Navigating Breastfeeding Challenges with a Premature Baby

Navigating Breastfeeding Challenges with a Premature Baby

Meet the Mum behind Made To Milk Reading Navigating Breastfeeding Challenges with a Premature Baby 10 minutes
By Earlybirds
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When Breastfeeding a Premmie Feels Hard: You’re Not Alone

Breastfeeding is often pictured as a natural and beautiful experience, but for parents of premature babies, it can also be one of the most emotional and challenging parts of their journey. Many premmie parents hope to breastfeed their baby, only to find that their little one struggles to latch, tires quickly, or simply isn’t ready to feed at the breast. For some, medical complications or low milk supply make breastfeeding even harder, or not possible at all.

If you’re facing these challenges, please know you are not alone. Feeding a premature baby looks different for every family, and no matter how your baby receives nourishment—whether through breastfeeding, pumping, donor milk, or formula, you are providing love, care and exactly what your baby needs.

In this blog post, we’ll explore why breastfeeding can be more difficult for premature babies, the reasons behind these challenges and supportive ways to navigate this journey, including the use of nipple shields.

Whether you're breastfeeding, pumping, or finding alternative feeding solutions, your efforts are enough, and your bond with your baby is not defined by how they feed. Please also always seek professional advice to ensure the best possible experience for you and your little one.

Why can breastfeeding be harder for premature babies?
Breastfeeding is more difficult for premature babies due to several factors related to their development and medical needs. Here are the main reasons:

Immature Sucking Reflex Full-term babies develop a coordinated suck-swallow-breathe reflex around 32–34 weeks of gestation. Many premmies lack this reflex, making it difficult for them to latch and feed effectively.
Weak Muscle Tone Premmies have weaker jaw and tongue muscles, making it harder to create a strong latch and extract milk.
Fatigue and Low Stamina Breastfeeding requires a lot of energy and premmies tire quickly. They may fall asleep before getting enough milk. That's exactly why we design our premature baby clothing the way we do, so that your baby conserves as much energy as possible for feeding. Our easy access kimono style NICU T-Shirt, NICU Singlet, Isolette Suit and Jumpsuit make dressing quick and stress free and our fully lined Knot Hats help baby retain their body heat which in turn helps conserve energy. 
Medical Complications Some preemies have respiratory issues (e.g., underdeveloped lungs, apnea) that make feeding more difficult. Others may have gastroesophageal reflux (GERD), causing discomfort while feeding.
Small Mouth Size Their tiny mouths can make it hard to latch onto the breast properly. Special positioning or nipple shields may be needed.
Need for Tube Feeding Many preemies need nasogastric (NG) tubes for feeding initially because they are too weak to nurse. Transitioning to the breast takes time and practice.

Low milk supply can be also be challenge when breastfeeding a premature baby, but it’s usually a result of the baby’s early birth rather than the cause of feeding difficulties. 

How to support breastfeeding for premature babies
  • Pump breast milk so it can be given via a bottle or feeding tube until the baby is ready to latch
  • Use skin-to-skin contact (kangaroo care) to help stimulate milk production and encourage natural feeding instincts
  • Work with a lactation consultant for positioning and latch techniques
  • Be patient - some premmies need weeks before they can exclusively breastfeed

Why premature birth can affect milk supply

  1. Delayed Milk Production – Mothers of premmies may experience a delay in their milk coming in because their bodies weren’t fully prepared for lactation
  2. Lack of Direct Breastfeeding – If a baby is too small or weak to breastfeed effectively, the breasts don’t get enough stimulation to produce a full milk supply
  3. Stress and Medical Factors – Many mothers of preemies experience stress, medical complications or C-sections, which can interfere with milk production
  4. Frequent Pumping Challenges – If a baby can’t latch, a mother needs to pump regularly to maintain supply, but pumping isn’t always as effective as direct feeding at the breast

How to boost milk supply for a premmie

✔ Start pumping early and often – Use a hospital-grade pump within a few hours of birth and pump every 2–3 hours (at least 8 times per day).
✔ Practice skin-to-skin contact (kangaroo care) – This helps stimulate milk production and bonding.
✔ Try power pumping – Mimics cluster feeding by pumping for 10 minutes, resting for 10 minutes, and repeating for an hour.
✔ Stay hydrated and eat well – Good nutrition and plenty of fluids support milk production.
✔ Consider lactation support – Herbs like fenugreek or medications (as advised by a doctor) can help.
✔ Work with a lactation consultant – They can help with latch techniques and transitioning from pumping to breastfeeding.

