How to Feed Premature Babies?

How to Feed Premature Babies?

The addition of a newborn to the family brings immense joy to everyone. However, for babies who arrive before the expected due date, new parents experience not only delight but also anxiety and concern. How should we feed a premature baby? To address this, the following relevant knowledge is provided.

(1) What milk is best for premature babies after birth?

Premature babies have limited innate nutrient reserves and require rapid growth after birth, necessitating more nutrition. However, their gastrointestinal tracts are not yet fully developed, leading to poor digestive and absorptive capacities. Therefore, it is best for premature babies to be fed with breast milk. The composition of breast milk for premature babies is superior to that for full-term babies, facilitating digestion, absorption, maturation of gastrointestinal functions, enhanced immune response, and beneficial neurodevelopment. Human milk has an osmotic pressure close to isotonicity, placing a light burden on the kidneys, making it more suitable for premature babies. Breastfeeding extremely low birth weight premature babies can also prevent rickets, growth retardation, and impaired cognitive abilities.

Early and frequent breastfeeding is recommended: Breast milk secretion may be delayed after premature birth, making it essential to initiate breastfeeding as early as possible and encourage frequent suckling to promote milk production. Early suckling also activates the gastrointestinal tract of newborns, facilitating the digestion and absorption of nutrients. However, premature, low birth weight infants generally achieve coordinated sucking and swallowing functions by around 34 to 35 weeks of gestational age. Premature babies born before 34 weeks may have difficulty suckling and might require feeding via a dropper. Research has shown that early oral feeding of premature babies with breast milk can promote the formation of gastrointestinal hormones and secretion of digestive enzymes, leading to faster weight gain.

However, for premature babies with smaller gestational ages and birth weights, the nutrients obtained solely from breast milk may not suffice. Relying solely on breastfeeding might lead to poor growth and skeletal development. Therefore, it is necessary to use breast milk fortifiers to ensure the baby's rapid growth. Breast milk fortifiers contain proteins, minerals, and vitamins, which are added to breast milk in specific proportions and then fed to the baby (never add directly to water or formula milk). For babies with gestational ages less than 2000 grams at birth, continued use of breast milk fortifiers after discharge is required until they reach a corrected age of 40 weeks (calculated from the expected due date). Subsequently, regular hospital visits for growth monitoring will help gradually discontinue the use of breast milk fortifiers and transition to exclusive breastfeeding.

(2) Feeding methods for premature babies

Clinical practice has demonstrated that when premature babies' abdomen exhibits bowel sounds after birth, indicating the initiation of intestinal peristalsis, oral feeding can be given, and the passage of meconium serves as an indication of the start of oral feeding. In the past, early oral feeding for premature babies with a history of perinatal asphyxia, dependence on artificial mechanical ventilation, and sepsis was thought to lead to necrotizing enterocolitis. However, subsequent research has proven that as long as premature babies do not have hypoxemia, metabolic disorders, shock, vomiting, abdominal distension, etc., they can receive oral or gavage feeding.

For premature babies, when their sucking, swallowing, and breathing are well-coordinated, they can begin self-feeding. However, due to their small stomach capacity, each feeding may not be as substantial as for full-term babies. Additionally, premature babies may get tired easily during feeding, with frequent starts and stops and breaks between feeding sessions, which is normal. Sometimes premature babies may experience choking while feeding, requiring utmost patience and attentiveness while feeding to avoid choking and spitting up. For breastfeeding, the baby may choke because the mother's milk is abundant and flows rapidly, and the baby may not be able to swallow quickly enough. In such cases, the mother can gently press the areola around the nipple to slow down the milk flow. For artificial feeding, it is crucial to choose an appropriate nipple. A nipple that is too large can cause choking, while one that is too small might make sucking difficult. If a baby seems to be in a hurry while feeding and starts to breathe rapidly, allow the baby to take a break, catch their breath, and then continue feeding. It is best to ensure sufficient milk intake every day, aiming for a daily weight gain of 30-40 grams for the baby.

Full-term babies usually begin complementary feeding at around 4-6 months of age, but for premature babies, complementary feeding should be adjusted based on their corrected age of 4-6 months. For instance, if a baby is born at 32 weeks, starting complementary feeding at 5 months of age based on their actual birth age would be too early. This is because their corrected age is only 3 months, and their gastrointestinal development is not sufficient. Adding complementary food at this stage can cause diarrhea and affect the baby's health and normal development.