Many first-time moms feel some degree of trepidation about feeding their newborns. Mix in the special nutritional demands of preemies, and those feelings of anxiety can easily become overwhelming. Babies born before 37 weeks of pregnancy are considered premature, and the earlier your baby is born, the more complications he is likely to have, including with his feeding habits. Depending on how early they are born, preemies might have nutritive complications resulting from low body fat, low blood sugar and jaundice, and because their digestive systems and reflexes are not yet fully developed, they may not yet be able to be fed from a bottle or breast. As such, there is no doubt that you will want to learn as much as you can about your tiny tot's nutritional needs so that you're fully prepared to care for him once he's home.
Milk Supply
To ensure that he is being nourished properly, it is likely that your preemie will initially spend time in a neonatal intensive care unit (NICU) and may even require a feeding tube. If you've had your heart set on breast-feeding, you may be dismayed and even feel a sense of loss to learn that your little one doesn't quite have the ability to latch on yet. Still, all hope is not lost. According to Amy Sullivan, R.D., L.D.N., C.D.E., a clinical dietitian at Children's Hospital of Pittsburgh, "The mother can pump as soon as she can — and should pump often to help bring in a good supply of milk. The mother should freeze the breast milk as soon as she pumps it. Then, when the physicians feel the baby is ready for breast milk, around 32 or 34 weeks, they can begin to use it."
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Supplementation
Because preemies are so small — they are usually weighed in grams, not pounds and ounces — they typically require nutritional supplementation in addition to your breast milk or formula. "Sometimes the babies are tube fed so that nutritionally they are not compromised," said Sullivan. "However, if there isn't enough breast milk, then the doctors may also supplement with formula." No matter how they are fed at first, nearly all premature babies need to receive extra vitamins and minerals, including calcium and phosphorus, which are typically added to breast milk or delivered through the use of formulas that are specially designed for preemies.
Breast- and Bottle-Feeding Readiness
Once your babe reaches that 32- to 34-week mark, the doctors may give you the green light to begin breast or bottle feeding, as it is around this time period that the baby develops the sucking reflex needed to "latch on" to a breast or bottle. "At first, feedings are usually every two to three hours, starting with a couple of ounces," said Sullivan. "From there, the doctors will determine if the baby is tolerating the feedings well." While your baby is still in the hospital, his blood levels will continue to be monitored to help ensure that he is meeting his nutritional targets and growing at an acceptable rate.
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Bringing Baby Home
Whether it's been days, weeks or months since his birthday, you're finally ready to bring your babe home from the hospital. You're excited, overwhelmed with joy — and incredibly anxious. While this nervousness is certainly understandable, you should take comfort in the fact that most hospitals will arrange a "well visit" soon after your baby comes home to check on his growth. "Continuing to check the amount of feedings and ounces per day is key," said Sullivan. "You can also tell how well a baby is doing by the number of wet and soiled diapers he's having a day. This also will help if the baby becomes constipated." Moreover, Sullivan says, in some states, such as Pennsylvania, a baby's progress is tracked through early intervention programs. "Parents has every right to contact their program if they feel that their baby isn't meeting milestones or if they would like an evaluation. This is another way that helps the parents have peace of mind that their little one is doing just fine," she said.
