How Should Feeding and Breastfeeding in Premature Babies Be?

As a mother of a premature baby, you may be worried about how to feed your baby, it’s very normal.

But don’t worry, in this article we prepared based on the Premature Baby Care book of Premature Baby Parent Counselor İnci Candemir, you will learn everything you need to know about the nutrition of the baby born with preterm birth.

How is a premature baby fed in intensive care?

Sucking and swallowing reflex of a full- term baby is 33-34. develops in weeks . Breastfeeding is a very demanding job for babies who say hello to life with preterm birth. Therefore, the following methods are used to feed premature babies in neonatal care units:

Nutrition through the vein

Babies born very early are fed with serum on the first day or in the first week. Their digestive systems are bypassed and high-calorie foods are thus mixed directly into their blood.

Nutrition with OGS-NGS

Cathetering method through the OGS (oral) or NGS (nasal) route. Premature baby food and breast milk are given to babies in this way.

sucking feeding

Premature baby who is ready to suckle; It can be fed by mouth, bottle and breast.

Breastfeeding of premature babies is one of the most difficult stages. Babies who are 34 weeks and younger usually have low sucking success to be satiated. In fact, we need to talk about “effective nutrition” here.

Effective feeding, when the mother completely empties the breast or the baby can suckle the amount of milk recommended by the doctor. In the first 5 minutes, the liquid part of the milk comes, premature babies cannot find the strength to pull the next dense consistency.

This does not mean that premature babies cannot breastfeed. Even the exchange of secretions called the “lollipop effect of the mother’s breast” is very useful. 

First increase your love, then your breast milk

İnci Candemir says that after mother’s love, mother’s milk is the most important medicine in the development of premature babies. The coming of milk is associated with suckling. Therefore, as a mother of a premature baby, providing milk is a process that requires patience and determination. But we’re sure you can.

How much breast milk should a premature baby get?

As much as he can get. Net.

How should you express breast milk?

• No matter how early your baby is born, if you milk regularly, you will see some milk coming in 3-4 days after birth. Because your body is programmed to produce milk, your hormones will be working after birth.
• 2 to 6 hours after birth is considered the ideal time to express milk. However, İnci Candemir says that every mother’s health status is not the same and that you should have started to express milk in the first 3-4 days.
• It is imperative that you get a good electric breast pump. Get one of the double-headed and powerful milking models. We’ve reviewed the 10 best electric breast pumps, be sure to read them.
• The amount of milk varies from mother to mother. Don’t worry, although it may seem small, the amount of milk your baby will consume initially will not be much.
• Pay close attention to the hygiene rules. Premature babies are more at risk of contracting infections. Always wash your hands before expressing your milk.
• Sit comfortably with your back straight. Keep any items you may need near drinking water.
• Regular milking is the most important trick of this business. Express your milk with a breast pump for 15 minutes, once every 3 hours. If you can empty your breast completely, after 3 hours, you can ensure the secretion of milk necessary for milking again.

• The speed setting of the electric breast pump should be as follows: lowest in the first 5 minutes, medium in the second 5 minutes, and highest in the last 5 minutes.
• Do not despair if your milk does not come out or if it is less in the first days even though you have been milking regularly. Keep on milking, your milk will definitely come in the coming days.
• Anxiety and stress are your main enemies.
• You should have gotten your sleep and rested. You only need to wake up once a night to express your milk. Night sleep is very important. You need to milk at least 7-8 times a day.
• A balanced and healthy diet is necessary for your milk. You can learn about miraculous foods from our article on Foods That Increase Breast Milk .
• If the conditions are suitable in the neonatal intensive care unit, kangaroo care is very effective in the delivery and quality of your milk.
• You can ask the nurse to give you the dirty cover or underwear used for your baby in the incubator. Keeping these items that carry the scent of your baby with you while you are milking will strengthen the bond between you and your lamb.
• Massage gently around the nipple before and after you start expressing. An effective preparation for milk flow. You can apply a heated damp towel and do the massage with olive oil.
• You can store your milk in the freezer for 6 months, 24 hours after thawing.

How should a premature baby be fed at home?

It is very important for your baby to have contact with the breast. However, for effective nutrition, you should continue to express your milk with a breast pump at home. That’s why feeding your baby with a bottle after milking is the safest method.

Feeding the premature baby with a bottle is, “Oh my God, she has to suckle from my breast.” Much more useful than your idea. Yes, if she can suckle, take whatever, but if she can’t -and she won’t be able to feed for a while because her reflexes haven’t developed- don’t forget that you can feed your baby with a bottle.

