CHENNAI: Padmaja Rajagopal went into labour in her 29th week of pregnancy. She was kept under observation for three days, after which she had to go through an emergency cesarean. “I did not see my newborn for four days, as he was admitted to NICU and I was in an ICU,” says Padmaja. For those four days, the newborn was fed milk from a milk bank, after which Padmaja started pumping milk to feed him. This went on for 35 days, till the baby was out of the NICU.
Similarly, Varsha Vinoth gave birth to her twins at week 32. They were fed formula milk, specially made for preterm babies. The difficulty and challenges doubled as she had to feed both her children. She used to pump milk from both her breasts at the same time to feed them.
A baby born before week 36 is called a premature baby. Breastfeeding a preterm baby is a different process as the mothers are required to constantly pump out the milk. “Mothers are encouraged to pump milk because it is made by a human to another human and no other form could ever match this,” says Kumutha Chandrika K, a lactation counselor. Initially, the mother may not know how much milk is enough milk, so the pumped milk is stored in a freezer or when it is in excess, donated to a milk bank.
Not an easy way out
“Unless and until you keep removing milk from your body, it will not make milk,” says Kumutha, adding that one learns to maintain their milk supply. Discipline is paramount at this point as the baby needs 15-20 ml of milk for each feed.
The operation makes it hard on the mothers, too. “It was a tiring and exhausting process as you need to pump the milk and then feed and again get ready to pump the milk for the next feeding. There was no time to rest or even think about something. Some days I used to lose hope,” says Manisha who also had a premature delivery. Varsha adds, “Sometimes it would be difficult to pump as it causes pain in the nipples and I have wounded my nipples while pumping.” Padmaja went through severe backaches during the process.
The new mothers are put on a schedule. “It is advised that the mother pumps at least 8-12 times a day, which is once in every two-three hours,” adds Kumutha.
Success transition
Preterm babies are fed through a feeding bowl usually. This happens until the baby develops suck reflexes. During the transition period, they are breastfed as well as given pumped milk. “You cannot let the baby suckle. They will not be effective initially, and they will not take in as much as they should. Once the baby figures out how to drink well, the mother can feel it. The breast will be very heavy before feeding and after feeding if the breast feels lighter, you’ll know that the baby has significantly emptied your breast,” adds Kumutha.
Sometimes the baby might have difficulties in taking the milk. Then an examination of the baby’s mouth, and body is done to see if it is having any tightness in their body or if they have any oral restrictions like if they have any lip tightness that is preventing them from drinking effectively from the breast. Such examinations will be done and can be corrected by consulting professionals.
While the mother goes through the daunting task, Kumutha notes that having a support system lowers the difficulty level. She suggests all family members have skin-to-skin contact with the baby. It helps the baby to gain weight and have an emotional connection with everyone.