Premature Baby Needs Care and Lactation Support

According to WHO, every year about 15 million babies around the world are born prematurely (before 37 weeks of pregnancy). Mother’s milk is the only source that can provide optimal nutrition for the baby, especially at this stage. In cases of mother-infant separation such as in the neonatal intensive care units (NICU), breastfeeding may become a challenge.

Therefore, at this stage it is important for the mothers to follow a routine and keep certain things in mind while taking care of their preemie along with good support system to help them in their journey.

Available Lactational Support for Mothers & Key Criteria

Here are the list of available lactation support for mothers and some of the key criteria.

Antenatal Education

All expectant mothers/couples should be educated about breastfeeding during pregnancy. Research has shown that 2nd trimester is the best time for antenatal education as the mother is receptive to information. In case, there is impeding premature labour/birth, breastfeeding should be an important aspect of counseling.

Informed Decision

Standardised information for NICU mothers must be provided by the support team (doctors and nurses at the NICU) about the value of mother's milk specifying techniques to build an adequate milk supply. Providing consistent and timely information to NICU families not only helps them feel included in their baby's care but also enables them to make an informed decision and understand options available.

First Expression of Milk Post Delivery

Hospital protocols should outline expression within 1 hour of birth; regular trainings of the NICU staff and audits of performance must be carried out. Stimulating the breasts in the first hours via expression is important. This supports timely initiation and long-term milk production.

Frequent Expression of Milk

Hospital protocols must also outline expressing 8 or more times per 24 hours, including in the night; regular monitoring must still be performed. Frequent expression is critical to achieving adequate volumes. Double pumping every two to three hours is beneficial for this. Mothers should be taught and made to practice both manual and pump expression.

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Sugars in breast milk can keep bacteria at bay

Mother’s milk, which consists of a complex and continually changing blend of proteins, fats and sugars, helps protect babies against bacterial infections. In the past, scientists have concentrated their search for the source of its antibacterial properties on the proteins it contains. However, an interdisciplinary team of chemists and doctors discovered that some of the carbohydrates in human milk not only possess antibacterial properties of their own but also enhance the effectiveness of the antibacterial proteins also present. “This is the first example of generalized, antimicrobial activity on the part of the carbohydrates in human milk,” said study director. “One of the remarkable properties of these compounds is that they are clearly non-toxic, unlike most antibiotics.”

The basic motivation for the research was the growing problem of bacterial resistance to antibiotics, which according to estimates causes 23,000 deaths annually. “We started to look for different methods to defeat infectious bacteria. For inspiration, we turned to one particular bacteria, Group B Strep. We wondered whether its common host, pregnant women, produces compounds that can either weaken or kill strep, which is a leading cause of infections in newborns worldwide,” researcher said. Instead of searching for proteins in human milk with antimicrobial properties, researchers turned their attention to the sugars, which are considerably more difficult to study.

“For most of the last century, biochemists have argued that proteins are most important and sugars are an afterthought. Most people have bought into that argument, even though there’s no data to support it,” a researcher said. “Far less is known about the function of sugars and, as a trained glycoprotein chemist, I wanted to explore their role.” To do so, the researchers collected human milk carbohydrates, also called oligosaccharides, from a number of different donor samples and profiled them with a mass spectrometry technique that can identify thousands of large biomolecules simultaneously. Then they added the compounds to strep cultures and observed the result under the microscope. This showed that not only do some of these oligosaccharides kill the bacteria directly but some also physically break down the biofilms that the bacteria form to protect themselves. 

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