Babies born before their due date need special care, especially if they were very small at birth (less than 3 pounds).  Feeding premature babies is a unique challenge; it mainly depends on how early they were born, whether they have any medical issues and the severity of those issues.  It is also important to track how often your baby eats so you can share this information with healthcare providers and other caregivers.

Breast milk is ultimately the best source of nutrition for a new baby; it has proteins in it that can help fight infection and to promote growth.  If your baby was born before 34 weeks they often can’t feed from a bottle or breast due to the fact that they have trouble coordinating sucking, breathing and swallowing all at the same time.  However those born after 34 weeks may be able to feed from a bottle or the mother’s breast.

A good rule of thumb is to feed your premature baby 8 to 10 times per day and that will help prevent dehydration.  Six to 8 wet diapers a day is one indication that your baby is getting enough fluids.  If your head is now spinning with the “how many”, the “when” and the “how much” you may find it helpful to take a moment and track this information.  Premature babies tend to sleep more often than full-term ones but the duration is usually shorter.  In addition, with premature babies, sometimes you need to awaken them to feed them.

Soon after the birth of your premature baby start pumping if your baby is not able to breast feed.  Don’t be afraid to ask for help and do not hesitate to make sure those caring for you know your desire to breastfeed.   Once your milk supply is strong enough you can decrease how often you pump.  At 36 to 40 weeks, premature babies usually are able to suck and will most likely breast feed every 3 to 4 hours, but they may still need additional formula.  Once your baby is able to start nursing be prepared to nurse frequently and since they cannot take in much as milk at each feeding until they’re closer to term pump afterward to keep your milk supply up.  Some new mothers find it helpful to track this; either how often pumping occurs and how much, how much formula is given at each feeding and information on whether or not the baby was content, fussy or tired.

The video below shows you how to track breast and bottle feedings using the Babble Soft Baby Insights Day Tracker. These online tools are meant to help new parents easily track feedings and monitor baby’s fluid intake. There is also a feed tracking worksheet that you can print out to quickly write down feeding information to input later. By entering the feeding and intake data into Baby Insights, then parents can take advantage of the various graphs and reporting that is readily available and can help you identify patterns and monitor baby’s weekly intake or intake across multiple days. Parents of premature infants have found these charts and graphs especially helpful when meeting with baby’s pediatrician.

Image by Getty Images via @daylife

Being a new mom is full of choices.  If you’ve made the choice to breastfeed your new baby rest assured that that is one of the most important decisions you will make as a new mother.  It’s hard to refute the benefits of breastfeeding and nowadays there are a lot of resources out there to help you along on this new journey such as how to find a certified lactation consultants, workplace accommodations for breastfeeding moms in the new health care law and health insurance plans that may cover breastfeeding related expenses.

The past few years has seen resurgence in the popularity of breastfeeding.  The American Academy of Pediatrics recommends that mothers feed their babies only breast milk for the first six months. Breastfeeding is associated with a lower risk of many issues including ear and respiratory infections, diabetes and sudden infant death syndrome for babies and a lower risk of breast cancer and ovarian cancer for mothers.  More recent is the study published in the journal Pediatrics, which states that if most new moms would breastfeed their babies for the first six months of life, it would save nearly 1,000 lives and billions of dollars each year.

If you are a new mom returning to work who does breastfeed then you probably are already thinking about what to do.  The need for a reliable, efficient and easy to use breast pump is almost essential to keep up with breastfeeding at work.  A good breast pump is also a necessity for moms of premature infants who may initially be unable to breastfeed and need to express their milk.  A high quality breast pump can be an additional expense for families that they might not have counted on. At this point you may want to contact your health insurance company to find out if they offer any assistance/programs for new moms; surprisingly many of them do.  And be sure to look into using your health-care flexible spending account (FSA) for breastfeeding related expenses too – many will cover breast pumps with a doctor’s note.

You may also want to consider having a visit from a certified lactation consultant either prior to returning to work for tips on pumping or at any point after baby has come home.  A lactation consultant is a health care professional who is knowledgeable, skilled, and experienced in lactation (breastfeeding). The lactation consultant’s primary focus is to provide education, assistance and support to breastfeeding women, including how to help and support those new moms returning to work. Services and visits from a lactation consultant may also be covered by your insurance.

One really good source of breastfeeding information on whether or not health insurance will cover a breast pump or a visit from a certified lactation consultant recently became available on Medela’s website. While Medela is best known for its breast pumps and accessories, they are also very invested in helping moms succeed in breastfeeding.  This online resource will help new moms with their questions about whether or not their health insurance will cover certain breastfeeding-related expenses, including for example, lactation consultant services, breast pump rental/purchase and other costs.

