What Is A Preterm Baby?
- A baby is considered full term if they are born between 37 – 42 weeks gestation. If your baby is born before this time they are classified as premature
- Approximately 8.5% of babies are premature
- Babies are classified as extremely premature if they are born before 28 weeks gestation, this happens to less than 1% of babies
- The gestational age of your baby is important as the more premature they are the less time they have had to develop in your womb – they may need medical support for their heart, lungs, stomach, controlling their body temperature and feeding
- Babies born prematurely may also have a low birth weight, meaning they weigh less than 2.5kg, as they haven’t had the chance to put on weight in the last stages of pregnancy.
Premature Babies’ Nutrient Requirements
Premature babies have a greater challenge in learning to feed than those that are full term, this challenge increases the smaller and younger they are. Those born before 36 weeks gestation have special nutritional needs as they grow more quickly than a full term baby, have immature digestive systems and may not be able to suck properly. Premature and low birth weight babies need their diet to;
- Reflect the nutrition they would be getting if they were still in the womb
- Help them to quickly gain weight
- Provide nutrients in a concentrated form, they can only eat small amount at a time and their immature digestive system is slow to break food down.
Feeding Types And Methods
There are a number of different feeding types and methods that may be used with preterm babies which will depend on their individual needs. These will be managed under medical supervision and include:
Breast milk is best for babies, including those who are preterm, as it is specifically designed to meet their needs and is different to the milk mothers produce for full-term babies. It will contain more protein, calcium and other nutrients than full-term breast milk as it is easier to digest and helps them to maintain a stable body temperature.
When a baby is very immature their mother can express breast milk, store it and when their baby is able to absorb it this can be fed to them via a tube in their stomach.
Human milk fortifier
Sometimes breast milk alone isn’t enough to give your premature baby all of the nutrients they need. Some need extra nutrients such as fat, protein, sugars and calcium which can be added to expressed breast milk in the form of a human milk fortifier.
Formula is another option which may be used to help give your premature baby the nutrition they need. They may be given extra feeds even if you are breastfeeding, these formulas are specifically designed for preterm babies.
If a premature baby is rushed to the intensive care nursery, to prevent dehydration and depletion of electrolytes, they are usually given an intravenous solution made up of water, sugar and electrolytes. Those babies who are very sick will then continue to receive nutrition intravenously until they can handle milk feeds. This is known as total parenteral nutrition (TPN) which is a balance of fat, protein, sugar, vitamins and minerals.
If a baby is delivered between 28 to 34 weeks gestation and they don’t require intravenous feeding, they will often be tube fed when they haven’t yet developed the reflex to suck. A small, flexible tube is placed in your baby’s nose or mouth and goes down to their stomach. Their feeds can then be given in the appropriate amount, whether expressed/fortified breast milk or formula, every few hours.
Tube-feeding helps deliver the nutrients needed to the stomach without the infant requiring to co-ordinate suck, swallowing and breathing rhythm. A Nasogastric tube may be used where the tube enters via their nose or mouth into the stomach. Only used in hospital under medical supervision.