Nurse helping mother breastfeed in hospital bed
Lactation

Breastfeeding a Late Preterm Baby

Key takeaways: Late preterm babies (34 to 36 weeks) often tire quickly, have trouble staying awake, and are at higher risk for jaundice, low blood sugar, and poor weight gain. Frequent feeding, skin-to-skin, pumping after feeds, and close follow-up help. Feeding usually gets easier as they near their due date.

Babies born between 34 and 36 weeks are called late preterm. Early term babies (37 to 38 weeks) share some of the same challenges. They may look like full-term babies but often feed more like younger ones.

Why Feeding Is Harder

  • Less stamina: they tire before taking a full feed.
  • Sleepiness: they may not wake to feed.
  • Weaker suck and less coordination of sucking, swallowing, and breathing.
  • Higher risk of jaundice, which can make them sleepier.
  • Higher risk of low blood sugar and low temperature.

Feeding Plan Basics

Your care team will give you a plan. Common recommendations include:

  • Feed at least 8 to 12 times in 24 hours, waking your baby if needed. Many plans say no longer than 3 hours between feeds.
  • Limit feeds to a reasonable length (often around 30 minutes) so your baby doesn’t burn more energy than they take in.
  • Skin-to-skin to keep your baby warm and encourage feeding.
  • Breast compressions to increase milk flow.

From the author

From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. If you want feeding help you can flip to in the middle of the night, my book walks you through feeding month by month, from the very first latch to the first birthday.

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Protecting Your Supply

Because late preterm babies may not remove milk well, many mothers are advised to:

  • Pump or hand express after feeds, about 8 or more times a day.
  • Give the expressed milk as a supplement using a method recommended by your team.
  • Use a hospital-grade pump if your baby isn’t feeding well.

Positioning Tips

  • Cross-cradle or football hold give more head support.
  • Support your breast with your hand (a “C” or “U” hold) so its weight isn’t on your baby’s chin.
  • Some babies benefit from a nipple shield for a time, with lactation follow-up.

Signs to Watch

  • Wet and dirty diapers increasing as expected.
  • Steady weight gain once milk comes in.
  • Color: watch for increasing yellowness.

Follow-Up

Late preterm babies should usually be seen within 24 to 48 hours after leaving the hospital, with weight checks until feeding is going well. Ask for an IBCLC visit.

It Gets Easier

Many babies feed much more efficiently as they approach their original due date.

Call your baby’s doctor right away if your baby: is hard to wake, won’t feed, has few wet diapers, looks more yellow, has a temperature that is too low or too high, or seems floppy.

The Bottom Line

Late preterm babies need extra support with feeding. A plan that includes frequent feeds, pumping, and close follow-up helps them grow while they mature.

Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.

Related Articles

Sources

  1. Boies EG, Vaucher YE; Academy of Breastfeeding Medicine. ABM Clinical Protocol #10: Breastfeeding the late preterm (34-36 6/7 weeks of gestation) and early term infants (37-38 6/7 weeks of gestation), second revision 2016. Breastfeed Med. 2016;11(10):494-500.
  2. Engle WA, Tomashek KM, Wallman C; Committee on Fetus and Newborn. “Late-preterm” infants: a population at risk. Pediatrics. 2007;120(6):1390-1401.
  3. Meier P, Patel AL, Wright K, Engstrom JL. Management of breastfeeding during and after the maternity hospitalization for late preterm infants. Clin Perinatol. 2013;40(4):689-705.

This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.

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