January 20, 2020
Infants born between 34-37 weeks gestation are at higher risk for breastfeeding difficulties as compared to term infants1. Late preterm infants have a higher risk for hypothermia, hypoglycemia, and physiologic hyperbilirubinemia. In addition, they tend to be sleepier at the breast and run the risk of insufficient milk transfer at the breast. It is reasonable to routinely supplement these infants in the early postpartum, until they demonstrate the ability to support themselves at the breast without supplementation. Late preterms ought to room-in with their mothers and feed ad lib. However, because they tend to be sleepier, they should be awakened to feed at least every 3 hours until mother’s milk has increased, and the infants are nursing well on their own without supplementation.
Mothers should be encouraged to express their colostrum or early milk after nursing, and offer expressed breastmilk to the infant after each feeding. If she is not able to express her own milk, approximately 5-10ml of either donor milk or formula should be offered to the late preterm after nursing on day 1, followed by 10-30ml offered after feedings on day 2 and possibly day 3, depending on mother’s milk supply, infant weight, and infant feeding skills. More details on breastfeeding the late preterm can be found in The Academy of Breastfeeding Medicine’s protocol #10 entitled ‘Breastfeeding the Late Preterm and Early Term Infants, Second Revision 2016’ https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/10-breastfeeding-the-late-pre-term-infant-protocol-english.pdf
- Academy of Breastfeeding Medicine. ABM Clinical PSrotocol #10: Breastfeeding the late preterm infant (34 0/7 to 36 6/7 Weeks Gestation) and Early Term Infants (37-38 6/7 Weeks Gestation) Second Revision 2016 Breastfeed Med. 2016; 11(10)