Infants with

Special Needs
Session Objectives:

- Discuss breastfeeding of infants who are preterm, low

birth weight or have special needs
- Describe how to assist mothers to breastfeed more than
one baby.
- Outline prevention and management of common clinical
concerns: neonatal hypoglycemia, jaundice and
dehydration, with regard to breastfeeding
- Outline medical indications for the use of foods/fluids
other than breastmilk
Breastfeeding Special Needs
Infants
The importance of breastmilk for preterm, low birth
weight or special needs infants

1. BREASTMILK contains :
- protective immune factors,
- growth factors
- enzymes
- special essential fatty acids

cont
The importance of breastmilk
2. In addition, breastfeeding:
- calms the baby and reduces pain
- gives the mother an important role in caring for
her baby,
- comforts the baby and maintains the link with
the family.

Babies with neurological conditions, cardiac problems

or cleft lip/palate and babies who are ill, need breast
milk = or more than well babies
Care can be divided into
categories based on the babys
condition:
Baby not able to take oral feeds.
Baby able to take oral feeds but is not
able to suckle.
Baby able to suckle but not for full
feeds.
Baby can suckle well.
Baby is not able to receive any
breastmilk.
Support for breastfeeding in a
special care baby unit
1. Arrange contact between mother and
baby, night and day
 Support for SCBU
2. Take care of mother

Stay together in hospital

Place to rest within hospital during visits

Have suitable seat near baby

Provide fluids and food for mom

Answer parents questions

cont
3. Help to establish breastfeeding
Assist mothers express milk within 6 hrs
Encourage skin to skin contact
Allow getting to know the breast
Give expressed breast milk by tube/cup

Weight is not an accurate measure of ability to breastfeed.

Maturity is a more important factor.

cont
Putting a baby to the breast
Pointers:

Baby just starting to wake up rapid

eye movements under the eyelids
Baby ready to feed suckling
movements/ hands towards mouth/
Avoid waiting for baby to cry
 10/3

Positioning a
preterm
infant

UNICEF/HQ93-0287/ Roger Lemoyne, China demo

Explain to mother what to expect
at feeds
Plan for a quiet unhurried feed in a
conducive environment.

Expect baby may :

feed for a long time
Rest between feeds
Some gulping / choking
Seem sleepy
Prepare the mother and baby for
discharge
A baby is ready if:
Feeding effectively
Gaining weight
Usually 1800-2000grams
Ensure mother can:
Recognize feeding signs, and signs of
adequate intake
Can position and attach for feeding
Breastfeeding more than one
baby
Mothers can make enough milk for
two babies, and even three.

The key factors are: Time, Support,

Encouragement from health care
providers, family and friends
 Well on
Breastmilk
Twins Grow
10/4

UNICEF/HQ92-0260/ Lauren Goodsmith, Mauritania

Breastfeeding a baby and older
child
No need to stop breastfeeding an
older baby when a new baby arrives.

Feeding the mother is the most

efficient way of nourishing the
mother, the new baby and the
younger breastfeeding toddler.
Prevention and management of
common clinical concerns
Common clinical concerns can be
AVOIDED by:
Early skin to skin contact
Early & frequent feeding
Rooming in
No added fluids
Good Observation
Hypoglycemia of the newborn
Hypoglycemia low blood glucose level
born prematurely
small for gestational age
mother or ill baby

- There is NO evidence to suggest that low blood glucose

concentrations in the absence of any signs of illness are
harmful to healthy, full term babies.

- Healthy full term baby with signs of hypoglycemia

investigate.
 Jaundice Dehydration

1st week of life Exclusive BF does not

need additional fluid
GIVE COLOSTRUM-
laxative to help pass the W/ diarrhea, breastfeed
meconium more frequently

Babies with breastfeeding difficulties -

small but frequent,
benefits both mother and baby
BF - breastfeeding
 The baby with neurological
difficulties
Breastmilk / breastfeeding is
important
Encourage early contact, early
breastfeeding
Awaken and stimulate baby
Help mothers position & attach
Help support her breast & babys
chin
 Kay Hoover and Barbara Wilson-Clay, from The Breastfeeding Atlas
UNICEF C107-21
10/5
Hand Position
DANCER
Medical Reasons for food other
than breastmilk
Distinguish the following:

Cant be fed at breast but BM food of

choice.
Should not receive BM & any other milk
BM is not available.
May need other nutrition (draft).

BM - breastmilk
Summary
- Infants who are preterm, low birth weight, ill or have
special needs.
- Baby not able to take oral feeds.
- Baby able to suckle but not for full feeds
- Baby can suckle well.
- Baby is not able to receive breastmilk.
- Breastfeeding more than one baby.
- Prevention and management of common clinical
concerns.
- Medical indications for food other than breastmilk.