Breastfeeding: Helping premature babies grow healthily

Author: Jing Yalin Peking Union Medical College Hospital

Reviewer: Feng Shuju, deputy chief nurse of Peking Union Medical College Hospital

Premature babies are anxious to come into the world early, but because of the immature physiological functions of their organs, they need more care and special medical care, so they have to be separated from their parents and come to the NICU (neonatal intensive care unit) to start their growth journey. Under the constant protection of medical godparents, they overcome various challenges and "upgrade" to become healthy newborns. Although the baby is temporarily separated from his parents during this period, he is not alone. Breast milk brings endless love and strength to the baby like magic, accompanies the baby, is the baby's strong backing, and helps the baby grow healthily.

Why is breastfeeding so important for premature babies?

1. The breast milk of premature mothers has a higher protein content and a lower fat content, which is easy to digest and absorb, reducing the risk of feeding intolerance.

2. The breast milk of premature mothers contains substances that promote the development and maturation of the intestines. The younger the gestational age of the premature baby, the higher the content of this substance in the breast milk. Breast milk can promote the maturation of the baby's intestines and prevent the occurrence of terrible diseases such as necrotizing enterocolitis.

3. Breastfeeding can speed up the process of enteral nutrition, shorten the use time of parenteral nutrition, and reduce the related complications of parenteral nutrition.

4. Breast milk contains unsaturated fatty acids and lactose, which are the main elements for brain development.

5. Breast milk contains a large amount of human milk oligosaccharides, which can increase the colonization of probiotics in the intestines.

6. Breast milk contains a large amount of immune-protective ingredients, which can improve the baby's immunity and reduce the occurrence of infections, especially the occurrence of life-threatening serious infections such as sepsis.

Breast milk is very important for premature babies. It can improve the survival rate of premature babies, promote the maturity of various systems, reduce the incidence of complications and improve prognosis. It is an important aid for babies to successfully "fight monsters and upgrade" and has benefits that cannot be matched by any medical means.

It should be noted that only exclusive breastfeeding can maximize these benefits, while the effect of mixed feeding will be greatly reduced. Then, the first difficulty arises. In the case of separation of mother and baby, how can premature mothers secrete enough milk? Drink more soup and strengthen nutrition? Find a lactation consultant for massage?

No, no, no, these are not the key to the problem. The most important step may be beyond everyone's expectation, that is, frequent and effective sucking is the key to promoting milk secretion! Then the question is.

Q: How can I achieve effective sucking when my baby is not around?

A: When the mother and baby are separated or the premature baby has no sucking ability, you can use a manual or electric breast pump to promote milk secretion by freely adjusting the frequency and strength of sucking the breast.

Q: What should I do if I don’t have a breast pump?

A: Hand-expressing can achieve the same effect, or even better than a breast pump, but mastering the method of hand-expressing requires learning and exploration. For premature mothers who need to express milk for a long time, it is usually recommended to use a breast pump. When the breast pump is not ready, hand-expressing can be done temporarily.

Figure 1 Copyright image, no permission to reprint

Q: When should I start pumping or hand expressing milk?

A: It is best to start using a breast pump or hand-expressing within 1 hour after the baby is born, and no later than 6 hours after the baby is born. In the first two or three days after delivery, mothers may not feel breast engorgement and the amount of milk secretion is relatively small, but this period is crucial for promoting milk secretion. If mothers can grasp these days well, they can smoothly increase milk secretion and become the baby's "little cow". In order to ensure that the baby has sufficient "rations", and to avoid suffering from breast engorgement, milk blockage, and even mastitis, and to save the cost of hiring a lactation consultant in the future, the efforts and efforts of these days are very worthwhile.

Q: What does it mean to suck frequently and effectively?

A: You should pump 8 to 12 times within 24 hours after birth, that is, once every 2 to 3 hours. You should also pump at the same frequency at night, 20 minutes per breast each time, usually no more than 30 minutes. It is possible that you can only pump out a few drops of breast milk, or even no drops, after so much hard work. Please don't be discouraged, keep going, and you will definitely get breast milk. We recommend filling out a breast pumping log, so that you can find your progress through recording, and seeing the milk production increase little by little will bring great confidence.

Q: I have to pump milk at night! It's so tiring. Can I pump more during the day and not pump at night or pump less?

A: Nighttime is the peak period for prolactin secretion, and milk secretion is most efficient. Not only can more milk be sucked out, but it can also stimulate the mammary glands to secrete more milk. It is very necessary to suck milk at night. If you don't suck milk for a long time at night, your efforts during the day may come to naught. Whether it is day or night, mothers should take the time to rest when they are not sucking milk.

Q: How long will it take to pump milk day and night like this? Is it going to last forever?

A: Mothers of hospitalized premature infants often maintain the same frequency of breastfeeding. As time goes by, the amount of milk produced will decrease. We recommend that mothers of premature infants produce 800 to 1000 ml of milk per day after delivery, so that even if the subsequent milk production decreases by 50%, there is still enough breast milk to feed her baby. So we need to set a small goal, that is, the daily milk production exceeds 800 ml. If this small goal is achieved, the frequency of breastfeeding can be appropriately reduced.

Q: After reaching the small goal, how should I express milk?

A: The most difficult time is finally over. Premature mothers can relax a little and reduce the frequency of breastfeeding. This frequency is no longer fixed. Each mother's situation is different. You need to feel and explore it yourself. It is enough to maintain 800 ml of milk production per day. It should be noted that the interval between breastfeeding should not exceed 5 hours, especially at night, and breastfeeding should be done at least once.

Q: Can my breasts withstand such frequent breast pumping?

A: When a new mother starts pumping milk, her nipples will be very sensitive. The previously delicate nipples will now be put to a great test. To avoid nipple damage, you should choose a suitable breast pump and use it correctly. The pumping time should not be too long, 20 minutes on one breast, generally not more than 30 minutes; the force should not be too strong, as long as there is no discomfort. Before pumping milk, just wipe the breasts with a clean towel. Frequent washing, even frequent washing with soap or alcohol disinfection, is not recommended to avoid aggravating the adverse stimulation to the nipples. After pumping milk, apply a small amount of sheep fat cream or milk to the nipples to protect the nipples.

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Although breast pumping is very hard, it is a process full of happiness and a sense of accomplishment. Mothers' thoughts and hopes turn into drops of sweet breast milk, which bring infinite love and strength to the baby and help the baby grow healthily.