Inci Candemir’s suggestions at this point are as follows:

• The safest, most practical and most common method is to give your baby the milk that you express 7-8 times a day with a bottle without the effort of breastfeeding from the breast. This way you will be sure of the amount of milk your baby is getting.
• If your baby is able to suckle from your breast, you should make sure that your breast is completely empty after breastfeeding. Therefore, use the breast pump after breastfeeding.
• If your baby has been able to breastfeed and gain weight for the past 1 week before being discharged from the hospital, you can expect this to continue when you get home.

You should also read this: Everything You Need to Know About Premature Baby Care at Home

How do you know if your baby is being fed effectively?

• If he rests his chin on your breast,
• If you have a long and strong sucking reflex,
• If his mouth is wide and open, his lower lip is turned outward,
• If your cheeks fill up while you suck, if you hear the sound of swallowing,
• If it fully grasps the brown part of the breast,
• Shows endurance without getting tired while sucking,
• If she’s gaining weight
• If she is happy after breastfeeding and sleeps for 3 hours uninterrupted, then things are fine.

The biggest question of breastfeeding mothers: Is my baby getting enough?

Suck, suck, suck, swallow, breathe and take a break

According to İnci Candemir, a healthy diet pattern for premature babies should be as above. It is very important to take a break while breastfeeding your baby. Even if the baby does not show any signs of fatigue during a 30-minute feeding, you should take at least 3-4 breaks.

The feeding frequency of premature babies in the hospital is once every 3 hours. If your baby has reflux, this frequency decreases to once every 2 hours. For this reason, you should feed your baby 8-12 times a day on average.

Don’t leave gassing until after feeding. During the 30-minute feeding period, you should make your baby pass gas at least 2-3 times.

Do you want to get to know him even better: Who are you, Premature Baby?

6 pills information for feeding position in premature babies

1. Bottle feeding is best for premature babies. Create a 45-degree angle between you and your baby, be directly opposite and support your little one from the neck.

2. During this grip, if the baby rests his feet on his stomach, he will be relieved.

3. In the following months, you can move to the side parallel position and rotate to support your baby’s right and left brain interaction. What we mean by rotation is this: With your baby’s left side parallel to you, hold the bottle with your right hand and then do the opposite. The same goes for sucking from your right and left breast.

4. Don’t wait for your baby to turn his head while feeding from the breast. Adjust the position of the breast according to your baby.

5. Making eye contact with your baby is very important to strengthen the emotional bond between you.

6. The semi-swaddling position makes premature babies feel safe as in the fetal position. Freed from involuntary hand-arm movements, the baby can focus more on sucking.

Can premature babies be given pacifiers?

Yeah. Because it is possible to encourage and support sucking reflexes with a pacifier. Normally, pacifiers are not recommended for newborns, but for premature babies, pacifier plays a key role in establishing a relationship with nutrition and improving their abilities.

In the long run, when your baby’s sucking problems decrease, you can set yourself a goal of limiting and quitting pacifier use.

Let’s list the benefits of pacifiers for premature babies as follows:

• Your baby’s hospital stay is shortened.
• It helps in weight gain.
• It has a positive effect on the heartbeat.
• It relaxes your baby.
• It helps to suppress feeding in babies with reflux.

More information here: A-Z What You Need to Know About Pacifier Use for Babies

Which bottle?

İnci Candemir states that the determinant of bottle selection is the baby. Every brand of bottle may not be suitable for every baby. By offering a few alternatives to your baby, you can continue to feed him with the model he likes.

Which bottle should you buy?: 9 Baby Bottle Brands and Models Most Preferred by Moms

How to choose formula for premature babies?

Before you are discharged from the hospital, the nurse will tell you which formula to give your baby.

Formula foods developed for premature babies are usually given to tiny turtles up to 2500-3000 g. Then, with the approval of the doctor, you switch to newborn foods .

For food preparation, pay attention to the following:

• Wash your hands thoroughly before preparing food.
• Boil and cool the clean drinking water you will use in the food for 10 minutes beforehand.
• Stick to the measuring spoon. Do not over or under feed.
• Pre-boil and cool the bottle in which you will put the formula.
• Shake the bottle until the formula is well dissolved in the water.
• The food that is opened should be consumed within 4 weeks at the most, keep in mind.

Premature baby foods have different ingredients and flavors. Try different brands if you have gas problems or your baby doesn’t want to eat.