How nipple shields can support premmie breastfeeding

A nipple shield can help premature babies breastfeed by making it easier for them to latch and extract milk effectively. Here’s how:

1. Improves Latch for Small or Weak Babies
Premmie babies often have smaller mouths and weak muscles, making it hard to latch onto the breast. A nipple shield provides a firmer, more pronounced shape that is easier for them to grasp.
2. Slows Milk Flow for Easier Feeding
If a mother has a forceful letdown, a nipple shield can regulate milk flow, preventing the baby from choking or struggling.
3. Helps Babies Transition from Bottle or Tube Feeding
Many premmies start with bottle or NG tube feeding, which requires less effort than breastfeeding. A nipple shield mimics the feel of a bottle nipple, making the transition to direct breastfeeding smoother.
4. Increases Milk Intake with Weak Suck Reflex
The shield helps hold milk in the tip, reducing effort and allowing babies to drink with less energy. Some shields also stimulate milk flow more effectively, ensuring the baby gets enough nourishment.
5. Provides Comfort for the feeding parent
If a mother has flat, inverted, or sore nipples, a shield can make nursing more comfortable while allowing the baby to feed.


How to use a nipple shield for a premature baby 
  • Choose the right size—a lactation consultant can help determine the best fit.
  • Ensure proper positioning—the baby should still have a deep latch, with lips flanged outward.
  • Monitor weight gain—some babies may need extra support if they aren’t getting enough milk.
  • Wean off gradually—once the baby develops a stronger suck, try removing the shield to encourage direct nursing


Advantages and challenges of using a nipple shield
Using a nipple shield may offer several benefits:

  • Provides palatal stimulation for babies who need help sucking rhythmically
  • Assists small babies in improving milk transfer when latched properly
  • Supports a wide, open mouth position during feeding
  • Helps maintain a secure latch for babies who struggle with breastfeeding

While nipple shields can be beneficial, they also present some challenges:

  • Some babies may become dependent on the shield’s firm texture, making the transition back to the breast more difficult.
  • It may take weeks for some babies to fully wean off the shield.
How to use a nipple shield correctly
It is recommended to seek guidance from a lactation consultant or breastfeeding specialist to ensure proper use and effective milk transfer however here are some handy hints:
1. Express a few drops of breast milk onto the inside of the shield to help it adhere to the skin.
2. Express milk into the tip of the shield to encourage the baby to latch.
3. Stretch the shield’s brim outward and place it over the nipple.
4. Position the cut-out side where the baby’s nose will be.
5. Flatten the brim of the shield onto the breast and hold it in place.
6. Aim the tip of the shield at the baby’s nose and encourage a wide-mouth latch.

Cleaning and storing a nipple Shield
  • Rinse with cold water immediately after use.
  • Wash in hot, soapy water, ensuring all milk residue is removed.
  • Rinse thoroughly and allow to air dry or pat dry with a clean paper towel.
  • Store in a clean, dry container with a lid, washing the container daily.
Weaning off the nipple shield
Mothers and babies using nipple shields should remain in close contact with a lactation consultant or child health nurse for support. Weaning off the shield may take time, but with expert guidance, many babies successfully transition to direct breastfeeding. However, some babies continue using the shield long-term without impacting their breastfeeding journey.

Conclusion: Every Feeding Journey is Valid and Important

Breastfeeding a premature baby can be a journey filled with challenges, emotions, and uncertainty. Whether you’re struggling with latch issues, relying on pumping, supplementing with donor milk or formula, or finding your own unique way to nourish your baby, know that you are not alone. The most important thing is that your baby is fed, loved, and growing—no matter how that happens.

If breastfeeding is difficult or not possible, it does not define your ability to care for and bond with your child. Every effort you make, from holding your baby skin-to-skin to providing nourishment in any form, is an incredible act of love.

Remember to seek support when you need it—whether from lactation consultants, healthcare providers or fellow parents who understand the journey. With time, patience, and the right resources, you will find a feeding solution that works for both you and your baby. You are doing an amazing job.

Help and support with breastfeeding

It is okay to ask for help if you are finding it difficult. Breastfeeding is something that mums and babies need to learn. Sometimes partners and families need support too.

Support from partners, families and friends can help mums to continue breastfeeding.

Australian Breastfeeding Association
The Australian Breastfeeding Association (ABA) runs the National Breastfeeding Helpline. This 24/7 free service, is available on 1800 mum2mum (1800 686 268).

For further support, consider these resources:
Australian Breastfeeding Association: Comprehensive breastfeeding support and information, including the use of nipple shields
Breastfeeding and Nipple Shields Video by the Australian Breastfeeding Association

Shop our range of NICU friendly Premature Baby Clothing designs, Lactation Products & Nipple Shields

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Meet the Mum behind Made To Milk

Meet the Mum behind Made To Milk