Feeding your early term (37-38 week gestational age) or late preterm (35-36 week) babe is no walk in the park.
Early term and late preterm babies can be some of the most challenging newborns to feed (breast or bottle). And it seems like no one really warns ya about that or normalizes that for new moms. So we're going to go ahead and do that:
It's very normal to struggle with feeding your 34-38 weeker more than you'd expect.
1. They are really hard to feed!
You might feel exhausted by it all (tracking feeds, pumping, waking baby, positioning, trying to latch, finding your nipple shield, using a supplemental nursing system, caring for your bloody nipples and your healing body...) and you might feel like a failure (or liked you failed). We want to offer you a hug and the assurance that you are NOT failing. You and baby are learning and it's common to have a sharper learning curve compared to 39-40 week term babies.
2. Using formula doesn’t mean you failed
If you use formula and abandon breastfeeding because your mental health is important and bottle feeding formula works- remember, it is just another form of success towards the goal of a thriving baby. For anyone who needs to hear this: You're doing great. You'll get through this. Your baby is perfect and he/she will be exactly right. ♥️
So why are 36 weekers so hard to feed?
Even though they are only a few weeks early, often they are sleepy and disorganized because their nervous system is still maturing. This causes them to do several things which can make feeding especially hard (especially for a first time parent)!
3. They go from zero to 60 screaming which makes it hard to latch
They go from asleep to screaming in like 1 second flat, making it near impossible to get them latched, even when your nipple is right there is their mouth.
4. They may fall asleep the minute they get on the breast
They tire out easily, falling asleep mere moments after they started feeding.
5. They are super hard to wake up
They can be really hard to wake up because they are disorganized and they aren’t eating well so they don’t have a lot of energy to spare!
6. Their feeding cues are often chaotic
They don’t give clear feeding cues which makes it easy for an exhausted new parent to miss that the baby needs to eat or to notice that they baby hasn’t eaten enough.
Obviously babies born even more prematurely will usually have more feeding challenges but frequently those babies go to the NICU and are working with both lactation consultants and OTs or SLPs trained in feeding. Everyone expects a baby born at 22-33 weeks to need some help. It's just that 35-38 weekers are generally healthy and doing well so mom and baby may not get as much support which can lead to bigger issues (like jaundice and poor weight gain, low milk supply, mastitis, feeling highly anxious or like you're failing as a new mom...)
📝 note to insurance carriers and hospital policy makers: Feeding support is just as essential for mommas of early term and late preterm babies and should be available for ALL moms, not just those who can afford it.
7. Skin-to-skin holding in the first few weeks can really help
There are things you can do to help and it will get better! One of the most important things you can do is help your baby get calm, organized, and excellent sleep. The very best way to do this is by holding baby nearly constantly in skin-to-skin position (mom and partner can take turns).
"Around 4am on night 2 [with bloody nipples, lactation support, and incredible determination] she latched perfectly for the first time." - Kim (a ne w mama of a 36 weeker and a feeding specialist & lactation consultant herself)
Often parents do skin-to-skin the first day then stop but your baby may need to be held in this position every day for a few weeks! This allows you to help your baby wake up and have quick, easy access to your breast.
8. Tools can help
You might need some extra tools to help your baby breastfeed successfully. Common ones include:
a nipple shield
a supplemental nursing system (SNS)
formula or pumped or donated breast milk
a breast pump
Using these tools can actually increase your success with breastfeeding (yup, even the formula!) and can help you avoid low supply (or the opposite problem-engorgement), bloody nipples, a super sleepy baby, and a baby who only wants a bottle.
Now your best bet is to use these tools with the help of a lactation consultant but keep in mind you may need to order yourself the tools ahead of time and the consultant can show you how to successfully use them and when to stop using them.
We’re going to get into the topics of skin-to-skin care, supplemental nursing systems, nipple shields, & breast pumps in our next post so stay tuned!