If your baby was born a little early—late preterm (between 34 and 36 weeks, 6 days) or early term (between 37 and 38 weeks, 6 days)—they may be healthy, but still face a few challenges when it comes to breastfeeding. Every drop or small amount of human milk provides amazing health benefits and protections for a premature baby. This guide is here to help you navigate breastfeeding during this special time, with tips to address the unique needs of your baby.

Why Breastfeeding a Preterm Baby May Be Different?

Premature infants might be sleepier, have a harder time latching, and need extra help keeping their body temperature and blood sugar stable. While breastfeeding can take some time and patience, with good support, your baby will grow stronger, and feedings will become easier.

Sleepier Than the Average Newborn

Your late preterm baby may be more sleepy in those early weeks than a full-term infant and this can interfere with their ability to feed effectively. They may tire quickly during feedings and might not have the stamina to breastfeed for long periods at first. They may need to be awakened regularly for feedings and need help staying awake while feeding to make sure they get enough milk.

Temperature Regulation

Late preterm infants may have difficulty keeping themselves warm, as their bodies have less fat and underdeveloped mechanisms to regulate temperature. Skin-to-skin contact is the best way to keep newborns warm while bonding. Place your baby against your bare chest, covered by a warm blanket. This provides warmth, helps regulate their body temperature, and makes breastfeeding easier. This practice is also called Kangaroo Care. The World Health Organization (WHO) recommends Kangaroo Mother Care (KMC) to help both full-term and preterm (or with low birth weight) newborns survive and thrive.

Risk of Jaundice

Late preterm infants are at higher risk for jaundice. Frequent feeding (at least every 2–3 hours) helps to clear bilirubin from your baby’s system and reduce the risk of jaundice. Underfeeding and excessive weight loss are key risk factors in many cases of elevated jaundice levels so it's vitally important to monitor your baby for adequate intake. 

Protection From Infection

Late preterm infants have an underdeveloped immune system and are more vulnerable to infections. Special care is taken by hospital staff and in the NICU (Neonatal Intensive Care Unit) to reduce these risks. Whether you are breastfeeding or offering expressed breast milk, you are passing on vital immune factors and antibodies, helping to strengthen your baby’s immune system and keeping them healthy.

Low Blood Sugar (Hypoglycemia)

Babies born early are at greater risk of hypoglycemia because their bodies have lower energy stores to maintain stable blood sugar levels on their own, especially in the early hours after birth. Signs of hypoglycemia include jitteriness, poor feeding, or extreme sleepiness. In the first 24–48 hours of life, your baby may have their blood sugar tested multiple times to monitor for hypoglycemia. Frequent feedings are the best way to help prevent low blood sugar. If hypoglycemia persists despite feeding, your healthcare provider may suggest supplemental feedings of expressed colostrum, glucose gel, donor milk, or formula. 

Tips for Successful Breastfeeding with a Late Preterm Infant:

  • Track Feedings and Output: Monitor your baby’s weight and diaper output (at least 6 wet diapers and 3 stools per day by Day 4–5) to ensure they are getting enough milk.
  • Ensure a Good Latch: A proper latch is crucial for effective breastfeeding. If you need assistance, a Lactation Consultant can help you with positioning and latch techniques.
  • Stimulate your Baby: Gently rub your baby’s back and use breast massage and compressions to help keep them alert and transfer more milk.
  • Offer Both Breasts: If your baby falls asleep during a feed, wake them gently by changing their diaper, talking to them, and offering the other breast.
  • Start Hand Expression: If your baby isn’t latching well, is too sleepy for full feeds, or you're concerned about weight loss or jaundice, start hand expression after feeding attempts. Providing extra colostrum ensures they get enough milk until breastfeeding improves.
  • Stay Hydrated and Eat Well: Drink plenty of fluids and maintain a balanced diet to support milk production.
  • Practice Good Hygiene: Keep hands and pump supplies clean. The CDC recommends sanitizing pump parts once a day for newborns and preterm infants, in addition to regular washing with hot, soapy water. Ensure visitors are healthy to avoid exposing your baby to illness.

When to Seek Help

  • If Your Baby Needs Extra Milk: Sometimes babies need more milk than breastfeeding alone provides. Pumping can be a helpful way to supplement. A Lactation Consultant can guide you on when to start pumping, how often to pump, and how to safely store your milk. Pumping can help you establish or increase your milk supply, until your baby is strong enough to breastfeed effectively on their own.
  • Poor Weight Gain: If your baby is constantly sleepy or not having adequate wet or dirty diapers, contact your healthcare team for guidance and support.
  • Signs of Dehydration or Jaundice: If your baby is not feeding well, shows signs of dehydration (fewer wet diapers or dark urine), or develops jaundice (yellowing skin or eyes), contact your pediatrician immediately.

Every drop of milk you provide makes a real difference for your little one’s health and protection. You’re not alone on this journey. With time, patience, and the right support, your baby will grow stronger and breastfeeding will get easier.

Disclaimer: Our classes and accompanying materials are intended for general education purposes and should not replace medical advice. For personalized recommendations, please consult your healthcare provider and/or lactation consultant.