- Updated on Jul 25, 2024
Article written by Mylena, pediatric nurse.
@you_and_milk
Transitioning from the aquatic environment to the aerial environment is a challenge for the newborn, especially when they are born prematurely. Indeed, a premature birth inevitably means hospitalization in various neonatology departments (resuscitation-intensive care/neonatology/kangaroo unit) for a more or less long period depending on the degree of prematurity. It is important that the mother can HAVE (yes, SEE her child at birth) contact with her baby as early as possible, from the delivery room, regardless of the care her child receives. The same applies to the father: promote the parent/baby bond alongside the birth, which is not always idealized.
The goal is to not separate the parents from their baby from the delivery room to the neonatology ward and throughout the hospitalization. We do not know it yet, but these points will be factors of success for the initiation of milk production.
Yes, because added to this is the question of breastfeeding. Breastfeeding is a choice of the heart, and sometimes even when it was not the initial choice, the question almost no longer arises in the case of a premature birth. Breast milk, called white gold, is an important source of antibodies rich in proteins, carbohydrates, lipids, and immunoglobulins. All these components prevent a feared pathology in premature infants: enterocolitis, which is a lesion of the internal surface of the intestine that can lead to necrosis.
Practically, how to establish breastfeeding in the context of a premature birth? How to stimulate lactation?
What we know: a premature baby is capable of sucking, swallowing, and breathing simultaneously from 34 weeks gestational age, but what we especially know is that we must adapt to the child because each child is different!
In this circumstance, childbirth has been exhausting for the mother, and when she decides to initiate breastfeeding, the first breastfeeding sessions after birth are not always possible, and the mother is inevitably exhausted both mentally and physically. Pediatric nurses must be unwavering support and accompany the mother as soon as possible to promote breastfeeding. Just as the personal entourage whom the pediatric nurse will also support.
Mothers have not necessarily been able to share the famous welcome feeding with their babies: it will just be postponed!
The recipe for successful breastfeeding, neonatology pediatric nurses will support the mother in:
-SKIN TO SKIN (a lot ^^): promotes lactation and the hormones responsible for milk production (prolactin) and milk ejection (oxytocin), contact feedings, nutritive feedings depending on the newborn, basically baby close to the breast!
Speaking of oxytocin: it plays an important role in milk production because it is the hormone of love and attachment. In neonatology, skin-to-skin and mother/father/child contact are encouraged to produce this hormone in large amounts by creating a relaxed atmosphere and continuous support. In other words, the more soothing the environment, the more oxytocin will be secreted in the mother's body and the easier milk production will be!
-Setting up milk expression sessions while waiting to achieve full breastfeeding (some mothers will choose exclusive pumping = pumping is breastfeeding): explain to the mother the importance of the frequency of pumping (if possible 8 times per 24 hours at the start) and carefully measure nipple size to encourage good drainage. Pumping should not hurt; explain the pump's operation and especially adjust the pump just below the pain threshold.
-Expressing milk near the baby even if the baby sleeps in the incubator helps produce more milk because the mother looks at her baby.
-Encouraging the presence of the parents is important, comfortably positioning the child on the parents, promoting the mother's rest during these cozy moments.
-Offering galactagogues (breastfeeding teas, almonds, etc.): be careful, too many galactagogues kill the galactagogues, and these are taken in 3-week courses with 3-week breaks.
-You understand: it is love and the presence of the parents that will be the main drivers of breastfeeding.
From the moment lactation is established: the mother has the cards in hand to carry out her breastfeeding as she wishes with her baby!
And who am I?
I am Mylena, a PASSIONATE pediatric nurse for over 10 years
I am an instructor in baby massage, specialized in breastfeeding, swaddled bathing, babywearing, and soon a consultant in child pain (DIU in progress)
At the heart of my intensive neonatology unit, I support and care for the newborn and therefore also care for their parents: over time, we form a triad of trust. Neonatology is a challenging service due to its very technical environment, and my role is to make this environment warm by keeping the newborn and their parents in a cocoon of peace.
I also support many mothers on my social network Instagram: @mymy_babynurse: I discuss many rich and varied topics around the psychomotor and emotional development of the newborn and child.
