This information may seem very basic for many of you but I'm responding to
the question from the doula/lactation "supporter" who asked about feeding skills
of preterm babies and the practices of some of the local resources.  I'm sure
that many others will respond to this. And there is plenty of information in
the archives on "early" or preterm babies, as well as in the lactation
journals and up to date reference books.
Treesa,
Babies who are born early, low birth weight or small for gestational age
often do not have the muscle tone, fat pads in the cheeks or ability to sustain a
latch for feedings of sufficient length and "strength" to grow well. That does
not mean that they can't breastfeed. It's a common practice, tho, in some
NICUs, usually per the doctor's orders (a doctor who may just want to "make it
eaiser for baby or mom") or one who is focused on quantity rather than quality
of feedings. In some cases, use of a nipple shield will help baby feed at the
breast better until they are closer to term...and mom usually has to pump for a
while to stimulate her milk supply until baby is strong enough and to have a
supplement if needed.
It is very discouraging to have moms think that they can't breastfeed until a
certain age or date is achieved. You can help by offering to assist mom put
baby to breast (using a nipple shield if necessary) or instructing her on the
progression of development of sucking and feeding skills. Many mothers of
premies that I've worked with did not have any good information on early babies. I
always encourage parents to become familiar with the differences, even had my
own copies of books to lend parents. Download articles (accurate ones of
course) from the internet to share or educate parents. Sometimes they "get it" and
sometimes they are so focused on the baby that they unconciously choose to
pump and bottle feed because they think it's easier. Once baby gets closer to
term, and mom is confident in reading the baby's cues, it might be eaiser. It is
wonderful that you are there as a PP doula to support her in this endeavor. I
wish I had a dollar for evey mom who I've spoken with or worked with that "got
it" when baby matured. Just as many give up tho, as succeed. I think support,
patience and information is the key.
Good luck to you and hang in there!
Mary Kay Smith, RN, IBCLC
Canton MI

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