Each individual mother and baby will begin to start breastfeeding at a different time. Many things can affect when a baby starts feeding such as the gestation and health of the baby, the baby’s energy levels, past illnesses and experiences, as well as the mother’s health and how often a mother can be in the NNU.
To be successful at suck feeding, a baby needs to have a stable heart rate and breathing pattern, they need to be able to coordinate their sucking and breathing with swallowing milk; they need to be awake and alert and show an interest in sucking – that is open their mouth, root, and suck rhythmically on a finger. They also need protective reflexes of gag and cough – your baby’s nurse can explain these more fully to you. These features tell us that baby has the capacity to suckle; to breastfeed, they also need to take the breast tissue into their mouth and hold it in place. A premature baby or one with a chronic condition, e.g. bronchopulmonary dysplasia, may be be able to feed for short periods of time before quickly going back to sleep. Be prepared for breast feeding to take a while to establish; the staff in the nursery will advise you on how well your baby is progressing and able to participate in what should be a positive and enjoyable experience for him and you.
Once you notice your baby showing some interest in the breast, perhaps during kangaroo care, you can help them enjoy a few licks or sucks from the breast. Finding the right position for your baby to feed can take a little time and practice. Take advice from the nursing staff and do not be afraid to try different ways of holding your baby during a feed. To begin with you have to be very patient as this stage of learning to feed can vary so much between babies. To be able to feed effectively and manage all their feeds from the breast may take your baby several weeks.
A typical pattern to how a premature baby manages suck feeding is as follows:
- At around 28-30 weeks gestation, babies already know the smell of your breast milk and now may lick drops of milk from your nipple; if they do take the breast tissue into their mouth, they might only manage a few weak sucks.
- Between 30 and 32 weeks, babies may begin to take stronger sucks and these might be in bursts of 3-4 sucks but with long pauses between each burst of sucking.
- After 32 weeks, and until about 36 weeks, babies may begin to root at the breast and generate stronger sucks with more sucks in a burst. However, at this stage they may still have long pauses between runs or bursts of sucking. As each stage progresses and babies mature, they are able to take more of their feed from the breast.
- Once a baby reaches 35 to 36 weeks corrected gestation, they should be able to manage more than one breastfeed a day without having top-up milk.
