Every year, an estimated 1 in 10 babies is born prematurely, which amounts to approximately 1.2 million children in the Region of the Americas.
Prematurity, defined as birth before the 37th week of gestation, is one of the leading causes of neonatal mortality, morbidity, and disability. Newborns face a significantly higher risk of complications — from breathing difficulties, infections, and poor growth to delays in neurological, school, and lifelong development.
When it is not possible to avoid preterm birth, the most beneficial interventions are those that can increase the chances of survival and improve health outcomes for premature infants.
These interventions are provided to mothers shortly before or during delivery to prevent immediate or future health-related problems in the premature newborn, such as lung immaturity, susceptibility to infection, and neurological complications.
To establish lactation when an extremely premature birth occurs, it is important:
1) Manually expressing colostrum, within the first three hours after birth, initiates the milk production process and has several benefits:
- It empties the mammary gland which, together with the action of the hormones that promote labor and delivery, are a powerful stimulus to initiate milk production.
If the newborn’s clinical condition is favorable, skin-to-skin contact should be initiated immediately after birth.
The vital signs of mother and baby should be checked regularly to monitor their well-being. The person accompanying the patient, family member, doula or health care staff should monitor the woman’s wakefulness to protect the newborn’s safety in this vulnerable period.
Banked human milk (BHM) is the alternative of choice for feeding preterm infants (PTNB) as it provides the opportunity for them to receive a diet consisting of exclusive human milk when the milk of the baby’s own mother is unavailable, scarce or contraindicated.
In terms of its benefits, BHM is somewhat inferior to the mother's own, but superior to artificial formula.
Banked human milk is the alternative for feeding premature newborns because it allows them to receive a diet consisting of exclusive human milk when the baby’s own mother's milk is unavailable, scarce or contraindicated.
It should be noted that BHM is superior to artificial formula.
Human milk banks should have standards and procedures in place to ensure that they provide sustainability, safety, and appropriate clinical and ethical use.
Early skin-to-skin contact and early breastfeeding are two closely linked interventions that should be carried out immediately after birth.
Immediate and prolonged skin-to-skin contact facilitates lactation, enriches the microbiome of newborns, prevents hypothermia and hypoglycemia, and stabilizes respiratory function.
Early suckling at the breast stimulates the activation of milk secretion and transfers colostrum, rich in immunoactive substances, especially important for those born prematurely.
Early skin-to-skin contact and early breastfeeding are two closely linked interventions that should be carried out immediately after birth.
Immediate and prolonged skin-to-skin contact facilitates lactation, enriches the microbiome of newborns, prevents hypothermia and hypoglycemia, and stabilizes respiratory function.
Early suckling at the breast stimulates lactogenesis II (activation of milk secretion) and transfers colostrum, rich in immunoactive substances, especially important for those born prematurely.
The hospitalization of premature, small and/or sick newborns poses multiple challenges to breastfeeding, including:
When a child is born prematurely, some things are important to initiate and sustain the mother’s milk production:
- In the birthing area:
• Immediate, direct and continuous skin-to-skin contact, whenever clinically possible.
• Extraction of colostrum for administration into the newborn’s oropharynx.