The Milky Way

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The Milky Way explains the 9 stages which the premature child goes through in the process from birth until breastfeeding.

It will be an individual journey, for each premature child, as to where and when he/she reaches any stage in the process.

The whole process may take weeks or even months. At some stages you may experience the infant´s progress stands still or takes a step(s) back in the process. This all depends on your child´s condition and age.

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The 9 stages

Why skin-to-skin contact?

It is important to your premature child
It stimulates your child's ability to suckle and swallow
It provides your child the safety and contact it needs
It stabilizes the condition of your child and stimulates your child's development.

How to practice skin-to-skin

Your child lies on mum or dad's bare chest, only wearing a nappy/diaper. Cover your child with af blanket/duvet, avoiding the child getting cold.
Your child may also be positioned at the breast - or enjoy suckling on a dummy/pacifier

The childs lips are softly touching the nipple

Position your child on your chest or close to your breast so he child can sense, feel and smell your breast.
Squeeze a little milk from your nipple and let your child's lips touch and taste the milk.
Let your child sense the smell of your skin and milk.
It is encouraged for your child to have his/her tube-feed while placed by your breast.

Your child licks and tastes the milk and may open its mouth to attempt to suckle on the nipple.
A little milk in your child's mouth stimulates your child's ability to suckle. The positive stimulation of your child's mouth is progression in the process of successful breastfeeding.
Your child is encouraged to have its feeding-tube while placed at your breast.

Child close to breast with open mouth. Sign of wanting to suckle

The first signs that your child wants to suckle may be weak. The signs can be:
opens/closes and moves mouth and lips, tongue moves in and out of mouth, puts hands to or in mouth, turns head with open mouth/rooting.
Support your child to lie comfortably and well balanced.
Your child practices at the breast, holds nipple in mouth and attempts latch/suckling.
Your child gets its tube-feed while it practices at the breast.

Your child is placed at the breast. Your child's interest in the breast may be different at each meal and may to start only be once a day.
Your child may only be able to suckle shortly before needing a rest or even falling asleep.
It is important to let your child take the lead as it will show it's need/interest.
Your child still gets full tube-food minimum 8 times per day.

Your child is offered the breast when awake and showing signs/interest/is rooting.
Be attentive of when your child is about to wake up (or wake him/her up by changing the nappy/diaper)
Your child's ability to and desire for breastfeeding will vary and must be respected.
Your child is offered the breast and no longer a dummy/pacifier.
Your child breastfeeds before the tube-feed is commenced. When he/she breastfeeds with audible swallowing, then the tube-feed volume can be reduced.

The child is now only being fed by breast

Your child has now got the energy to breastfeed effectively and does so with obvious swallowing sounds several times within a 24 hour period.
Your child is fed when he/she is hungry.
Your child has a minimum of 8 feeds a day.
An individual breastfeeding plan is made/agreed upon.
Your child will have smaller tubefeeds when he/she has been breastfeeding.
Your child will be weighed every 2nd day.

When your child breastfeeds well and appear full after this, he/she will not be given milk via feeding tube.
Your child has a minimum of 8 feeds a day.
Your child is breastfed when he/she is hungry or you wake him/her up for instance by changing the nappy/diaper.
Be aware of the amount of wet and dirty nappies/diapers per day.
Your child will be weighed every 2nd day.
Mum continues to pump/express milk after an individual plan made with the nurses.

Your child is now purely breastfeeding and decides when/how often with a minimum of 8 feeds within a 24 hour period.
Your child is weighed every 2nd day until you are going home.
Breastmilk pumping/expressing is reduced, however, it is a good idea to continue with this 1-2 times a day until breastfeeding is fully established and your child is thriving/gaining weight as expected.