Premature baby feeding
- Premature babies need to eat at least every three hours. Tiny babies have tiny tummies. This means they’ll have to eat a lot of small meals for them to gain weight.
- Your baby will eat at their own pace. While they may be eating every three hours, the premature baby feeding process is often slow. You'll soon recognize their pattern of swallowing and breathing. Babies who eat slowly seem to take more milk at each feeding and may be satisfied and sleep longer between feedings.
- Their mouths are often extra-sensitive. If your baby has spent their first few days with tubes and respirators in their mouth, they may assume that anything that goes into their mouth is painful, which could include a breast or a bottle.
- Premature babies are slow to feed. Feeding them too fast by mouth may result in a feeding aversion or spitting up. They are also likely to have more digestive issues than a full-term baby, since their digestive system may not be as mature as a full-term baby's.
Try these premature baby feeding tips
- Each baby is unique. Follow the advice of your baby's doctor.
- Introduce your baby to a nipple. Even if they are still feeding by tube, this will help them adjust to bottle-feeding when they’re ready. You may need to try different nipples at first.
- Stick to breast milk or one type of formula and nipple to help them adjust.
- Keep a record of your baby's feedings.
- Get growth charts, specially designed for premature babies, from your baby's doctor to help monitor their progress.
- Keep your baby on a fairly regular schedule of awake and nap time, to help them eat better.
- Make sure your baby is fully awake before feeding.
- Don't force your baby to eat. If they’re not sucking as fast, sealing their lips or turning away, they may be full.
- Feed them on demand, not a schedule. Studies have shown that premature babies grew at a faster pace when fed on demand.
- When your baby is developmentally ready, slowly introduce solid foods while they are still on formula.
- Enlist the help and support of family and friends, to give yourself a break.
Preemie Nutrition
Most premature babies have low birth weight.
If a baby is too premature to breastfeed, moms are encouraged to pump their milk, as breast milk is considered to be best for the baby. Sometimes, doctors will recommend using a breast milk fortifier, to help give your baby the extra protein, vitamins, calcium and other nutrients they need at this early stage.
If you can't pump or breastfeed, or choose not to, ask your baby’s doctor about the specially designed formulas available for premature or low birth weight babies.
Premature babies may have more digestive issues than full-term babies.
Chances are, your baby’s feeding skills haven't fully developed yet. This means they’ll likely be slow to feed, or they may feed too fast and spit up or develop a feeding aversion. But there are some things you can try to help:
- Introduce your baby to a pacifier. This can help get them used to the feeling of bottle-feeding for when they’re ready to switch over from the tube.
- Record their feedings, so you can keep track of spit ups and how much they’re keeping down.
- Monitor your preemie’s progress with growth charts from the doctor.
- Try to keep them on a sleep schedule.
- Make sure they are fully awake before feeding
- Be aware of indicators, so you know when your little one is full or tired.
- Slowly introduce solids when they are developmentally ready.
Babies who are born premature often undergo developmental testing and programs.
If your baby weighs less than 3.5 lbs. at birth, they will most likely be referred for formal developmental testing around their 1st and 2nd birthdays. If your baby is born prematurely, your doctor may recommend an infant stimulation program. This usually involves working with a physical therapist or specialized healthcare professional to learn gentle exercises, positioning and other ways to interact with your premature baby and help them with physical development. Early intervention programs can help with social and functional skills and provide support for the family.
Preterm babies have a harder time maintaining the proper water balance in their bodies. These babies can become dehydrated or over-hydrated. This is especially true for very premature infants. Keep the following preemie nutrition facts in mind as you navigate feeding your baby:
- Premature babies may experience more water loss through the skin or respiratory tract than babies born at full term.
- The kidneys in premature babies have not grown enough to control water levels in the body.
- The NICU team keeps track of how much premature babies urinate (by weighing their diapers) to make sure that their fluid intake and urine output are balanced.
- Human milk from the baby's own mother is the best for babies born early and at very low birth weight.
- Human milk can help babies avoid infections and sudden infant death syndrome (SIDS) as well as necrotizing enterocolitis (NEC).
- Many NICUs will give donor milk from a milk bank to high-risk babies who are not able to get adequate amounts of milk from their own mother.
- Special preemie formulas can also be used. These formulas have more added calcium and protein to meet the special growth needs of premature babies.
- Older premature babies (34 to 36 weeks gestation) may be switched to regular formula or a transitional formula.
- Babies who are given breast milk may need a supplement called human milk fortifier mixed into their feedings. This gives them extra protein, calories, iron, calcium, and vitamins. Babies fed formula may need to take supplements of certain nutrients, such as vitamins A, C, and D, and folic acid.
- Some infants will need to continue taking nutritional supplements after they leave the hospital. For breastfeeding infants, this may mean a bottle or two of fortified breast milk per day as well as iron and vitamin D supplements. Some babies will need more supplementation than others. This may include babies who are not able to consume adequate amounts of milk through breastfeeding to get the calories they need to grow well.
- After each feeding, babies should seem satisfied. They should have 8 to 10 feedings and at least 6 to 8 wet diapers each day. Watery or bloody stools or regular vomiting could indicate an issue and you should discuss them with your doctor.
Preemie Weight Gain
Weight gain is monitored closely for all babies. Research suggests developmental delays could be associated with premature babies who experience slow growth.
- In the NICU, babies are weighed every day.
- It is normal for babies to lose weight in the first few days of life. Most of this loss is water weight.
- Most premature infants should start gaining weight within a few days of birth.
- The desired weight gain depends on the baby's size and gestational age. Sicker babies may need to be given more calories to grow at the desired rate.
- It might be as little as 5 grams a day for a tiny baby at 24 weeks, or 20 to 30 grams a day for a larger baby at 33 or more weeks.
- In general, a baby should gain about a quarter of an ounce each day for every pound (about 1/2 kilogram) they weigh. (This is equal to 15 grams per kilogram per day. It is the average rate at which a fetus grows during the third trimester).
If you are experiencing difficulty affording specialty premature formulas for your baby, financial assistance is available.
Enfamil has developed a program called Helping Hands Sample Assistance, to help families who need specialty formulas for their premature baby but have difficulty affording them. Depending on your needs, the Helping Hand program provides either long-term assistance or a free, one-time shipment of products. To us, all babies deserve the very best start in life. Ask your doctor if you qualify for this program.
