Durante la lactancia materna hay numerosas ocasiones en las que la mujer puede necesitar extraer leche, aunque hay otras que no lo necesitan a lo largo de toda su lactancia. Por ese motivo hoy te…
Bebés prematuros y lactancia materna: la leche materna se considera prácticamente un medicamento para los bebés nacidos antes de tiempo.
Un bebé prematuro no es simplemente un bebé pequeño. Se trata de un bebé que ha nacido antes de tiempo y que, por tanto, no ha tenido tiempo de madurar el tiempo suficiente; un bebé inmaduro. Lógicamente, también es un bebé pequeño y con menos peso, pero lo fundamental es que sus órganos no han madurado el tiempo necesario y tienen que hacerlo fuera del útero materno. Por eso, a los bebés nacidos antes de la semana 37 se les considera prematuros, independientemente del peso que tengan en el momento del nacimiento.
Dependiendo del grado de prematuridad pueden tener más o menos dificultades, más o menos importantes: problemas respiratorios, dificultades de succión o inmadurez para la coordinación de la succión/deglución/respiración, vaciamiento gástrico lento y reflujo gastroesofágico, bajo tono muscular y baja fuerza, inmadurez neurológica, etc.
Parece claro entonces que, en estas circunstancias de vulnerabilidad, lo ideal es que los prematuros reciban el mejor alimento: la leche de su madre o en su defecto, la leche humana donada, que se considera prácticamente un medicamento.
Una leche especial para el bebé prematuro
Se sabe que el calostro y la leche de transición de las mujeres que dan a luz de forma prematura tienen una composición diferente a las que dan a luz a término. Es decir, la leche de las madres de prematuros está adaptada a ellos, a sus necesidades, aportándoles mayor cantidad sustancias inmunológicas (más defensas: immunoglobulina IgA, lisozima, lactoferrina, macrófagos, linfocitos, neutrófilos…) y mayor cantidad de proteínas que la leche de una mujer con el parto a término.
Además, para el desarrollo de su sistema nervioso son fundamentales los ácidos grasos de cadena larga, especialmente presentes en la leche humana y con mayor capacidad de absorción.
Ya sabemos que la leche materna es el mejor alimento para el recién nacido, y que la ausencia de ella puede conllevar riesgos para su salud. Pues bien, esta afirmación se hace especialmente cierta e importante en el caso del bebé prematuro, al ser un bebé inmaduro y vulnerable por las circunstancias que ya hemos comentado.
Y sin embargo…
Sin embargo, las tasas de lactancia materna es prematuros son bajas. Más si cabe que las de las de los recién nacidos a término, que ya de por sí lo son, y no se acercan a las recomendaciones de la OMS. Es cierto que hay ciertas dificultades añadidas, y que no es fácil, pero es importante que desde los centros sanitarios se le dé el valor necesario a la lactancia materna y se le transmita esa información a los padres, a la vez que se les ofrezca apoyo y soporte para poder llevar a cabo la lactancia.
Cuando una mujer tiene a un bebé por parto prematuro, lo más probable es que sea una situación inesperada. Cuando estás embarazada lo último que te planteas es que tu bebé pueda nacer antes de tiempo, ya que la imagen que tienes en tu cabeza es la del bebé sano, a término y sin ninguna dificultad ni problema de salud. Además de la sorpresa, aparecen también sentimientos de miedo y angustia, llegando a temer también incluso por su vida.
Ante esta situación desesperanzadora y angustiosa, es lógico que muchas madres cedan los cuidados a los profesionales sanitarios, que ni siquiera se planteen la lactancia materna como opción y que desconozcan que en esa situación, la leche materna puede hacer que aumenten las opciones de supervivencia de su hijo o que disminuyan las posibles secuelas. Esta información se la tiene que proporcionar el personal sanitario, de manera clara y sin presiones, además de ofrecerle todas las herramientas a su alcance para poder hacerlo posible.
Estimulación del pecho lo antes posible
Para estimular la subida de la leche y una adecuada producción de leche posterior, lo recomendable es la extracción de calostro lo antes posible. La situación ideal sería en la primera hora postparto, pero si no es posible, al menos que se realice antes de las 6 horas. A partir de ahí, lo recomendable es llevar a cabo una nueva extracción cada 3 horas, aproximadamente 8 veces al día, siendo una de las cuales de madrugada.
Es normal que en las primeras veces salga muy poca cantidad, apenas unos mililitros, pero de forma progresiva esta cantidad irá aumentando.
Al principio recomiendo la extracción manual, porque las cantidades de calostro son mínimas y podrían perderse entre los tubos del sacaleches (los profesionales que atienden a los prematuros suelen llamar al calostro «oro líquido»). Pero tras dos o tres días, la estimulación con sacaleches puede ser más cómoda y eficaz; preferiblemente si el extractor es doble y con motor hospitalario.
