Importance of Feeding Premature Babies Enough Milk
Premature babies are small at birth, and may not be able to tolerate milk feedings right away. Although IV feeding provides important nutrients that help your baby grow stronger, babies grow much better from milk feedings than from IV fluids. Because of this, many preemies don't grow well in the NICU and are small for their age when they are discharged from the hospital.
Good nutrition does more than just help preemies to grow longer and heavier. Milk feedings help preemies' brains to grow. Premature babies who get better nutrition early in life have bigger brains and fewer developmental delays as they get older.
To help their brains grow, it's important for preemies to have good catch up growth in their first months of life. Ideally, catch up growth should happen by the time a baby is 3 months corrected age. This means that, by 3 months after a preemie's original due date, he or she should be somewhere in the average range for height, weight, and head circumference measurements.
What Type of Milk Should I Be Feeding My Premature Baby?
Breast milk is best for babies, including preemies. To help make sure your baby is getting enough protein and calories for catch up growth, your doctor may recommend that you add human milk fortifier (HMF) to some or all of your milk. Once your baby has good catch up growth, talk to your doctor about switching to exclusive breastfeeding or regular breast milk.
If you are formula feeding, your baby may need a special preemie discharge formula. Preemie discharge formula has more protein and calories than regular formula, and is available at most supermarkets and throught WIC with a doctor's note. Brands of preemie discharge formula include:
- Similac Neosure
- Enfamil Enfacare
- Cow & Gate Nutriprem 2
How Much Milk Should My Baby Drink?
Most breastfed newborn babies breastfeed about 8 to 12 times per day, or about every 1 1/2 to 3 hours. Bottle fed newborn babies drink about 1 1/2 to 3 ounces of milk every 2 to 3 hours.
When you're figuring out how much you should be feeding your premature baby at home, talk to NICU staff about how much your baby was eating in the hospital. Neonatologists use complex equations to figure out how many calories a preemie should be eating for good growth, and won't discharge a baby until he is eating at least that much. If your baby is drinking at least as much in the early days at home as he was in the hospital, he should grow well.
If your baby is not getting enough milk, he or she will show signs of dehydration, including:
- Fewer than 6 wet diapers in a 24-hour period
- Sunken eyes
- Sunken fontanelles (soft spots)
- Crying with no tears
Regardless of whether you are breastfeeding or bottle feeding with formula or breast milk, your baby will look healthy and will grow well if he or she is getting enough to eat. Take your baby in for regular pediatrician visits so your baby's doctor can weigh him and measure his length and head growth.
Encouraging Your Preemie to Eat More
If your baby seems to be taking in less milk at home than he or she was in the hospital, or isn't growing well, talk to your pediatrician about how to get your baby to eat more. Whether you're breastfeeding or bottle feeding, the following tricks may help:
- Feed your baby as soon as he's hungry: Crying is a late hunger sign. Babies may breastfeed better or drink more milk if you feed them as soon as they begin to look hungry. If your baby is sucking on his fist or gumming her blankets, offer a feeding.
- Make sure your baby is fully awake: If your baby tends to fall asleep during feedings, try to keep him awake and interested. Sit your baby up to bottle feed, or play with his toes during breastfeeding. If your baby falls asleep but you think he's still hungry, wake him up with a diaper change.
- Burp your baby during feeding: If your baby's belly is full of air, there won't be room for milk. Burp your baby midway through a feeding, or whenever he starts to slow down.
- Use breast compression: If you're breastfeeding, compress the breast at the end of a feeding to enourage your baby to drink every drop of high-calorie hind milk.
American Academy of Pediatrics. "Breastfeeding Initiatives FAQs" Accessed 12/19/11 from http://www.aap.org/breastfeeding/faqsbreastfeeding.html
Cooke, R. "Nutrition of Preterm Infants After Discharge." Annals of Nutrition & Metabolism 2011(suppl 1): 32-36.
ESPGHAN Committee on Nutrition. "Medical Position Paper: Feeding Preterm Infants After Hospital Discharge." Journal of Pediatric Gastroenterology and Nutrition May 2006; 42, 596-603.
Kids Health from Nemours. "Formula Feeding FAQs: How Much and How Often." Accessed 12/19/11 from http://kidshealth.org/parent/pregnancy_newborn/formulafeed/formulafeed_often.html#
March of Dimes. “When to Call Your Baby’s Doctor.” Accessed 6/25/09 from http://www.marchofdimes.com/baby/sickbabycare_calldoctor.html