Feeding a Preemie in the NICU: What You May Not Know
When your baby is in the neonatal intensive care unit (NICU), so much of what is happening both to and around your preemie can feel out of your control. The unfamiliar surroundings, the medical terminology, and the requirements for your little one’s health will likely leave you with many questions — including how your baby will be fed if they are too premature to nurse or bottle-feed.
As a NICU parent, it’s important to know that you do have a voice in the decisions affecting your baby’s health and that you can advocate for the best possible nutrition to help your preemie grow and thrive. Below are five things about feeding a baby in the NICU that many preemie parents may not realize, with answers you may be surprised and relieved to learn!
Learning to eat can be challenging.
You may be wondering when your baby will be able to breastfeed or bottle-feed as planned, but know that for preemies, eating requires a learning curve. Preemies must first learn to suck and swallow, and then learn to coordinate the two while continuing to breathe. That can be a lot for such a small baby to grasp! Understand that it will take time for your preemie to get a handle on these new skills in order to nurse effectively —for some it comes quickly, while for others, it can take much longer.
Fed is best.
While you may not be able to feed your baby directly through breast or bottle right away, remember that fed is best, no matter how your baby eats. Before breast or bottle, your preemie will likely eat through an IV first, then through a tube inserted into the nose or mouth and passed through to the stomach. Try not to feel guilty about not being able to feed your baby yourself — as mentioned above, learning to eat like a full-term baby takes time.
You can still give your baby breast milk.
Breast milk is full of antibodies and nutrients that offer premature babies a world of benefit in protecting against illness and providing fuel for growth. Don’t be discouraged if your little one is not able to nurse in the NICU! Your breast milk is still the very best thing for your preemie, which is why most NICUs provide a breast pump so that you can pump your milk. In fact, the American Academy of Pediatrics (AAP) recommends breast milk for all preemies, either mom’s own milk or donor breast milk (if mom’s milk is unavailable or supply is inadequate).
Your milk may need a boost.
While your breast milk is vital for your baby, preemies need extra calories, protein, and nutrients to thrive. That is why the AAP recommends adding a "human milk fortifier" to mom’s own milk or donor milk. However, it’s important to know that not all of these fortifiers are made from human milk! Actually, many human milk fortifiers are made from cow milk, which has been known to increase the risk of severe complications in premature infants. Ask your baby's care team about adding a fortifier made with 100% donor human milk by Prolacta Bioscience to your baby's breast milk instead of the standard cow milk-based fortifier.
Forcing a feeding is not helpful.
Your baby will move at their own pace while learning to eat, so remember that forcing a feeding will not speed things up. In fact, trying to encourage a feeding that doesn’t come naturally could increase the chances of your baby developing an “oral aversion,” in which babies refuse anything in their mouths, including a breast or a bottle.
There is nothing more important as a preemie parent than to remember to be gentle with yourself and your little one. This new experience can have a steep learning curve for everyone involved, but by equipping yourself with the right knowledge, you will feel much more prepared to make important decisions and advocate for the best nutrition for your baby in the NICU.
Kaitlyn Kirby is a mother of one and an award-winning content creator for all things related to modern parenting.