Cuidados Canguro
Está comprobado que los cuidados canguro son beneficiosos tanto para el bebé como para los padres, y si este tipo de cuidados son importantes en los bebés a término, en el caso de los bebés prematuros lo son aún más. Algunos de los beneficios que se conocen de tener al bebé piel con piel son los siguientes:
- El bebé sincroniza la respiración con la del cuidador, disminuyendo las apneas respiratorias.
- Ayuda a mantener un mejor control de la temperatura.
- El bebé tiende a estar más tranquilo, llora menos, y así gana más peso y evoluciona mejor.
- Los padres se sienten miembros activos de los cuidados de su hijo/a y no meros espectadores, en un acto que favorece mucho el vínculo.
- Favorece la lactancia materna aumentando el estímulo de oxitocina.
- Ayuda frente a infecciones. Si la mamá está en contacto con el bebé y las bacterias del entorno directo, a través de su leche le transmite anticuerpos frente a esas bacterias.
De nuevo, mencionar la importancia de que los profesionales de la salud informen a las madres y padres de estos beneficios. Además, es importante que se eliminen las restricciones de horario en las unidades neonatales para que los padres puedan estar el mayor tiempo posible con sus bebés.
Contacto con el pecho lo antes posible
Aunque el bebé prematuro no esté preparado para mamar, sí es conveniente que su boca esté en contacto con el pecho de su madre de forma frecuente, realizando la succión no nutritiva (nombre popularmente conocido, aunque yo prefiero utilizar el término de succión afectiva).
A partir de las 28 semanas de gestación ya pueden hacer succión afectiva, con lo cual no tiene sentido retrasar el momento de ponerlos al pecho.
Evitar tetinas e interferencias con la lactancia materna
Dependiendo de la edad de prematuridad, el bebé puede alimentarse de una forma u otra. Si es muy inmaduro, lo habitual es que esté alimentado por sonda naso u orogástrica y, conforme vaya creciendo, utilizar otros métodos de forma combinada. Y es mejor utilizar vasito de alimentación o finger feeding (dedo-jeringa) para alimentarlo, evitando las tetinas para evitar la confusión tetina-pezón.
Leche materna donada
Cuando no es posible alimentar al bebé con la leche materna de la propia madre, o no se dispone de las cantidades suficientes, antes que ofrecer leche artificial, está indicado dar leche de donante. Actualmente hay 13 bancos de leche materna en España y en el año 2016, 1550 madres donaron más de 7400 litros de leche materna.
La leche humana donada ha disminuido de forma considerable los riesgos asociados a la alimentación con fórmula, como por ejemplo, la enterocolitis necrotizante (muerte del tejido intestinal, una condición muy grave).
Apoyo emocional
Los padres de un bebé que ha nacido antes de tiempo necesitan, además de apoyo logístico, e información, mucho apoyo emocional. Deben pasar, entre otras cosas, el duelo por no haber tenido un hijo a término, con la incertidumbre añadida de saber si tendrá o no algún problema de salud, si podrá llevar una vida normal….
No es nada fácil, y en muchas ocasiones las familias se ven desamparadas y perdidas en el hospital.
Por desgracia, frecuentemente veo mujeres, que llegan a mi consulta, que han tenido un bebé prematuro y que quieren darle el pecho, a las que no se les ha informado de ninguna de estas cosas. Bebés que tras 15-20 días ingresados, se van de alta sin haber hecho una toma directa al pecho. Mujeres que no han podido apenas tocar a sus hijos mientras estaban en la incubadora. A las que nadie les ha dicho que es importante que estimulen el pecho frecuentemente para mantener o incrementar la producción.
Algunas mujeres consiguen una lactancia directa. Otras, una lactancia más o menos prolongada de forma diferida. En otras, no se consigue retirar los suplementos o que el bebé coja directamente el pecho. A otras, directamente, nadie les informó, nadie les ayudó ni alentó a hacerlo y no se plantearon que fuera posible.
Por favor, informemos a las familias y démosles soporte. La leche humana es el mejor alimento para los prematuros, los más vulnerables, hasta el punto de ser considerado un medicamento. Démosles esa oportunidad, a los bebés y a sus madres.
Porque las mujeres con información, apoyo y confianza, pueden conseguirlo. Si necesitas ayuda, asesoramiento o información, puedes consultar online a nuestro equipo de profesionales. Además, podéis descargar gratis la app de Criar con Sentido Común tanto para plataformas Apple como para plataformas Android, y tenéis una semana gratis para probar todas las ventajas de la membresía a la Tribu, realizar todos los cursos online disponibles y consultar a nuestros/as especialistas.
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Biography of actress anya-taylor-joy Anya Taylor-Joy: personal life, wedding with Malcolm McRae, husband, relationship with parents. Filmography, roles in films and TV series «The Witch», «The Queen’s Walk», new projects and the latest news for 2024.
Biography of actress Anya Taylor-Joy https://anya-taylor-joy-az.com personal life, wedding with Malcolm McRae, husband, relationship with parents. Filmography, roles in films and TV series «The Witch», «The Queen’s Walk», new projects and the latest news for 2024.
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