118 Breastfeeding
Special
Situations
Babies that
were born too
early or very
small should be
kept against
your skin for
warmth.
Babies with special needs can breastfeed
Small baby. If a small baby cannot suckle strongly enough to
feed itself, you will need to remove your milk by hand and feed
the baby with a cup. Begin right after birth, and continue even
when the baby can suckle some by itself. This will help your
breasts make more milk. If your baby weighs less than 1½
kilos or 3½ pounds, it may need special medical care, including
a tube that goes through the nose and down to the stomach.
Your milk can be given through that tube. Talk with a health
worker about this.
Baby born too early. Babies born too early need extra
help to stay warm. Place the baby naked, with a hat and a
diaper or nappy, upright inside your clothing, against your skin
and between your breasts. (It helps to wear a loose blouse,
sweater, or wrap tied at the waist.) In some places this is
called ‘Kangaroo Care’. Keep skin-to-skin contact inside your
clothing day and night, and breastfeed often. If the baby
suckles weakly, also give milk you have removed by hand.
Cleft lip or cleft palate. These babies may need special help to
learn how to suckle. If the baby has only a cleft lip, it can still
suckle well. (To help make a seal, use your finger to cover the
cleft.) If the roof of the mouth is also open, try to hold the
baby up straight while keeping a good feeding position. You may
need to get special help. You can remove your milk by hand to
keep up a good supply while the baby is learning to suckle.
Yellow baby (jaundice). A yellow baby needs plenty of sunlight
and breast milk to get the jaundice out of its body. Some babies
with jaundice are very sleepy. If a baby is too sleepy to take the
breast, remove milk by hand and give it with a cup and spoon, at
least 10 times in 24 hours. Put the baby in the sun in the early
morning and late afternoon. Or keep the baby in a bright room.
Most jaundice does not start until after the first 3 days of
life and clears up by the 10th day. If the baby has jaundice
or very yellow eyes at any other time, or if a jaundiced baby
was also born very early, or if the yellow or
sleepiness gets worse, the baby could
have a serious illness. If possible, take
the baby to a health center or hospital.
Twins. Sometimes one twin is smaller or
weaker. Be sure that each baby gets plenty
of your milk. You have enough milk for both
babies. Be sure you are getting enough to
eat too.
Where Women Have No Doctor 2012