OneOp asked Rose Marie Straeter, MA, RLC, IBCLC a few questions about breastfeeding the premature infant or one born with a disability. Here’s what she had to say:
Why is it important to breastfeed infants with disabilities? Is there research which supports better outcomes for children with disabilities who receive breastmilk and/or are breastfed than those who do not?
There are numerous research articles describing the health benefits of breastfeeding for infants’. These include a reduction in diarrhea, enhancement of the response to vaccines, fewer ear infections, less respiratory infections, fewer allergies, reduction of diabetes and childhood cancers, and a decreased chance of obesity later in life. Breastfed infants can digest breastmilk easier with less constipation. Breastfeeding improves infants’ jaw, teeth, and speech development and increases brain growth resulting in higher IQs. These benefits are important for all babies, including infants born with disabilities. Breastmilk provides the best nutrition possible.
How can professionals help a mother understand the importance of pumping when she might not even be able to touch her baby for days? Also, what are some strategies for pumping while a baby is in the NICU?
The best strategy is empowering the mother to make an educated decision about the nutrition her infant will receive both while he/she is in the hospital and after the baby’s discharge. The mother may not be able to hold her baby but she can give the infant a special gift of breastmilk that will provide numerous health benefits. Research shows breastmilk shortens the hospital stay for babies in the NICU. They are less likely to have NEC (Necrotizing enterocolitis), a gastrointestinal emergency that occurs when the bowel undergoes necrosis (tissue death). NEC is the second most common cause of morbidity in premature infants. Infants who are breastfed are three times more likely to avoid NEC.
Pumping should begin within the first hour after birth with a hospital grade pump. Most mothers find double pumping not only saves times but increases their milk supply. There are numerous techniques to improve the amount of breastmilk obtained via a breast pump.
It should be noted that this is an emotional time for families and professionals should respect that. Consider seeking additional help from the social worker or other professionals within the hospital.
What are some common breastfeeding issues for babies born with health, physical, sensory and other types of impairments and/or disabilities? What are some possible solutions to address these issues?
Tongue-tie can impact breastfeeding but is easily remedied by having the frenulum clipped as soon as possible after birth. Some of the most common problems related to breastfeeding have to do with low muscle tone. Prematurity and medications given during labor might result in problems with sucking. Consulting with an IBCLC (International Board Certified Lactation Consultant) can help to manage these issues. Other conditions such as tongue protrusion (common with children with Down syndrome), cleft palate/lip, low muscle tone or oral motor control (common with CP), irritability (common with FAS or children born with addiction) can also be addressed through consultation with an IBCLC. Each infant and each breastfeeding situation is unique and should be handled on an individual basis.
Is there a specific length of time that it typically takes for a premature baby (or a baby with a disability) to successfully breastfeed?
The general rule of thumb is that breastfeeding reaches a successful state around the time of full gestation. In other words, most premature infants can breastfeed successfully around the time of their gestational due date. This should not be misunderstood to mean that a newborn cannot breastfeed if he/she is born prematurely or is a late pre-term infant. Often babies born prematurely or infants with disabilities will need some assistance to ensure they are able to obtain sufficient breastmilk, as they are typically sleepy and have underdeveloped muscle tone. With proper breastfeeding management these babies succeed and thrive.
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