Earlier this week I attended a great breastfeeding conference in Houston. Our speaker, Barbara Wilson-Clay, BSEd, IBCLC, discussed the various challenges that mom’s face when breastfeeding and what we, as healthcare professionals, can do to help promote and support breastfeeding.
Premature infants, babies born less than 37 weeks, and “near term” infants (also known as the late preterm infant), babies born between 34-36 weeks gestation, were the focus of discussion There has been a great deal of attention placed on the near term infant the last few years. In most institutions, babies born at 35 weeks and older and who do not exhibit signs of respiratory distress, are regulating their temperature, are eating and have normal blood glucose levels will most likely remain in the well-baby nursery. The problem arises when we treat these preemies like full term babies and expect them to eat, regulated their temperature and behave like their full term counterparts. These babies tend to have lower muscle tone, thinner cheek pads and may not show well-organized feeding cues. These factors put these babies at risk for poor feeding which ultimately results in early abandonment of breastfeeding.
Here are some tips for success:
• If your baby cannot breastfeed initially, initiate pumping as soon as possible. If you have not been given a double electric pump, be sure to ask your nurse and/or lactation consultant ASAP so you can start saving your “liquid gold”.
• Practice skin-to-skin as much as possible. The close skin-to-skin contact helps to promote breast milk production, regulates baby’s temperature and is comforting to both you and your baby. Learn more about kangaroo care at Kangaroo Mother Care.
• Utilize lactation consultants if having difficulties with breastfeeding. Ensure your baby has a good latch to avoid trauma to your nipples and breast tissue.
• Be sure to breastfeed or pump a MINIMUM of 8 times per day.
• Some preemies may need to use a nipple shield. Consult your lactation consultant for proper size.
• If you are worried that you are not making enough for your baby, take your baby in for a weight check. Weigh the baby before the feeding, nurse your baby and then recheck the weight to see how much your baby ate (*be sure to weigh your baby with the same clothes and diaper for accuracy).
There are multiple factors that contribute to delays in lactation and may require some supplementation. Your breast milk can be supplemented in a variety of ways. Milk can be expressed with a breast pump (a double electric pump is best) and by using hand expression. Removing colostrum with both hand expression and pumping is very effective in increasing breast milk production. Once the breast milk has been collected, it can be fed to your baby in a variety of methods. Your lactation consultant can demonstrate these methods to you: cup feeding, finger feeding, spoon feeding and paced bottle feeding.
Cracked, sore nipples are another major reason that many moms abandon breastfeeding. Sore nipples can occur for a variety of reasons but is most frequently due to improper latch of the baby. If your nipple looks pinched or resembles the shape of lipstick when your baby comes off of the breast, your baby is not latched correctly. Infection (bacterial, fungal or viral) is another source of sore nipples and if not treated can lead to mastitis (a breast infection) which will require antibiotic therapy for treatment. Whatever the source for sore nipples, lactation consultants are experienced in identifying the problem and consulting with your healthcare provider in developing a plan for healing while continuing to support and assist you in providing your baby with the best nutrition possible…your breast milk.
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Author : Diba Tillery RN, BSN, IBCLC, CPST
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