If you’ve given birth prematurely, your breast milk is ideal for your baby’s needs; it’s rich in antibodies and certain nutrients. But not all preemies can breastfeed successfully, and some need extra protein, iron, calcium, and vitamins A, D, and E to help them grow and gain weight.
Most preemies need about 120 calories a day for each 1,000 grams they weigh. To get that amount, they may need human milk fortifier added to their diet or a special preterm or transitional formula, depending on their health and gestational age, says James Lemons, M.D., director of neonatology at Indiana University School of Medicine.
At 32 weeks or younger, infants aren’t yet strong enough to breastfeed, so they’ll need to receive all their nutrition intravenously or through tube feeding. Moms should begin to pump and freeze their breast milk as soon as their baby’s born so their milk supply doesn’t dry up.
At 32 to 34 weeks, babies have a limited ability to suck and swallow. Almost all of their nutrition will still come from an IV or a preemie formula with a preemie-size nipple.
At 34 to 36 weeks, most infants can be weaned from the IV and should have a good handle on sucking, swallowing, and breathing. They can’t breastfeed exclusively yet but should nurse every four hours or so and be given fortified formula.
At 36 to 40 weeks, preemies usually have a good sucking rhythm and most likely will breastfeed every three to four hours. But they’ll still need additional formula.
At 40 weeks and up, babies should be able to breastfeed exclusively if they have no complications, such as breathing difficulties or heart irregularities. Your baby’s ready if he’s gaining three and a half to seven ounces a week, wants to nurse at least every three hours, and soils at least eight diapers a day.