Image via Wikipedia

When helping my cousin with her new baby during a trip to NYC, I was reminded of some tips to increase milk supply.  When my first was born, my milk didn’t come in until over 10-14 days later.  I was recovering from an emergency c-section and was exhausted.  I was so distressed that I wasn’t able to provide enough food for my son that I often broke down in tears.  When he was a week or so old, my mom, husband, and I took him to a local mother’s store and with the help of a wonderful lactation consultant I weighed him, fed him, and weighed him again.  I freaked out because he weighed exactly the same as before!  Talk about feeling like a bad mommy.  However, after a few minutes we all realized that we had forgotten to put his socks back on when we weighed him the second time, and he had actually gained some weight!  Phew!  I can laugh about it now but boy at the moment…

Well-meaning lactation consultants and nurses told me repeatedly that I shouldn’t supplement.   I felt guilty (ugh!) about doing it, but I had to and I’m glad I did.  A few weeks later once my milk was in we no longer needed to supplement.  When my daughter was born, I had no qualms about supplementing the first couple of weeks of her life because I knew with certainty she would breastfeed exclusively and it gave me some time to recover a bit faster.  This time my milk came in within 3 to 5 days.  So here are some ideas from my experience and my cousin’s:

Fenugreek. This seed is commonly used in pill form to increase milk supply.  Fortunately for me, it is often used in Sri Lankan and Indian cooking and since my mom was here the first couple of weeks my kids were born I got to eat lots of tasty curries cooked with fenugreek.  I’m convinced this is what helped bring my milk in faster.  I’ll never know for certain but it was a yummy endeavor nonetheless!

Dark beer.  My cousin was advised to drink dark beer to help increase her supply.  We were both discussing how it was too bad that she wasn’t advised to drink a lot of red wine…which we both love.

Garlic.  I also ate a little more garlic than normal in the curries my mother made, but I have heard that some people will eat so much that their milk starts smelling like garlic!  They say that babies like the flavor/smell of garlic in their mother’s milk so they suck harder and eat more.  Go figure!

Whole grains/Oatmeal.  I’m not sure how this works but it’s probably related to why dark beer is helpful.

Rest. Sleep. Warm Showers.  Although it’s very hard to get any rest those first several weeks home, it’s probably what the body needs most to help stimulate milk production.  When you sleep, relax, and rest your body has time to make milk without added stress.  Stress has been shown to decrease milk supply because your body is using it’s energy for things other than making milk!

Aruni
Founder, Babble Soft

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These tips are based on our experiences, as well as those of our friends and readers.  Please always consult with your doctor before implementing any tip that might impact the health of your baby.  If you have a tip you’d like to submit please send an email to blogger(at)babblesoft(dot)com.  Please check the ‘baby tips’ or ‘baby advice’ categories to make sure your tip (in some form or fashion) hasn’t already been posted.  If it has been, feel free to comment on that post and support the tip.  We also welcome respectful challenges to the tips because ‘everything is relative!’  We will, of course, give anyone who submits a tip we publish credit and a link back to their site!

Here’s a tip on breastfeeding a newborn:  Use TWO boppies.  When I had my son in 2002, I received a boppy (breastfeeding pillow) at my baby shower.  I really liked using it but discovered that I often had to put cushions or pillows beneath it to get our newborn son at a comfortable position for feeding.  The cushions would slip out or somehow (I don’t know how) he would kick them out.  I would then find myself hunching over and my back aching a bit after a while.  When my daughter was born in 2005, I received another one and happened to try stacking them and putting them both around my waist.  It was great!  Since I’m a bit short-waisted having the two breastfeeding pillows made me sit up straight thereby forcing me to maintain good posture (a plus).  Having two boppies was helpful to me in the cradle, cross-cradle, and football positions.  In the football position, I would put both boppies stacked on each other to my right or left and then I would place my daughter with her head toward me and her body/feet behind me resting on one of the sides of the boppy.  I used two for the first probably 12-16 weeks of her life.

Of course it’s not that easy to take a boppy with you when you are breastfeeding/nursing-in-public so on those occassions I propped them on our big, fat diaper bag because I always had it handy.

If you can’t afford another boppy, try to find a really sturdy/hard cushion that you can place under the boppy for the football position.  You’d have to find two slightly firm cushions if you want to use them for the cradle and cross-cradle positions.  You can also ask a friend if they are done with their boppy…I just gave one of ours away to a friend.  We also used our boppy for tummy time, sitting support, and all sorts of fun things that I’m sure you are not supposed to use it for.

Aruni
Founder, Babble Soft

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These tips are based on our experiences, as well as those of our friends and readers.  Please always consult with your doctor before implementing any tip that might impact the health of your baby.  If you have a tip you’d like to submit please send an email to blogger(at)babblesoft(dot)com.  Please check the ‘baby tips’ or ‘baby advice’ categories to make sure your tip (in some form or fashion) hasn’t already been posted.  If it has been, feel free to comment on that post and support the tip.  We also welcome respectful challenges to the tips because ‘everything is relative!’  We will, of course, give anyone who submits a tip we publish credit and a link back to their site!

