QUESTION:  I have two questions: 1. My baby was born 10 weeks premature. Even though she is so immature, she is a great nurser. We are supplementing her with two bottles a day of breast milk mixed with Enfacare premie formula. Is there anything else I should be cautioned about with nursing a premature baby? 2. Are there any foods that should be avoided while breastfeeding other than the obvious drug and alcohol?

It sounds to me like you are doing a beautiful job! Kylie was born at 30 weeks gestation, and now has an adjusted age of 33 weeks. She will be a much healthier baby and get out of the hospital sooner because of your efforts to keep her breastfed. The likelihood of her having retinal disease of prematurity also is much less because you are working to hard to pump and keep her breastfed. Aside from the fortifier recommended by the neonatologist, I would try to keep her as exclusively breastmilk fed as possible. Many of the wonderful advantages of breastmilk are dose related. A premie seems to need the protection provided by breastmilk even more than a term baby. For example, in a study by Lucas published in the Lancet in 1992, premature babies had a 8.3 point IQ advantage on the WISK by the age of eight years old if fed their mothers milk. This is a more pronounced advantage than even the term baby receives.

There are no foods that I recommend you avoid, aside from those that you mentioned.

Try as best you can to keep your production high so that the transition to the breast will be as easy as possible for Kylie. Remember that taking milk from a bottle is very different than taking milk from your breast. Instead of suction, she will use her jaw and tongue to massage milk from the little pools that lie beneath the areola. It will be much easier for her to access your milk if you production is generous. Pumping at least 8 times every 24-hour period (6 times during the day and 2 times at night), will hopefully produce more than she needs now, but will be money in the bank for tomorrow. Good luck. You are giving your premie a gift that only a mother can give!

Dr. Jane Morton, Clinical Professor of Pediatrics at Stanford University School of Medicine, is an expert on nursing premature infants as well as a member of the Breastfeeding.com medical advisory board. Dr. Morton has answered several of your breastfeeding questions. Look for more Q&A forums with Dr. Morton in the future.

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