An early start

Your breast milk has important health benefits for your premature or sick baby.

Breast milk is easier for babies to digest (especially your premature baby), helps baby’s own immune system, and has special qualities designed for premature babies. Even the smallest amount is of benefit to your baby.

An early start

No matter how premature or sick your baby is, you should still be able to express breast milk to give to your baby. When your baby is born, colostrum (the first milk) will be produced in your breasts. It is likely to be a stressful time if your baby is sick or born prematurely, but it is important to start expressing soon after the birth (within the first six hours). This will help your body start to produce milk for your baby – even if your baby isn’t ready to feed.

When you start to express your breast milk, hand expressing is best. The midwives will be able to show you how to do it. Once your breasts feel fuller you can use a hospital grade pump. If your baby is not feeding from the breast at all, you will need to express frequently to establish and maintain your milk supply (8 to 10 times a day). Once your supply is established you may be able to reduce the number of times you express in a day, but talk to your midwife or nurse before you do this.

Kangaroo care

Kangaroo care describes a way of holding your premature baby that gives skin-to-skin contact and an opportunity for physical attachment and bonding with your baby.

For mothers, it may improve milk supply and help you to establish breastfeeding. For the father, or non-breastfeeding partner, it is another way that you can have a meaningful role in caring for your baby.

In a neonatal intensive or special care nursery, the nursing staff can help you prepare yourself, your baby and the environment for kangaroo care. Your baby needs to be medically stable before kangaroo care can begin.

Feeding milestones for premature babies 

From birth	Your baby will feel comfortable and warmest held against your skin with only a nappy on. The nursing staff will show you how to do this. Early and regular skin-to-skin contact enhances the development of your baby's feeding ability.
At around 24 weeks	Your baby is able to make sucking movements and swallow, but not at the same time, so drinking milk is not yet possible.  Your baby will enjoy exploring their hands and fingers so it’s good to let them have free hands to reach and suck and taste them.
From 26 to 30 weeks	Your baby will start to develop a gag reflex and, if they are well enough, will enjoy licking a few drops of milk from the breast. You might give a taste of milk by doing mouth care with a cotton bud and a drop of your milk. Your baby may also enjoy the scent of your milk on a cotton wool ball placed nearby.
From 30 to 32 weeks	If you touch your baby’s cheek at around this time, your baby will start turning their head to the side. During kangaroo care try stroking your baby’s cheek and they will turn to your breast and enjoy the taste of milk dripped onto their lips. Your baby might try to suckle but may still be too weak to latch and suckle well. Most feeds will still be through a tube.
From 32 to 35 weeks	Your baby will still need a lot of tube feeds, but during this time they will start to coordinate their ability to suck, swallow and breathe. Your baby will try to breastfeed and breastfeeding will be the best ‘sucking’ feeds to start with. Your baby will gradually get better at it in the weeks to come but may tire easily.
After 35 weeks	Your baby will gradually get better at sucking and will take more oral feeds. They may occasionally still get tired and need the occasional tube feed. Even though your baby is bigger they will still love kangaroo care.

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