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. These babies 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. This guide is here to help you navigate breastfeeding during this special time, with tips to address the unique needs of your baby.¹ 

Sleepier Than the Average Newborn

Your late preterm baby may be more sleepy than a full-term baby and this can interfere with their ability to feed effectively.¹ They may tire quickly during feedings and might not have the stamina to nurse for long periods at first. They may need to be awakened regularly for feedings and need help staying awake during feeding to make sure they get enough milk.¹ 

Temperature Regulation

Late preterm infants may have difficulty keeping themselves warm, as their bodies have less fat and underdeveloped mechanisms to regulate temperature.¹ Skin-to-skin contact is the best way to keep your baby warm while bonding.¹ Place your baby against your bare chest, covered by a warm blanket. This provides warmth, helps regulate their body temperature, and makes breastfeeding easier. 

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.¹ Underfeeding and excessive weight loss are key risk factors in many cases of elevated jaundice levels. 

Protection From Infection

Late preterm infants have an underdeveloped immune system and are more vulnerable to infections.¹ Breastfeeding passes on vital immune factors and antibodies, helping to strengthen your baby’s immune system and protect them from infections, 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.^1,2,3 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. Feeding your baby frequently is the best way to help correct low blood sugar. If hypoglycemia persists despite feeding, your healthcare provider may suggest supplemental feedings of expressed colostrum, glucose gel, or formula. 

Tips for Successful Breastfeeding with a Late Preterm Infant:^4,5

• Track feeding and output: Monitor your baby’s weight and diaper output (at least 6 wet diapers and 3 stools per day after 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 keep them alert and help them 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 gain or jaundice, start hand expression or pumping. Providing supplemental 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:

What If I Have Questions?

If you are interested in learning more, these Aeroflow classes expand on some of the topics discussed above:

• Ultimate Breastfeeding Prep
• Pumping 101
• Lactation Q&A

Want More Info?

For a directory of Aeroflow’s other Care Guides offering information on pregnancy, baby care, and more, browse our comprehensive list of titles:

References