Barbara Henle is an assistant nurse manager in the NICU at The University of Vermont Children’s Hospital at the UVM Medical Center.

The best food an infant can receive after birth is breast milk. This is especially true with a premature or sick infant, who has the added challenge of needing the best nutrition so that they can grow, as well as fight infection. We do all we can at the Neonatal Intensive Care Unit (NICU) at The University of Vermont Children’s Hospital to encourage and support a mother’s decision to breast feed her baby, for a variety of reasons.

What makes breast milk so healthy?

Colostrum, the first milk a breast feeding mom produces, is full of antibodies that may confer immunity to the infant as well as target micro-organisms in the baby’s intestines which, in premature infants, increase the risk of developing an acute inflammatory disease of the intestines called Necrotizing Enterocolitis (NEC).  Infants receiving only human breast milk are at a significantly reduced risk of developing NEC.  Breast milk produced after colostrum also confers immunity, and studies show that breast fed infants have a lower incidence of infections as well as improved brain growth, all very important factors to consider with a premature infant.

The benefits of breast milk also extend to the long term. Breastfed infants have a significantly reduced risk of Sudden Infant Death Syndrome (SIDS) during the first year of life. They also are at less risk of developing diabetes, childhood obesity, or allergic diseases such as asthma. Further, a healthier baby that is able to avoid some of the complications of prematurity will have a shorter hospital stay, will save health care dollars and will be home sooner with his or her family.

What if my premature baby is too sick to breast feed?

Depending on the gestational age of an infant at birth, he or she may require respiratory support and assistance that prevents him or her from initially breast feeding.  In this case we provide breast pumping information and equipment, special breast feeding rooms, instruction and encouragement by trained lactation consultants and nursing staff.

We can store this milk in special freezers and refrigerators meant only for storage of breast milk.  When the baby is deemed medically stable enough to receive feedings, we will give the colostrum first to ensure he or she receives this important immunity-containing milk.

Some very premature infants lack the suck/ swallow coordination of a full-term infant, and may need time to grow before they are able to nurse from mom.  In these cases we may insert a gavage tube (a tube inserted through the nose and into the baby’s stomach) which allows the baby to receive breast milk that has been warmed to body temperature in a special warmer, which slowly drips into the baby’s stomach just as it would were the baby able to nurse.  We usually encourage this feeding time as a special time for mom (and dad) to relax in a recliner and snuggle their baby skin-to-skin on their chest.  This provides very important bonding time as well, as skin-to-skin contact helps increase mom’s breast milk production. The goal is for baby to eventually begin nuzzling at the breast, learn latching and sucking, and be able to take all their feeds through the natural process of nursing.  The journey to full breast feeding is one that we support each step of the way.

What about donor breast milk?

We also keep a supply of human donor breast milk.  This is carefully screened and safe breast milk that we offer to infants that meet certain criteria (such as extremely low birth weight) or for reasons such as mom being ill or not having a sufficient supply of her own breast milk.  We weigh all these circumstances carefully and if a joint decision is made with the family to proceed, we offer donor breast milk at no charge. This enables us to offer breast milk from the very start, even when mom’s own milk might not be readily available.

Our NICU is committed to offering breast milk and fully recognize all the health benefits of feeding our babies exclusively with breast milk. We will always choose breast milk as the first and best option for feeding our very special patients.

Barbara Henle is an assistant nurse manager in the NICU at The University of Vermont Children’s Hospital at the UVM Medical Center.

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