Published April 2012, next review April 2015

Taking your premature baby home from hospital

Feeding your premature baby at home

It's important to seek advice promptly if you need help with breastfeeding or tube feeding at home.

By the time you are discharged from hospital, you will probably have been helping to feed your premature baby in the baby unit. If you feel you need more practice, tell the healthcare team. Find out more about feeding premature babies.

Tube feeding at home

Even if your baby still needs some more tube feeding, you may be able to bring him home, as long as the team feels you have the skills you need to take on this task. This means you can go home earlier than you would otherwise.

Learning about tube feeding

The team will show you how to insert and check the position of the tube and give the feed, and they will tell you what to do if your baby vomits. They will watch you carry out all these processes and make sure you are doing them competently and confidently before they discharge your baby. They will also show you how to encourage him to suck, gradually moving him towards breast or bottle feeding.

Breastfeeding at home

If you have already started breastfeeding your baby, you may feel quite confident at this stage. However, some women find that being away from the hospital - with different furniture and cushions, and without the knowledge that help is close by - breastfeeding can become tricky again. If you are unsure, worried, or feel that you are not coping, talk to your healthcare team.

Common breastfeeding problems

If you find feeding painful, this may be because your baby is attached incorrectly, so ask for advice on positioning your baby. If that's not the issue, it could be one of the problems below.

Blocked duct

Symptom

  • a tender lump in your breast, pain while breastfeeding

What you can do

  •  feeding your baby as often as possible may help to clear the blockage, as well as expressing with a pump or your hand.

Mastitis

If you develop symptoms of this infection, you must seek medical treatment.

Symptoms

  • a tender lump in your breast, a red swollen patch that is painful to touch
  • flu-like symptoms, such as a temperature.

What you can do

Try to carry on breastfeeding, as milk flow will help to clear any blockage. If the breast is producing pus, don't worry, it is still safe to breastfeed. If it is too painful, try expressing the milk instead (although do not later feed this expressed milk to your baby), while continuing to feed from the other breast. Visit the doctor to get antibiotics - it is possible to get a variety that does not affect breastfeeding.

Thrush

This fungal infection can be hard to get rid of, as it can be passed between you and your baby. Premature babies are particularly susceptible to thrush because of their weak immune system.

Symptoms

  • a burning sensation on your breasts during feeds
  • little red spots around your nipple
  • mottled white patches on your baby's lips or inside his mouth
  • red spots around his anus.

What you can do

See your GP for a prescription for antifungal treatment. Good hand-washing hygiene can help to prevent the spread of fungal infection.

Expressing milk at home

You may have been used to expressing your milk from doing it in hospital while your baby was unable to breastfeed. Now that you are home you may like to continue expressing in addition to breastfeeding, so that someone else can feed your baby. You can express by hand or use electric or hand pumps.

If you are concerned that your milk supply is drying up, talk to your healthcare team immediately.

Find out more about expressing.

Bottle-feeding hygiene

If your baby started bottle feeding in hospital, you will already have had some practice. To keep good bottle-feeding hygiene:

  • get into a routine for washing and sterilising the bottles
  • be prepared: remember that you need to use freshly boiled water to make up the feed, so you must allow time for it to cool down to body temperature before giving it to your baby.

Preterm baby formula

Because of the risks associated with formula feeding, premature babies and other babies particularly vulnerable to infection may be recommended liquid infant formula for the early months, which is sterile. Depending on your baby's nutritional needs, your healthcare team may prescribe special preterm formula until your baby is ready to move on to standard.

Standard baby formula

Bottle-fed babies are significantly more likely than breastfed babies to be hospitalised with gastroenteritis. This is at least partly because the process of preparing a bottle of milk has a number of opportunities for bacteria to contaminate the feed.

Safety tips for preparing formula milk

  • Wash your hands. You are touching every piece of equipment, including the teats, bottle and scoop, so you need to wash your hands very carefully before and after mixing feeds.
  • Clean the bottles and teats thoroughly. If you leave even a tiny speck of powder inside the teat, this could contaminate the next feed.
  • Prepare the milk with care. Powdered milk is sometimes contaminated with bacteria, which is why the water must be boiled to at least 70oC (160oF), to kill off any bugs.
  • Avoid storing milk. The longer you leave the milk after mixing it - even in the fridge - the more chance there is that bacteria can grow. It's safest to make up feeds one at a time, as your baby needs them.

Find out more about why the guidelines on how to use formula milk are so strict.


In this section


Taking your baby home:

You can also read about

The following organisations can give you more information about the topics covered in this section.


Sources

Bick, MacArthur, Winter (2009) Postnatal care: evidence and guidelines for management, London, Churchill Livingstone

BMJ (1999) Protective effect of breastfeeding against infection, British Medical Journal, 300:11

Department of Health (2011) Guide to bottle feeding: How to prepare infant formula and sterilise feeding equipment to minimise the risks to your baby, London

Jeon GW, et al (2011) Preterm infants fed nutrient-enriched formula until six months show improved growth and development, Paediatrics International, doi: 10.1111/j.1442-200X.2011.03332.x.

Meeks M, Hallsworth M, Yeo H (2010) Nursing the neonate, Chichester, Wiley-Blackwell, p353

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On this page


Tube feeding at home

Breastfeeding at home

Common breastfeeding problems

Expressing milk at home

Bottle-feeding hygiene



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Feedback on health information

TIP

Returning home may mean breastfeeding when friends or family are visiting. If you feel uncomfortable feeding in front of people, make sure you're wearing loose clothes, with a shawl, to enable you to feed discreetly.

'With a premature baby, every little ounce of milk means so much. I went to the health visitor twice a week to get him weighed. The foremost thing in my mind was to feed him up and get him as big as possible.'

AMINA

DID YOU KNOW?

Breastfeeding may be sore for the first second or two as the milk starts to flow, but other than that should not hurt.