Providing breast milk to preterm babies

Expression of milk

Breastfeeding can be challenging for parents of a preterm baby, because preterm babies may not be able to drink directly from the breast. Therefore, expression of milk is the best solution to offer mother’s milk to a baby until breastfeeding is achievable.

Frequent expression of breast milk shortly after delivery maximises milk supply and supports the development of colostrum to transitional milk and mature milk. Mothers of preterm babies should be made aware that they will not produce a lot of milk immediately. It takes time for the milk supply to build up.

Important is to continue stimulating the breast and to pumping milk regularly. Even though the quantity of milk produced seems low, at the beginning, every drop of milk is important for the baby and the quantity will increase over time.

Colostrum can be obtained directly after birth by massaging the breast or by using a breast pump. According to experts, milk should be expressed regularly every 2 to 3 hours and at least 15 minutes in the days and weeks following delivery to stimulate milk production.Practicing kangaroo care before or during milk expression can improve the amount of milk. If skin-to-skin contact is not possible also looking at the baby or even a picture might stimulate the milk production.

Methods of milk expression

There are different opportunities for mothers to express breast milk.

Hand expression
can be taught by a lactation specialist. Milk can be effectively expressed, collected in a clean container and stored afterwards. There is no need for a pump or electricity, so that mothers can express their milk any time and place (even though it takes some time).

Mother’s milk can also be expressed by manual or electrical milk pumps.

Manual milk pumps
can be used without electricity just by effort e.g. by pressing a lever. They are lightweight and portable. Nevertheless, it can be quite tiring, if a mother needs to express her milk on a daily basis. But they are a very good option for pumping milk when there is no access to electricity or an electric milk pump.

Electric milk pumps
can be used as single or double pump.

Research has shown that using a double pump is more effective for milk production and that milk expressed by double pumping provides a higher fat level comparing to milk expressed by a single pump. It is also less time consuming as both breasts can be expressed simultaneously.

Hygienic aspects should be considered for optimal storage and transport of expressed breast milk. Milk pumps should be used with sterile expressing sets and bottles which are provided by hospitals. Transferring of milk from one container to another increases the risk of contamination. Parents should ask health professionals or a lactation specialist for the latest guidelines on the storage of breast milk in refrigerators.

Cooling bags with cooling elements between the bottles are the best option for transporting expressed milk and for ensuring the continuous cold chain.

When feeding the milk to a baby, it should be as fresh as possible and must not be at room temperature for more than 4 hours. The milk must not be at room temperature for more than 4 hours. Also personal hygiene, such as washing hands before expressing the milk or taking a shower regularly is necessary for clean breast milk.

Health professionals or lactation specialists at the hospitals can help to discover the best solution for parents to provide milk for their baby.