Feeding your baby
This section will provide you lots of information about feeding options available to your baby. This includes the type of milk and ways your baby can be fed.
Please speak to your baby’s health care team about the best options for your baby.
Lactation consultants and midwives (PCH) are available every day to provide support to breastfeeding women, offer advice to optimise your milk supply, and support expressing milk and breastfeeding your baby. Please ask the nursing staff to contact the lactation consultant to arrange a time for you.
The Expressing breast milk for your baby booklet details expressing, cleaning and sterilising the equipment, storing and transporting expressed breast milk as well as troubleshooting common problems like sore nipples and changes to your milk supply.
More information can be found on the KEMH Breastfeeding website, including video resources on expressing, feeding and breastfeeding challenges.
King Edward Memorial Hospital
The Neonatal Nutrition Room (also known as the Milk Room) is located on Ground Floor, B Block and is where your expressed breast milk (EBM) is organised.
The Milk Room nursing staff will organise storage and distribution of milk to your baby.
Breast pumps and expressing equipment are loaned to you once you are discharged from the maternity ward.
Where: Neonatal Nutrition Room
When: Between 11am and 12pm daily
Perth Children's Hospital
The Milk Room at PCH organises storage and distribution of milk to your baby.
PCH does not have breast pumps for hire however there are breast pumps available for expressing within the unit. Please discuss with your bedside nurse, lactation consultant or midwife.
Having your baby in the Neonatal Unit can be a stressful time, which can affect your ability to express enough breastmilk for your baby.
There may also be situations where expressing or breastfeeding may not be an option (surgery, illness or medication).
With your consent we may be able to offer donated breastmilk, also known as pasteurised donor human milk (PDHM).
It is the next best milk for babies who meet the criteria (less than 33 weeks gestation and/or less than 1500grams at birth) and can be given until your baby reaches a corrected gestation of 34 weeks. You will be approached by a member of the PREM Bank or a lactation consultant if your baby can receive donated breast milk.
Learn more about the PREM Bank, including how to donate breast milk.
Establishing breastfeeding and bottle feeds can vary greatly between babies and is dependent on their individual journey through the Neonatal Unit.
Our aim is to establish a feeding plan with you which is appropriate for your baby's needs.
Tube feeding
Initially your baby may receive all their feeds via a nasogastric tube (NGT) or orogastric tube (OGT).
As your baby is beginning to learn how to breastfeed and suck from a bottle their feeding tube will remain in place until they are able to complete their whole feed.
You can hold the syringe if your baby is stable and tolerating their feeds.
You will always have a nurse with you to help and there is a learning package available for you to complete to build your confidence.
Breastfeeding
Breast experiences with skin-to-skin cuddles can begin from 28-30 weeks in all infants including those on HHF or CPAP. Increasing suck strength may occur from 30-32 weeks. From 34 weeks onwards, the ability to co-ordinate sucking, swallowing and breathing improves as your baby matures.
The initial introductions to the breast involve non-nutritive sucking (which means sucking on empty breast after you have expressed), with a gradual introduction to nutritive sucking. Milk will still be given by the feeding tube in decreasing amounts until we are sure your baby is able to breastfeed enough milk.
Some signs your baby is looking to suck a feed include:
- sucking on their feeding tube or dummy
- rooting reflex (moving their head looking for a breast or bottle)
- swallowing their own saliva
- resisting tube feeds (straining and pushing milk back up the tube)
The use of nipple shields in preterm or small babies who are unable to maintain attachment has shown to reduce infant fatigue and increase milk transfer and duration of breastfeeding.
Nipple shields assist preterm babies who:
- are unable to keep the correct attachment at the breast (constantly slipping off)
- fall asleep as soon as they are attached
- are unable to maintain regular nutritive sucking
If you are considering using a nipple shield, please speak to the lactation consultant or midwife who will advise if this will help you.
Once your baby is completing some breastfeeds and not needing extra milk by the feeding tube, it may be appropriate to introduce bottle-feeds for when you are not available, and your baby is demanding a suck feed (e.g. at night). This will only be introduced if you agree to bottle feeding as part of the feeding plan.
Your baby will hopefully learn to suck all of their feeds as a combination of both breastfeeds and bottle feeds. Once you are discharged home, it is a good idea to continue with both types of feeding as your baby settles into a routine. If your goal is to exclusively breastfeed your baby, then gradually replace a suck feed with a breastfeed over the first few weeks at home. Going to breastfeeding only can quickly tire your baby out as they use a lot of energy breastfeeding and they may have trouble maintaining their weight.
Bottle feeding
If you are planning on bottle feeding please ask your baby's nurse for assistance. Babies born preterm or unwell may require different holding positions and bottle teats to find out what works best for them while they learn to feed.