BENGALURU: Preterm birth is when a baby is born before the 37th week of pregnancy, unlike the normal pregnancy cycle that lasts for 40 weeks. Reports say approximately 5 - 18 per cent of babies born across the world (in 184 countries) are premature. India has a significant number of preterm births every year. With preterm babies or preemies, there is a higher risk of health complications, serious disability, or even death as their organs are not fully developed.
Paediatric doctors worldwide have recommended breastfeeding as the optimal nutritional choice for all preterm babies. Not only does breast milk provide the best nutrition, but also contains digestive enzymes, immune protection, growth factors, and hormones to protect premature babies from many infections. Since preterm infants have less endurance as compared to matured babies, mother’s milk is the best nutrition for preterm babies. With breastmilk feeding, these babies will have a low chance of suffering from necrotising enterocolitis, diarrhoea, urinary tract infection, pneumonia, and late-onset sepsis. Also, the mortality rates for breastfed preterm babies are lower than for babies who are formula fed. Preterms who receive breast milk have significant advantages in mental development and visual acuity. However, feeding preterm babies comes with several challenges for the mother to overcome.
Challenges
Though medical sciences prove formula milk has poorer outcomes in terms of growth and development and infections in preterm babies, it still becomes a challenge to initiate and sustain breastfeeding in the mother of a preterm baby. Separation of the mother from her baby becomes a major stress factor if the baby is admitted to the NICU. Supporting her and providing her right education would have a significant role in her success in breastfeeding. While breastfeeding, the most important factor lies in the ability of the mothers to produce sufficient milk to meet the needs of the preemies. In this regard, kangaroo mother care (skin-to-skin contact) is an integral part of the care of a preterm baby.
With preemies, the mothers should practice both breastfeeding and breast milk expression. Initially, the babies may not be able to breastfeed due to weak suction pressure. If the baby is in the NICU or is not able to suck properly, the mother is advised to initiate lactation by expressing breastmilk quickly after the delivery (within six hours) and continue at least eight to 10 times a day. This goes on for some time until direct breastfeeding is well established. Both hand expression and mechanical breast pumps provided by the hospitals can be used to express breastmilk. It also helps reduce any maternal stress the mothers go through after childbirth.
Good maternal support from the family and the NICU is essential in this period that can boost the confidence of new mothers in expressing breastmilk in a relaxed and comfortable environment. The hospitals should assist in the correct method of expression and storage technique of the expressed breastmilk and breastfeeding in the neonatal intensive care unit (NICU). Not only does breastfeeding benefit nutritional and immunological growth in premature babies, it also helps enhance a better bonding of the mothers with their babies. Through extensive care and breastfeeding, these babies can grow and reduce any risk of illnesses that may occur due to early birth.
(The writer is consultant - lactation specialist, Manipal Hospital, Old Airport Road)