By Tracy Gaudlip, IBCLC, Lic.LC
Congratulations on the birth of your baby! Adding a new member to your family is an exciting event that almost always brings with it new challenges, and more so if your baby arrives earlier than expected. Babies who arrive after 34 weeks, but before 38 weeks gestation are referred to as “late preterm” or “near-term.”
Late preterm babies might look like healthy full-term babies, but they do not share the same feeding behaviors. Instead of showing predictable hunger cues followed by robust feedings at the breast, late preterm babies tire easily at the breast before completing a full feeding or are difficult to wake to feed. Sometimes they can appear to have a good latch, and you can see they are sucking and swallowing, but often they are not able to obtain enough milk at the breast. Because of this, these babies are at a higher risk of excessive weight loss, dehydration and jaundice.
If you desire to breastfeed your late preterm baby, simply arming yourself with the appropriate expectations can make this time less overwhelming, especially as you transition from your stay in the hospital to your home.
To ensure your baby eats enough and you establish a full milk supply, begin using a double electric breast pump as soon as you can after delivery. Pump often -- 6-8 times every day -- for about 15 minutes. Milk supply can vary from woman to woman, but after one week postpartum, you should be making at least 16 ounces in 24 hours.
Offer your breasts to your baby every 2-3 hours, waking her if necessary. Since she tires easily at the breast, it’s best to limit breastfeeding sessions in the early days to 10-15 minutes and consider it “breast practice.” Late preterm babies need supplemental feedings in addition to any milk they receive at the breast. Your pumped milk is the first choice; however, if you cannot obtain enough at first with the breast pump, infant formula is the acceptable alternative.
It’s important that your baby sees his pediatrician as soon as possible after discharge from the hospital for follow-up and a weight check. Some weight loss after birth is normal, but if your late preterm baby’s weight loss is greater than 7% after his third day, this indicates a need to closely monitor his weight and diaper output. Your baby should be gaining 20-30 grams each day, and by day four, should have six or more wet diapers and four or more dirty diapers.
At Breastfeed Atlanta, we have several state licensed IBCLC lactation consultants as well as lactation counselors on staff who will be glad to sit down with you at a private consultation, either in our office or in your home, to discuss your breastfeeding challenges, monitor your baby’s weight, and come up with a personalized feeding and supplementing plan so you can reach your breastfeeding goals.