Success tips for feeding your late preterm baby

11/25/2019 by Maegen Storm, APRN, CNP

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Congratulations on the birth of your baby and your decision to breastfeed! Breastfeeding your late preterm baby (born between 34 and 38 weeks of gestation) may have some unique challenges. Because they aren't as physically mature as a full-term baby, preterm infants may cue to eat less often, tire more easily while feeding and have less strength to suckle milk from the breast. 

This doesn't mean you can't exclusively breastfeed. Often, as late preterm babies near their original due date or soon after, they're able to nurse effectively and exclusively from the breast. 

Here are a few tips to ensure your baby is getting enough to eat, and you're able to maintain your milk supply: 

  • Your baby should be eating every two to three hours around the clock, even if they aren't showing cues. Wake the baby gently with skin-to-skin time, by lightly undressing, talking to them, or changing their diaper. 
  • Your baby may not be ready until a few weeks old to fully feed from the breast at every feeding. If they keep falling asleep at the breast within a few minutes, try nursing every other feeding or giving a bottle of pumped milk for the opposite feeding. Or, pump and give baby the expressed milk after they stop breastfeeding. 
  • Your baby's cheek muscles may not be fully developed, so they may not be able to extract milk from the breast efficiently quite yet. A nipple shield may be helpful. Your International Board Certified Lactation Consultant (IBCLC) or nurse can help you learn to use it. The shield can be used until baby is able to take all feedings easily from the breast, and then weaned off of it. 
  • To maintain a full milk supply, it's a good idea to pump or hand express milk after breastfeeding three to four times a day to stimulate milk production. This should be continued until the baby is nursing well from the breast, and your milk supply is fully established. Most moms are producing at least 16 ounces a day by one week of age. If you're concerned about your supply, reach out to your breastfeeding professional. 
  • Your baby's provider will want to monitor their weight to ensure they're growing well. Your baby should be gaining about four to seven ounces a week. Fortified breast milk supplements may be recommended to ensure adequate growth. 

Although breastfeeding your preterm infant may require a little more practice, providing breast milk is a wonderful way to give them the nutrition and germ-fighting antibodies they need to grow and thrive. Reach out to your lactation specialist to help with your unique situation. We're here to help you meet your breastfeeding goals!

Maegen Storm, APRN, CNP, is a certified pediatric nurse practitioner in Employee and Community Health's (ECH) Division of Community Pediatric and Adolescent Medicine (CPAM) and has a special interest in breastfeeding for the health of the baby. Maegen and her husband have enjoyed partnering to breastfeed their four boys.