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Breastfeeding a Premature Baby

Breastfeeding a Premature Baby

All babies need proper nutrition to grow, but it’s especially important that premature babies gets the nutrients found in breast milk.

When it comes to breastfeeding, preemies and their moms face a unique set of challenges. Perhaps your baby is in the neonatal intensive care unit (NICU) and you cannot nurse directly from the breast yet, or maybe you have a low milk supply. While these first weeks and months of parenthood may not be what you had planned, don’t fret. In most cases, you can still provide your little one with the nutritional benefits of your breast milk to support them as they get stronger and healthier. 

We’re breaking down the various aspects of feeding and the best ways to help ensure your baby gets the nourishment they need.

Benefits of breastfeeding your preemie

Your preemie has a lot of growing to do, and breast milk plays a pivotal role in their development. Here are just a few reasons why experts agree that breast milk is best for babies. 

  • Breast milk is packed with tons of nutrients and contains special elements that help boost underdeveloped immune systems. 
  • The nutrients in breast milk promote brain development and reduce the likelihood of allergies, infections, and illnesses in adulthood. 
  • Breast milk is easier to digest than cow’s milk. 

Breastfeeding can also foster an emotional bond between mom and baby.

When should I start breastfeeding my preemie?

When it comes to being ready for breastfeeding, every mom and baby is different. The process may begin a little later when you have a premature baby since your little one is less developed and you’ve had limited time to start producing milk. That said, it’s not uncommon for moms of preemies to be able to breastfeed their babies from birth. Be sure to let your baby’s healthcare team know if you’d like to breastfeed.

Potential premature baby feeding problems

Premature babies can experience feeding challenges, but they are usually temporary. These issues generally resolve once your baby has had a little more time to grow.

The baby may not be ready to breastfeed

Some premature babies can breastfeed right after birth, but others may be too small or sick to nurse. The good news is that by expressing your milk right after delivery, you can still nourish your baby with your liquid gold. Even if you can’t nurse just yet, you may be able to bottle feed them your milk or have it administered via a feeding tube. 

Fortunately, nature has prepared your breast milk, especially for your preemie. When a baby is born prematurely, the breast milk produced is higher in protein, minerals, and fats that are more easily digested and absorbed. That first milk also has lots of antibodies to support your baby’s immune system.1 

Whether you use the breast milk now or freeze it for later, your baby will benefit from it. And if you find expressing milk a little tricky, check with your healthcare provider to see if they can refer you to a lactation specialist.

Immature sucking and swallowing skills

It takes coordination to suck, swallow, and breathe while feeding from a breast or a bottle, and some preemies need a little extra time to get the hang of it. And until they do, they may choke or gag during an uninterrupted feeding.2 

In these cases, the infants may be fed using the gavage feeding method, which is when a tube is placed through their nose or mouth into their stomach. The hospital may be able to store your breast milk and use it for these feedings so that your baby doesn’t miss out on that abundant breast milk nutrition.3

Underdeveloped gastrointestinal (GI) tract

If your baby cannot properly absorb nutrition because of an underdeveloped GI tract, they may be fed using total parenteral nutrition (TPN). This feeding method delivers a mix of fluid, sugars, electrolytes, protein, vitamins, minerals, and fats through a vein.4 It’s complete nutrition that will help your baby develop and grow. TPN feedings will decrease as your little one’s ability to digest milk increases.

How to increase milk supply while pumping

If your preemie can’t breastfeed yet or is still in the NICU, you can use a breast pump to extract milk. Here are some tips that may help you increase milk supply while pumping. 

Pump frequently

Pumping frequently, at about the rate your baby would feed naturally, can help ensure you’re producing a steady milk supply. The milk you extract can be given to them through a bottle or tube at any time.

Consider lactation supplements (galactagogues)

While there’s no specific food that has been found to increase milk supply, there are a few lactation supplements you may want to try if you’re looking for a breast milk boost. These supplements, called galactagogues, are teas and herbs that have been used throughout history to promote milk production. Popular ones include fenugreek seed extract, the blessed thistle plant, and alfalfa.5  Ask your healthcare professional if a lactation supplement may be an option for you. 

Use a quality breast pump

A high-quality, hospital-grade breast pump may make it easier to increase your milk supply. If your baby is in the NICU, the unit may have one you can use.

Establishing milk supply can take time

If, for any reason, you’re unable to express milk in the first weeks of your preemie’s life, that doesn’t mean you won’t be able to later. When the time is right, you can try relactation, the process of resuming the production of breast milk. Nipple stimulation can jumpstart things and can be done through nursing, hand expression, pumping, or a combination of these techniques. This process will often lead to milk extraction, which signals that your body needs to continue producing more milk. It generally takes a few days to a few weeks to completely rebuild your milk supply.

Fortifying breast milk

While breast milk is a nutritional powerhouse, preemies with a very low birth weight need additional nutrients to grow at the optimum rate. If your baby was under 1,500 grams at birth, they require extra protein, phosphates, sodium, and calcium. To provide your little one with everything they need, you can fortify your breast milk with nutritional supplements that come in liquid and powder form. Talk to your doctor first.

What if breastfeeding isn’t possible?

If breastfeeding isn’t an option, your pediatrician or neonatologist will manage your baby’s feeding to ensure their unique nutritional needs are met.

How often do premature babies feed?

Preemies have tiny tummies and should eat lots of small meals, on demand, generally every three hours. But your doctor will provide some guidance. Once your little one is ready to leave the hospital, your healthcare provider will let you know the quantity and frequency of feeds, as well as the specific nutrition your baby will need. Ask your baby’s doctor about supplementing with a formula and premature formula options that are specifically made for your little one’s needs.

Breast milk is especially important for premature babies. It helps them grow stronger and provides them with immune support and brain-building nutrients. Breastfeeding a preemie isn’t always easy and not always possible, but luckily there are several options to ensure your little love gets the nutrition they need.


All information on, including but not limited to information about health, medical conditions, and nutrition, is intended for your general knowledge. It is not a substitute for a healthcare professional's medical identification, advice, or management for specific medical conditions. You should seek medical care and consult your doctor, OB-GYN, or pediatrician for any specific health or nutrition issues. Never disregard professional medical advice or delay seeking medical care because of something you have read on



  1. Providing Breast Milk for Premature and Ill Newborns
  2. Development of suck and swallow mechanisms in infants
  3. Feeding Difficulties
  4. Total parenteral nutrition - infants
  5. Boosting Your Breast Milk Supply With Galactagogues