If you need help with breastfeeding, Babble Soft offers a Free Trial to create your own breastfeeding log to help you manage your breastfeeding schedule. All you need is an email address to try it out!

Now here’s an article I wrote about how I eventually established breastfeeding with my kids that might be helpful to you or someone else you know who is struggling with breastfeeding.

Our son was born by emergency c-section making my post birth recovery time challenging because a) I was exhausted, b) he didn’t seem to sleep very much and c) I developed a breast infection.  Now a) and b) are par for the course when having a baby but c) knocked me senseless.  I didn’t want to take any more medication given that I had just come off of several after the c-section so I waited to see if the pain would go away.   When I reached the point where I would wake up from a restless sleep with tears in my eyes from the excruciating pain and I began having thoughts like “I wish I could die right now, but I can’t because I have to feed my baby,” I began a round of antibiotics.  Within a week or so I felt sane again.

Now part of the reason I contracted the breast infection was because I wasn’t breastfeeding correctly.  It took about 7 to 10 days for my milk to come in and then because of the infection probably 10 weeks for me to quit wondering how the human race survived before bottles and formula!  Here are some tips that helped me establish a successful breastfeeding relationship with my children.

1. Mentally prepare yourself that it can take up to 8 to 12 weeks.  Some insightful person…maybe a nurse or my lactation consultant, told me “Give it 8 to 12 weeks before making a decision on whether you want to quit breastfeeding.”  So I told myself ‘this is a marathon, not a sprint. Breastfeeding is important to me and my husband, and I can’t quit before 12 weeks.’  I remember saying that to myself almost every day and when I was 8 -10 weeks into it I realized “Wow, this isn’t so bad.  In fact it’s pretty darn neat!”

1. It’s OK to supplement as long as you continue to pump!   I was so afraid to supplement because I was repeatedly told that supplementing was the worst thing I could do, which of course made me feel like an awful mom.  But let me tell you, if you are exhausted and your baby isn’t gaining weight, it is one of the best things you can do.  After feeling guilty for a week because my milk wasn’t coming in and my baby wasn’t gaining weight, I decided to supplement and what a relief.  I had more confidence when our daughter was born 2 ½ years later.  I continued to pump and kept track of how much I pumped to keep up my milk supply which is very important to do.  It was less physically and emotionally draining for me to pump and give him a bottle one or two times per day until I could rest and gain back my strength.  I’m so glad I did because my milk supply built up and continued to increase!

1. Don’t be afraid to take that baby off!  Some well meaning nurses told me that when the baby is finished he will fall off.  They didn’t know my son.  He would stay on for over an hour on each side just suckling half asleep if I let him.  I remember breastfeeding sessions that would last 90 minutes which when I had to start over again in an hour and a half reduced me to tears.  I believe not pulling him off when I thought he was done contributed to my getting the breast infection.  With my daughter I produced so much milk that after 8 to 10 weeks I was able to take her off sometimes at 7 to 10 minutes!

1. Keep a breastfeeding log.  So that you have an idea of how much time you are breastfeeding, what your breastfeeding schedule is, and maybe even what position you are breastfeeding in, keep a breastfeeding log.  When our son was born I used a form I created in Microsoft Excel to jot down often illegible notes.  Fortunately when our daughter was born, we had an alpha version of our mobile software program, Baby Insights, available.  I could easily keep track of my pumping and breastfeeding schedule which helped me understand her feeding patterns and how much milk I was producing.

1. Drink plenty of water.  Drinking plenty of fluids, eating well, and getting good rest is a huge contributor to successful breastfeeding.  In fact a vast majority of breast milk is water.  Keep a bottle of water next to you when you breastfeed.

1. Ask and/or pay for help.  Whether it’s a lactation consultant, a post-partum doula, your significant other, a grandparent, or a friend who has breastfed before, ask for help.  A good lactation consultant can give you great tips on how to get your baby to latch on and feed properly.  If you can afford a post-partum doula a few hours per week, they can be a god-send with both household and breastfeeding support.  Ask your spouse to help you manage your breastfeeding schedule by keeping the breastfeeding log, bringing you water, fresh fruit, snacks, and the baby!

1. Relax. I know this is easier said than done, but I found the more relaxed I was, the more my milk flowed.  Lack of sleep and stress actually reduces your body’s ability to create breast milk.  And worse you may start to resent the process and maybe even your baby!  Watch a funny show or movie.  Take a nap.  Take a leisurely walk.  Chat with a friend.  Or just bawl your eyes out…we all know what a stress relief that can be!

Once your milk flow is established consider donating to a Mother’s Milk Bank near you.  I donated to the Mother’s Milk Bank of Austin with my daughter and it was a wonderful feeling knowing that my milk was going to help sick and premature babies.

Aruni Gunasegaram, President/Founder of Babble Soft