Maintaining lactation

All newborns can be fed breastmilk. The exceptions are very rare congenital metabolic disorders. The message "mother's milk is the best" is brought to the fore in sick newborn and infant nutrition.

Newborns in special and intensive care units can suckle if they have the coordinated suck-swallow-breathe reflex (usually around 34th gestational week), are not on mechanical ventilation and are clinically stable.

Preterm babies under 34 gestational weeks, children on mechanical ventilation or those whose disease deteriorates cannot suckle. Children with cleft palate, other abnormalities, such as heart defects, neurological or genetic disorders, such as Down syndrome, may have difficulty suckling. In these situations, the baby can be fed breastmilk in a way that best suits his/her condition, until he/she is able to suckle.

If you are separated from your newborn for more than six to eight hours (preterm baby, sick newborn placed in an intensive care unit or transferred to another institution), you need to start emptying your breasts. In this way, you will stimulate milk production and enable your baby to get your milk, the best possible food.

Your milk is the best food for your baby. When you are separated from your prematurely born or sick child, it seems to you that there is nothing you can do for her or him. Your milk is actually something that only you can provide to your baby.

Tips for hand expression of breastmilk

  • You must empty your breasts regularly, 6-8 times in 24 hours, in order to imitate the breast stimulation provided by a healthy, full-term newborn who is with his/her mother.
  • Hand expression should take 20 minutes; the period between two sessions should not be longer than 5 hours, and you should by all means do it at least once during the night.
  • In the first few sessions, the amount of milk may be minimal; it increases with practice.
  • You can trigger the milk ejection reflex (oxytocin reflex) when you are in a comfortable and relaxed position, thinking of your baby, holding his/her photo or toy, watching him/her if you are together, gently warming and massaging the breast, gently stimulating the nipple between your thumb and forefinger .
  • It is important to take care of hand hygiene and hygiene of the utensils for collecting and storing milk.
  • Like breastfeeding, hand expression is a skill that is learned. You will get the necessary advice and assistance from the staff in the maternity hospital or intensive care unit; don't be afraid to ask for help.

Hand expression is recommended in the beginning. In addition to collecting milk, hand expression can help relieve the uncomfortable feeling of engorgement in the breasts, reduce the swelling of the areola of an engorged breast so that the baby can latch on, release clogged milk ducts. In these cases, hand expression takes much shorter.

Pumps, manual or electrical, can significantly facilitate milk collection, especially if the child will not be able to suckle for a long time, or the mother and child are separated for other reasons (mother's illness or early return to work). New generation electrical pumps are adapted to mothers' different needs; a disadvantage is their high price. The pumping equipment must be maintained and sterilized according to the manufacturer's instructions.

Maintaining lactation can be difficult and strenuous for the mother, especially if she is separated from the child for a long time. If you fail, you should know that there are specialized formulas, tailored to the needs of your child. In addition to nutrition, the warm and supportive relationship and love you give to your child play a key role in his/her optimal growth and development.