Key points about breastfeeding your premature baby at home
- offer your baby the breast when they show early feeding cues
- breastfeed your baby at least 8 times in 24 hours
- wake your baby for feeds if needed and avoid gaps longer than 4 hours
- continue expressing and giving top-up feeds as advised by your baby’s healthcare team
- talk to a health professional if you have concerns about your baby’s feeding or wellbeing
Breastfeeding your premature baby at home
Once you are home, you and your baby will continue to build on the feeding skills you developed in hospital. Pay close attention to your baby’s feeding cues and offer the breast in response to these cues.
All pēpi (babies) are different. Discuss a feeding plan for your baby with their healthcare team.
Caring for and learning to breastfeed your premature baby can be an emotional journey. You may need ongoing support after you return home. Your whānau (family), friends, midwife and neonatal outreach nurse may be able to support you.
Your baby’s healthcare team can tell you about breastfeeding support available in your area.
Feeding your premature baby
Offer your baby the breast when they show early feeding cues. Your baby should breastfeed at least 8 times in 24 hours.
You may need to wake your baby to make sure they feed often enough. Avoid gaps longer than 4 hours between feeds unless your baby’s healthcare team has given you a different feeding plan.
Your baby may want or need to feed every 1 ½ to 3 hours. This is normal and should be encouraged.
Watch your baby’s sucking and swallowing rather than watching the clock. Bursts of steady sucking and swallowing help show that your baby is taking in milk.
Breast compressions may encourage your baby to swallow more often. This is particularly useful if your baby becomes sleepy at the breast. Breast compressions involve gently squeezing your breast while your baby feeds. Ask a health professional to show you how to do this if you're unsure.
Feeding cues
Feeding cues are signs that your baby is ready to feed. Responding to early feeding cues can make breastfeeding easier.
Early feeding cues
Your baby may:
- stir or begin to move
- open their mouth
- turn their head and search for the breast, called rooting
Signs your baby is becoming hungrier
Your baby may:
- stretch
- move more
- bring their hand to their mouth
Late feeding cues
Crying is a late feeding cue. Your baby may also become agitated or their face may become red.
If your baby is crying, calm them before offering the breast. You could try:
- cuddling them
- holding them skin-to-skin against your chest
- talking gently to them
- stroking them
Expressing and supplementary feeds
Continue expressing as advised by your baby’s healthcare team.
Your baby may need expressed breastmilk as a supplementary feed. This is sometimes called a top-up. Your midwife, neonatal outreach nurse and your baby’s healthcare team will guide you.
Your baby’s healthcare team will help you gradually reduce expressing as needed. This will happen when your baby is breastfeeding well and gaining weight.
You may need to increase expressing again if your milk supply reduces or your baby is not gaining weight. Talk to your baby’s healthcare team before changing your expressing plan.
When to get medical help
See a health professional if you are concerned about your baby’s wellbeing at any time.
Ask for help if your baby:
- is not feeding as well as they were when they left hospital
- is swallowing less often during feeds
- has fewer wet or dirty nappies
- is not gaining weight as expected
Talk to a health professional if:
- feeding causes nipple pain or damage
- your breasts remain uncomfortably full after feeding
- you have concerns about your milk supply
Follow the urgent medical advice provided when your baby left hospital if they show signs of being unwell.
PlunketLine is available 24 hours a day, 7 days a week, on 0800 933 922 for advice and support for you, your baby and your whānau. Calls are free from cell phones. You do not need to be registered with Plunket to use this service.
La Leche League New Zealand provides breastfeeding information, support and encouragement for parents and whānau.
Acknowledgements
Adapted from the leaflet: 'Breastfeeding your premature baby at home. Matatiki, Child & Youth Health, Waitaha Canterbury'.
