growing at a very rapid rate during the first two years of life. Studies have shown that the more breast milk a baby receives compared to formula, the better their brain growth and developmental outcomes.
These are just a few reasons why providing your breastmilk is strongly encouraged for preterm babies. If you have any questions regarding pumping or putting your baby to breast for the first time when they are ready, make sure to ask to speak with a lactation consultant.
How much milk should I be pumping?
Pump as often as your baby would normally breastfeed — about every two to three hours during the day. At night, you can wait a little longer between sessions, so you can get more sleep once your milk supply has been established. A common schedule is to pump seven times in the day and once in the middle of the night. Pump for about 15 minutes on both breasts at the same time.
Here's an example pumping schedule:
3 a.m. 8 a.m. 10 a.m. 12 p.m. 3 p.m. 5 p.m. 7 p.m. 10 pm.
Many mothers find that setting exact times for pumping and staying on that schedule makes pumping easier. But a strict schedule isn't necessary, that's up to you. The important thing is to pump eight times in 24 hours and to completely empty the breasts. If you don't empty your breast fully your body will think it is making too much and decrease the amount it makes. If you fully empty your breast it triggers your body to make more!
The first couple of days it is normal to see just drops of colostrum, and we encourage you to use hand expression to get the most of that precious early milk. By day 7 you should be making about 300 mls (10 ounces) a day, and by day 14 you should be making close to 750 mls (25 ounces) a day. Along the way, if you are not hitting these targets, please ask your baby's nurse to request an additional visit with a lactation consultant. She will be able to help you with pumping concerns and improving your milk supply.
The first milk you will make is called colostrum and it is very high in immune-boosting substances that are VERY beneficial for your premature baby. So make sure to bring every drop you make to your baby!
Who can I ask for help with pumping?
Ask your baby's nurse, the medical team, or the lactation consultants for help. They are there to help you from putting pumping parts together, to how the pumps work, to how to manually express breastmilk.
Pump as often as your baby would normally breastfeed — about every two to three hours during the day. At night, you can wait a little longer between sessions, so you can get more sleep once your milk supply has been established. A common schedule is to pump seven times in the day and once in the middle of the night. Pump for about 15 minutes on both breasts at the same time.
Here's an example pumping schedule:
3 a.m. 8 a.m. 10 a.m. 12 p.m. 3 p.m. 5 p.m. 7 p.m. 10 pm.
Many mothers find that setting exact times for pumping and staying on that schedule makes pumping easier. But a strict schedule isn't necessary, that's up to you. The important thing is to pump eight times in 24 hours and to completely empty the breasts. If you don't empty your breast fully your body will think it is making too much and decrease the amount it makes. If you fully empty your breast it triggers your body to make more!
The first couple of days it is normal to see just drops of colostrum, and we encourage you to use hand expression to get the most of that precious early milk. By day 7 you should be making about 300 mls (10 ounces) a day, and by day 14 you should be making close to 750 mls (25 ounces) a day. Along the way, if you are not hitting these targets, please ask your baby's nurse to request an additional visit with a lactation consultant. She will be able to help you with pumping concerns and improving your milk supply.
The first milk you will make is called colostrum and it is very high in immune-boosting substances that are VERY beneficial for your premature baby. So make sure to bring every drop you make to your baby!
Who can I ask for help with pumping?
Ask your baby's nurse, the medical team, or the lactation consultants for help. They are there to help you from putting pumping parts together, to how the pumps work, to how to manually express breastmilk.
How can I increase my milk supply?
You can produce good milk for your baby even if you don't have a perfect diet or sleep pattern — but healthy habits like these do help:
There are things you can do to encourage your milk to flow. We call that "let down."
You can produce good milk for your baby even if you don't have a perfect diet or sleep pattern — but healthy habits like these do help:
- Sit down and eat at least three balanced meals and two healthy protein snacks every day. Your body needs an extra 500-600 calories per day to make milk.
- If possible, have someone prepare food ahead of time for you.
- A plate of sliced apples, cheese, and a few crackers in the refrigerator is easy to take out and eat.
- Every day, drink six to eight full glasses of water — or at least enough so that you don't feel thirsty.
There are things you can do to encourage your milk to flow. We call that "let down."
- Spend as much time as you can with your baby, if that is where you are most relaxed.
- While you are in your baby's room, close the curtain and pump right beside your baby, where you can touch and talk to him/her.
- Ask your nurse for help with Kangaroo care and let the baby 'nuzzle" your breast even if he/she is too small to actually latch on and suck.
- When you are not with your baby some moms find it helpful to look at a picture of their baby while they pump. Try doing deep breathing and imagining your milk flowing. Massaging your breasts while pumping helps encourage flow. Also try leaning forward; it helps you work with gravity and not spill.
What if I am taking medication?
Most prescribed and over the counter medications are safe to take while you are pumping or breastfeeding. Always check with your baby's doctor about giving your milk while on medications. Don't stop pumping or throw any milk away until you check with your baby's doctor, most likely it will be fine to continue to provide your milk for your baby.
Most prescribed and over the counter medications are safe to take while you are pumping or breastfeeding. Always check with your baby's doctor about giving your milk while on medications. Don't stop pumping or throw any milk away until you check with your baby's doctor, most likely it will be fine to continue to provide your milk for your baby.
Why is my breastmilk not enough for my baby?
Your milk is the best nutrition for your baby. However, breast milk alone does not have all of the nutrients that your premature baby would have received from the placenta during the last trimester of pregnancy. In order to make sure your preterm baby has enough protein and calories to continue organ growth (like your baby's brain and lungs), and minerals to help build strong bones (like calcium and phosphorus), you milk will need to be fortified. This means taking your milk and adding those supplements to it. Depending on your NICU, the added supplements could be from donated breast milk or from formula. Research studies have shown that babies who have good growth in the NICU that continues after discharge have improved brain growth and neurodevelopmental outcomes after discharge.
Your milk is the best nutrition for your baby. However, breast milk alone does not have all of the nutrients that your premature baby would have received from the placenta during the last trimester of pregnancy. In order to make sure your preterm baby has enough protein and calories to continue organ growth (like your baby's brain and lungs), and minerals to help build strong bones (like calcium and phosphorus), you milk will need to be fortified. This means taking your milk and adding those supplements to it. Depending on your NICU, the added supplements could be from donated breast milk or from formula. Research studies have shown that babies who have good growth in the NICU that continues after discharge have improved brain growth and neurodevelopmental outcomes after discharge.
