Lactation Services for: the Preterm Baby, Babies Born at 35-38 Weeks Gestation and Preterm Multiple Babies

Alternative Prenatal Education in your Home Breastfeeding Consultations Preterm Multiples Testimonial from Parents of Triplets

Despite medical technology and compliant women, babies are still born before their 40th week gestation. These babies tend to fall through the cracks when it comes to their breastfeeding needs. Those born between 35-38 weeks gestation usually remain in the newborn nursery and are discharged from the hospital along with their mothers. This means a woman delivering her baby vaginally only has 1-2 days in the hospital to learn everything she needs to know to get breastfeeding off to a good start.

Prenatal Education In Your Home

My recommendation for those who are put on bedrest during their pregnancies is to call for a prenatal breastfeeding class in the comfort of your home. Many times the doctors will give you permission to attend an outside class, however, the breastfeeding classes offered at area hospitals focus on the healthy newborn's needs. They usually do not dwell on the needs of babies expected to deliver early. Thus you will not receive adequate information to prepare you for breastfeeding your preterm baby.

Scheduling a prenatal instruction with me in the comfort of your home will not only maintain you and your baby's health, but it will provide you with your individualized plan of care to optimize your breastfeeding challenges. Common topics I cover include:

• Choosing an appropriate breastpump and how to use it properly to initiate and maintain an adequate milk supply until your baby can go to the breast.
• Specific latching needs of preterm babies, including but not limited to the proper placement and size of a nipple shield.
• Effects of various conditions such as pre-eclampsia, diabetes, infertility, multiples, preterm labor, and high blood pressure with effective plans to increase your odds of producing breastmilk and getting your baby to take your breast.
• Criteria for assessing how much your baby is getting at the breast.
• Storage and collection of breastmilk.

Breastfeeding Consultations

Those of you who have already had your babies need to know it is never too late to contact me for breastfeeding consultation. Leaving the hospital without your baby or bringing a 35 week baby home with you can feel overwhelming! Breastfeeding can soon become very frustrating! Help is here! Call me to schedule a lactation consultation to assist with getting your baby to the breast.

Preterm Multiples

Another specialty of mine are the preterm babies which are multiples. I really enjoy working with twins and triplets! The first letter of acceptance for mommies is to let go of the principle that all's fair! Usually one baby will breastfeed more effectively than the other(s). Same as one baby will crawl before the other(s), or walk before the other(s). It's simply a fact of life. In fact, I think my success with the multiples is based on taking each baby one-at-a-time and working with him or her as a singleton – assisting with latching like it's one baby, and then the next, and the next……

Positioning of twins or triplets at the breast is often done one at a time initially as you learn to latch your babies. During these initial few weeks, most moms find regular bed pillows to be most useful. Once you've gained the skill level to nurse one baby at a time, and your babies have learned the skill of latching, you may want to invest in an E-Z 2 Nurse Feeding Pillow which is nice and roomy for the babies. This may take a few weeks, and often moms have me help them with this transition as well.

Other key points to keep in mind…..

• Colostrum fed to preterm babies is the first medicine that coats their intestinal tracts and eliminates many gastrointestinal problems.
• Medela Symphony breastpumps are recommended for those babies born early or preterm and for multiples. It is also required by women who become pre-eclamptic and experience a delay in lactogenesis. (These fancy words mean that a stressor such as pre-eclampsia can cause the body to have a delay in making an adequate amount of breastmilk. Only droplets are seen in the flanges initially. Don't give up! If you pump 8 times in 24 hours ASAP after birth, you will most likely begin to see your milk increase in amount.)
• When nurses and doctors are spending a lot of time with your baby and you are separated from your baby by hospitalization, only you can provide the breastmilk. You have a very special part in your baby's life.
• Working with me to fine tune your pumping efforts can help you to increase your milk supply. I can guide you to when and how to take medicine (galactogogues) such as Reglan, or herbs such as More Milk Plus (fenugreek/ blessed thistle/nettles), and when or how to stop taking the galactogogues.
• There is no such thing as it being too late to get a baby to take the breast. It just takes the right tools, the right expertise, and time. The 3 Ps: Patience, Practice, and Persistence.
• Doing the same thing over and over doesn't cause the event to change. Trying to latch your baby and struggling over and over again doesn't often gain breastfeeding for you and your baby. Calling for assistance will!
• It is absolutely a possibility to measure exactly how much your baby is getting from your breast. Using the BabyWeigh Scale to weigh your baby pre/post feedings will tell us whether he/she is taking 2 cc's, 20 cc's, or 2 oz.
• Not all lactation consultants have the same work experiences. My work as a RN started by working in the Neonatal Intensive Care Units (NICUs) of places like Northwestern Memorial Hospital, University of Illinois Hospital, Rush University Medical Center, and Lutheran General Hospital.
• My graduate research project in the late 1980's was testing the reliability and validity of an Olympic Smart Scale (precursor to the BabyWeigh Scale) to measure volume of intake at the breast.
• Scheduling consultations with me can often prevent the need to take your baby to the doctor's office for frequent weight checks. Part of my consultation is to get weights and send a medical report to your baby's doctor.

I look forward to talking with you about my services and availability. Fulfilling my passion of providing accurate breastfeeding information is done with support for your choices and decisions regarding feedings for your baby. Informed decision-making is the key! And remember, any amount of breastmilk for any length of time is healthy and good for your baby. - Carol Chamblin, RN, MS, IBCLC

Read Testimonial from Parents of Triplets

Read Increased Lactation Risk for Late Preterm Infants and Mothers: Evidence and Mnagement Strategies to Protect Breastfeeding by Paula P. Meier, Rn, DNSc, Lydia M. Furman, MC and Marguerite Degenhardt, NNP, RNC, DNP