Giving birth to a premature or other high-risk baby (or babies) does not mean you cannot breastfeed. Actually, the opposite may be the case. There is even more reason to provide your own milk for, and eventually breastfeed, a premature or a sick newborn. Providing your milk for your baby lets you participate in your baby's healthcare in a very crucial way. Because the benefits of mother's milk are so important to the high-risk newborn, you are able to do something for your baby that no one else can. Many neonatologists and neonatal intensive care unit (NICU) staff members strongly encourage mothers to provide their own milk for high-risk babies, even if those mothers do not intend to breastfeed later.
How your milk will be used by the NICU depends on the health status of your baby. Even babies who are not eating yet will benefit from breast milk. The nurses will use your milk to clean your baby's gums. This is called oral care. This introduces healthy bacteria into your baby's body. As your baby progresses, your milk will then be used to deliver calories through a tube or bottle. When it is appropriate, the NICU staff will help your baby breastfeed directly to get milk. As the mother of a high-risk newborn, you may have to overcome difficulties that a mother and full-term, healthy baby are unlikely to run into when learning to breastfeed. However, you and your baby will learn to breastfeed. It simply may take a bit more patience and persistence. How soon you and your baby can begin to breastfeed will depend on the maturity of your baby's brain and body systems. Although a baby's gestational age influences the development of stable body systems and the development of the reflexes needed for oral feedings, a baby's physical condition may also affect when direct breastfeeding can begin.
Until your baby is able to breastfeed, you can express your milk (remove milk from your breasts) to establish and maintain breast milk production. Milk expression also allows your high-risk baby to get the benefits of your milk as soon as his or her gastrointestinal tract is ready to handle gavage (tube) or oral (by mouth) feedings. Plan to continue to express your milk until you know your baby is able to get all needed nourishment directly from your breasts.