Breastfeeding Your Late Preterm or Low Birth Weight Baby

Breastfeeding Your Late Preterm or Low Birth Weight Baby

 

What “late preterm” or “low birth weight” means

A late preterm baby, also called a near term baby, is born early between 34 and 36 full weeks of pregnancy. Babies born a little early are often smaller than babies born at 40 weeks. Even if your baby looks like a full term baby, they do not feed the same way.  

Babies weighing less than 5 pounds, 8 ounces are called low birth weight babies. These babies can also have problems with feeding, even if they are born full term (37 to 42 weeks). 

Special feeding needs  

Late preterm babies and low birth weight babies have special needs for feeding for the first few weeks after birth. They usually feed slower and need to be fed at least every 3 hours, even at night. You may need to wake your baby to feed him or her.

Common things that affect their feeding include: 

  • Face muscles are not strong to get enough milk out of the breast.
  • Get tired more easily while breastfeeding than a full term baby.

How your baby is feeding needs to be watched carefully in the hospital and at home, including:

  • How well they are breastfeeding
  • Their blood sugar levels (blood glucose)
  • The number of wet and dirty diapers they have each day

Your health care team will teach you about how to do this before you go home. 

Breastfeeding 

Breast milk is the perfect food for your baby, helping to prevent allergies and infections. It is also easy for your baby to digest and has everything your baby needs to grow. 

Preterm babies often need several weeks to get to the point of breastfeeding without the help of supplemental feeds. Meanwhile, any breastfeeding you do with your baby is a success!

Every baby is also different and your baby may have specific feeding needs. Talk with your baby’s doctor, bedside nurse, or lactation consultant about a feeding plan. Your lactation consultant or bedside nurse can also help assess how your baby is latching on. This is a great way to make sure that your baby is latched deeply and getting your breastmilk.  

Getting started:

  • Offer the breast when your baby shows signs of hunger, called hunger cues. This might only happen 2 to 3 times each day during the first few weeks. 
  • Hunger cues include:
    • Clenched fists
    • Putting hands to mouth
    • Licking lips
    • Moving arms and legs
    • Sucking sounds
    • Crying
    • Turning head toward your body
  • If your baby is not showing signs of being ready to feed after trying for 5 to 10 minutes, pump and supplement with one of these options: 
    • Expressed breastmilk
    • Donor human milk
    • Similac Neosure
    • Regular formula

How much to supplement:

Using the chart below, go to the column for the number of hours since your baby was born. 

Amount to supplement at each feeding*
Hours of life since birth:If breastfeeding add:If formula feeding or not breastfeeding well, add:
0 to 24 hoursabout 5 ml supplementabout 10 ml
24 to 48 hoursabout 10 ml supplementabout 15 ml
48 to 72 hoursabout 15 ml supplement15 to 30 ml
72 to 96 hoursabout 20 ml supplement30 to 60 ml

* It is recommended that babies born at 35 weeks begin supplementing soon after delivery to provide them with nutrition and energy. 

Pumping

Mothers’ milk supplies vary greatly. To help your late preterm or low birth weight baby eat enough, try to hand express or pump your breasts along with breastfeeding your baby. This also helps keep your milk supply high. It is best to pump after every breastfeeding session or in place of breastfeeding. Using a hospital-grade double electric pump can save you time and effort.

If you need support for breastfeeding after leaving the hospital, you can call the Ohio State Breastfeeding Helpline at 614-293-8910.

© 2021 - February 18, 2021, The Ohio State University Wexner Medical Center.

This handout is for informational purposes only. Talk with your doctor or healthcare team if you have any questions about your care. For more health information, call the Library for Health Information at 614-293-3707 or email: health-info@osu.edu.