Breastfeeding is often described as one of the most natural acts for a mother and her baby. 

However, for many new mothers, particularly those with premature babies, the experience can be anything but straightforward. Premature babies, born before 37 weeks of gestation, often face unique challenges when it comes to breastfeeding. 

These challenges can stem from their developmental immaturity, health complications, or other factors, such as tongue-tie. 

In this blog post, we’ll explore the difficulties premature babies may encounter with breastfeeding, the role of conditions like tongue-tie in these challenges, and how parents and healthcare providers can support successful breastfeeding for preterm infants.

The Challenges of Breastfeeding for Premature Babies

Breastfeeding a premature baby can be significantly more challenging than breastfeeding a full-term infant. The difficulties arise due to several factors related to the baby’s early birth and developmental stage:

Developmental Immaturity

Premature babies are born before their bodies and organs have fully matured. This immaturity can affect their ability to coordinate sucking, swallowing, and breathing, which are crucial for successful breastfeeding. Their muscles, including those involved in sucking and swallowing, may be weaker, making it harder for them to latch onto the breast and maintain a strong suck.

Health Complications

Premature babies often require medical interventions, such as feeding tubes, oxygen support, or time in a neonatal intensive care unit (NICU). These interventions, while necessary, can disrupt the initial attempts at breastfeeding and delay the establishment of a breastfeeding routine.

Conditions such as jaundice, respiratory distress, or neurological impairments can further complicate breastfeeding efforts.

Tongue-Tie and Oral Restrictions

Tongue-tie (ankyloglossia) is a condition where the lingual frenulum, the tissue connecting the underside of the tongue to the floor of the mouth, is too short, tight, or thick. This restriction can significantly impact a baby’s ability to latch onto the breast, leading to difficulties in feeding.

Premature babies are more likely to have oral restrictions like tongue-tie, which can exacerbate the challenges of breastfeeding.

Energy Levels and Endurance

Premature babies may tire more easily during feeding. Breastfeeding requires endurance, and preterm infants may not have the stamina to feed for extended periods. This can lead to shorter, less effective feedings, which in turn can affect their ability to gain weight and thrive.

Lack of Early Skin-to-Skin Contact

Skin-to-skin contact (also known as kangaroo care) immediately after birth is beneficial for both mother and baby, promoting bonding and initiating breastfeeding. However, premature babies may need to be placed in an incubator or receive other medical care immediately after birth, delaying or limiting this crucial contact.

The Role of Tongue-Tie in Breastfeeding Difficulties

Tongue-tie is a common but often overlooked condition that can have a significant impact on breastfeeding, especially for premature babies. When a baby has a tongue-tie, the movement of the tongue is restricted, which can make it difficult to latch onto the breast effectively. This can lead to:

• Poor Latch: A baby with tongue-tie may struggle to latch onto the breast properly, leading to insufficient milk intake and frustration for both the baby and the mother.
• Nipple Pain: The improper latch caused by tongue-tie can result in sore or cracked nipples, making breastfeeding painful for the mother and discouraging continued breastfeeding.
• Inadequate Milk Transfer: Even when a latch is achieved, a restricted tongue may not be able to move effectively to extract milk from the breast. This can lead to poor milk transfer, insufficient milk intake, and slow weight gain in the baby.
• Feeding Fatigue: The effort required to feed with a tongue-tie can tire out a baby quickly, leading to shorter feeding sessions and less overall milk consumption.

For premature babies, who may already face challenges due to their developmental immaturity, the presence of a tongue-tie can further complicate breastfeeding. It is crucial to diagnose and address tongue-tie early to prevent additional feeding difficulties and support successful breastfeeding.

Supporting Successful Breastfeeding for Premature Babies

Despite the challenges, many premature babies can successfully breastfeed with the right support and interventions. Here are some strategies that can help:

Early Assessment and Intervention

Early assessment for tongue-tie and other oral restrictions is essential. If tongue-tie is identified, a simple procedure called a frenectomy can be performed to release the restricted frenulum and improve the baby’s ability to breastfeed.

Lactation consultants and pediatric dentists specializing in tongue-tie can provide valuable support and guidance to ensure the best outcomes for breastfeeding.

Skin-to-Skin Contact

As soon as it is medically safe, practice skin-to-skin contact with your baby. This not only promotes bonding but also helps stimulate your baby’s natural feeding instincts and can improve breastfeeding success.

Even if your baby is in the NICU, many facilities encourage kangaroo care, where you can hold your baby skin-to-skin to help them feel secure and supported.

Paced Bottle Feeding

If breastfeeding is not immediately possible, paced bottle feeding with expressed breast milk can help mimic the natural feeding process and ensure your baby is receiving adequate nutrition.

Work with your healthcare provider to establish a feeding plan that supports both your baby’s nutritional needs and your breastfeeding goals.

Use of Breast Pumps

For mothers of premature babies, using a breast pump can help maintain milk supply until the baby is ready to breastfeed. Regular pumping can also ensure that your baby receives the benefits of breast milk, even if direct breastfeeding is not yet possible.

Ongoing Lactation Support

Work with a lactation consultant who has experience with premature babies. They can provide personalized advice, help troubleshoot feeding issues, and offer emotional support as you navigate the challenges of breastfeeding a premature infant.

Patience and Persistence

Breastfeeding a premature baby may require more time and effort, but with patience and persistence, many mothers find that their baby eventually learns to breastfeed effectively.

Celebrate small victories along the way, and remember that every feeding experience is a step toward building a strong breastfeeding relationship.

Seeking Help

Breastfeeding a premature baby comes with unique challenges, but it is possible with the right support, interventions, and resources. Conditions like tongue-tie can complicate breastfeeding, making early assessment and treatment crucial for success. 

By working closely with healthcare providers, lactation consultants, and specialists in oral restrictions, parents can help their premature babies overcome these challenges and establish a successful breastfeeding routine. 

At the Tongue Tie Institute, we are committed to supporting families through every step of this journey, ensuring that both mothers and babies can experience the benefits of breastfeeding.

If you have concerns about your baby’s ability to breastfeed, especially if they were born prematurely or you suspect a tongue-tie, don’t hesitate to reach out to us for a consultation. Together, we can help your baby thrive.