How to feed premature babies?

How to feed premature babies?

Babies who undergo a premature birth require extra nutrition. It is crucial to provide them with the best possible nutrition as they continue to develop outside the womb. Breast milk could be the most probable and ideal nutrition for them.

However, premature babies may not be able to breastfeed directly. Their nutrition depends upon how premature the baby is and on whether they have other medical problems or not. The nutritional sources may vary and evolve as the baby grows older.

This article discusses some of the ways in which premature babies are fed in the early weeks.


Breast milk is the best possible feed for any newborn baby. It has many advantages over other methods of feeding. Breast milk protects the baby from infection and offers many long-term health advantages for both baby and mama. It reduces the likelihood of severe eczema, obesity, diabetes, gut problems, and sudden infant death. Moreover, it protects the mother against conditions like breast cancer, ovarian cancer, and diabetes.

Note that the babies born earlier than 34 weeks of pregnancy are likely not to be able to breastfeed directly. This is because sucking, swallowing and breathing is something all babies have to learn, and these babies are very small or premature to have the strength or coordination to manage this. They may intake breast milk or formula milk through a tube passing into their tummy via their nose or mouth. Extremely early, small or sick babies may need to be fed via a tube going into the vein at first.

Supplementing breast milk

As premature infants have different nutritional demands, thus in addition to breast milk vitamins, minerals, and proteins may be needed as fortifiers or separate supplements. Specially designed formula milk are available for premature babies. Donor-expressed milk and extra nutrients through a tube into the vein can also supplement the nutrients.

Note, in case of breast milk fortifiers, babies must undergo regular blood tests to check the levels of salts, minerals, etc. Talking about premature baby formula milk, it has extra nutrients to cover the extra demand and is first given by tube through the nose or mouth. Once the baby is able to suck and swallow a bottle feeder can be used.

Tube-feeding premature babies

The premature babies, unable to feed on the breast or bottle, are fed via a tube. It is a nasogastric tube that goes in through the nose, delivers the feed down to the baby’s tummy or stomach.

In addition, there is an orogastric tube that goes into the tummy through the baby’s mouth. The feed may consist of expressed breast milk, fortified breast milk or formula milk.

During tube-feeding, mothers are supposed to try “kangaroo care.” It is skin-to-skin contact between the mother and the baby which helps the bonding and closeness between the two.

Total parenteral nutrition

Very premature and sick babies are subjected to Total parenteral nutrition (TPN). All the nutrients are fed via a tube into a vein, sometimes through the belly button (umbilicus) into the vein there. This is preferable when the baby’s guts are not developed enough to deal with the feeds passing through the digestive tract. It also opts during necrotizing enterocolitis. Once the baby develops healthy guts, then tube-feeding can gradually replace TPN.

What can be the possible problems?

There are certain feeding problems in premature babies that may include colic and reflux etc. Premature babies may be more likely to get colic in the early weeks. A baby with colic may experience tummy ache, but it is not known for sure. On the other hand, reflux is a common condition characterized by the backward flow of milk from the stomach into the gullet. It may affect weight gain, and the baby may seem unsettled and cry a lot.

In any of the case, consult a child specialist for expert advice.


The author is a Medical Microbiologist and healthcare writer. She is a post-graduate of Medical Microbiology and Immunology. She covers all content on health and wellness including weight loss, nutrition, and general health. Twitter @Areeba94789300

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