Late Preterm Infants-how do you handle breastfeeding?

[GenevaLC]

We have all seen a huge increase in late preterm births, or "near term" as they used to be called, with babies coming to Well-Baby Nursery from 34 weeks to 36 6/7 weeks. As a lactation consultant we are struggling, but making headway, in getting the staff on board to address the specific problems with breastfeeding-poor sucking, sleepy, lethargic. We have a plan of action in place to assist these moms. What does your facility do to address the issue of the late preterm in regards to BREASTFEEDING/Feeding Plan?

[klone, MSN, RN]

All late preterm infants are supplemented, either with their mother's own milk, donor breastmilk, or formula. Generally, feed q3h (if infant won't latch, don't spend more than 10 minutes trying to get baby to latch), supplement with 10-15 ml, and pump after every feeding.

I had a late preterm infant and unfortunately, there was not all the research about its effects on breastfeeding that there is now. If I had known then what I know now, it's possible that I wouldn't have had supply issues.

Research has found that a late-preterm infant doesn't develop full suck strength until term, and even if the infant appears to be nursing well, s/he doesn't have the full ability to drain the breasts. If the mother isn't also pumping after feedings, she runs the risk of not developing a full milk supply. So I really stress to moms of late preterm infants that even if they appear to nurse well, she really needs to continue to pump after feedings for at least a few weeks.