Breastfeeding Your Premature Baby in the Hospital and Using Test Weights

How can I help my baby to get ready to breastfeed?

• Start to pump or hand express milk within 1 hour of Aim to pump at least 8 times per day
• Hold your baby skin-to-skin and let them explore, taste and try to latch on to your breast
• Try skin-to-skin in a laid-back position to help your baby practice rooting and grasping the nipple
• Give your baby tastes of your milk-express drops on your baby’s lips or give with a swab or dropper
• Plan to stay overnight when your baby is ready to breastfeed

When will my baby be ready to breastfeed?

Each baby is unique. Most babies start to show signs they are ready to breastfeed after 34 weeks of corrected age. This is the age in weeks at birth plus the number of days since birth. It is normal for babies to show signs that they are ready sometimes but not always.

What are the signs my baby is ready to breastfeed?

• Wakes up and stays calm and alert at the feeding time
• Brings hands close to face
• Rooting or looking for nipple, or puts hands in mouth

Your nurses will look for these signs each time your baby is scheduled to feed. When all the signs are present more than half of the time in a day your baby may be ready. Your nurses and doctors will tell you when your baby is ready to start breastfeeding.

How will I know how much milk my baby took in while breastfeeding?

Your nurse will use a special scale to check how much milk your baby takes in while breastfeeding. This is called test weights. The scale uses grams of weight.

• 1 gram equals about 1 milliliter (mL) of milk
• 30 mL = about 1 ounce of milk

How do test weights work?

Your baby is wrapped in a blanket wearing only a clean diaper with cords tucked in and weighed right before you breastfeed. After feeding, your nurse weighs the baby the same way. It is important  to use the same diaper, blanket and any clothes for both weights. Your nurse will tell you the amount taken in.

Why are test weights used for my baby?

Your premature baby needs a certain amount of milk to grow and may not show signs of hunger the way a full term baby does. Test weights make sure that your baby gets the right amount of milk through the feeding tube after breastfeeding. Studies show test weights are the best way to measure how much a premature baby eats when breastfeeding in the hospital.

When do test weights start?

You and your baby will have time to practice latching on and taking in milk before test weights start. Nurses will look for signs that you and your baby are ready for test weights and tell you the results. Signs you are ready are feeling of fullness in your breasts and increased amounts of milk when you pump. Signs your baby is taking in milk at breast are staying latched on and hearing your baby swallow often. Test weights usually start after your baby is 34 weeks and at least 2 days after birth.

What if my baby breastfeeds but the test weight does not show weight gain?

Premature babies sometimes latch on and suck but do not transfer milk from the breast. This is normal and can happen the first few times or after your baby has breastfed many times. It can take time before your baby always takes in a lot of milk at the breast. Test weights are the best way to make sure your baby gets all the milk they need to grow as you work on breastfeeding.

When will test weights stop?

When your baby is taking enough milk and no longer needs the feeding tube, test weights are not needed. By now your baby is close to going home and you can feed on demand. Your doctors and nurses will explain how much and how often your baby needs to eat to keep growing.

What if my baby needs extra calories added to my milk?

Some premature babies need more calories and nutrients in less liquid to help them grow. Breast milk with extra nutrients and calories added is  called fortified milk. If your baby needs fortified milk, this will be used for any tube feedings given after breastfeeding. When your baby is close to going home and no longer needs the feeding tube, they may still need some fortified milk. This can be given in a bottle.

What else do I need to know?

Breastfeeding a premature baby in the hospital takes practice and patience. Be gentle with yourself as you work on breastfeeding and take care of your needs first. Hold your baby skin to skin often and let them practice when they show cues. Let your baby sleep at breast if they are not showing feeding cues.

Questions?

This information is not specific to your child but provides general information. Talk to your nurses, lactation, and doctors about your feeding plan and preferences and any questions you have.

Reviewed 10/2022

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