Premature infants, or preemies, are not uncommon, so don’t panic if you have one.
Caring for a preemie will be more challenging, but by providing him with the right nutrition, he has a much higher chance of growing up normally.
Preemies are delivered before 37 weeks of gestation or pregnancy, while deliveries after that are considered to term.
Globally, it is estimated that one in 10 infants are born prematurely.
A common concern mothers have about their preemie is their nutrition and growth.
Start with breast milk
Preemies are often low birth weight (2.5kg and below) and have special nutritional requirements, as their bodies have not yet stored sufficient energy and nutrient reserves.
They also suffer from illnesses related to immaturity, such as acute lung disease.
It is of great help if moms are able to provide colostrum (the first stage of breast milk) as early feeds to their preemie as soon as possible.
This will help to prime and protect baby’s gut. Colostrum also contains antibodies that help protect your preemie from infections.
In many developed countries, when moms cannot provide their own breast milk, they can opt to use donor breast milk, which is collected and handled by accredited milk banks.
Preemies delivered before 34 weeks of pregnancy tend to have oral feeding difficulties such as sucking, swallowing and coordinating with breathing, as well as impaired gut motion, due to their immature body functions.
Thus, they are usually fed via a tube directly into their stomachs in the first week or two.
A special solution called total parenteral nutrition, which contains a blend of nutrients to support their energy needs and growth, may also be infused into their bloodstream.
Unlike term infants, preemies have a higher energy and nutrient requirement.
When your preemie has achieved sufficient breast milk feeds, your doctor may prescribe the adding of human milk fortifiers (HMF) to your expressed breast milk in order to ensure that your preemie receives the optimal nutrition needed to “catch up” on her growth.
However, if your supply of breast milk is insufficient, a special preterm formula may be given instead.
Bringing preemie home
In Malaysia, most hospitals allow preemies to be discharged when they show good consistent weight gain, have reached at least 1.8kg, are able to take milk from the breast or bottle, and have reached a corrected age of 36 weeks.
Proper nutrition is important to ensure adequate overall growth throughout and to reduce the risk of faltering or slow growth.
Most importantly, continue breastfeeding your preemie.
In some cases, your preemie may still require HMF. This is especially true in the case of very low birth weight (VLBW) infants that weigh below 1,500g at birth.
If your breast milk supply is still insufficient, you may need to add on a post-discharge formula (PDF) to top-up on the feeding.
However, if breastfeeding is not an option or if there is no breast milk available at all, your doctor may recommend the use of PDF alone.
PDF is meant for premature, low birth weight infants and is used after hospital discharge within the first year of life, until normal growth (age-corrected) is achieved.
Monitor baby’s growth
Monitor and keep track of your preemie’s growth closely.
Certain nutrients are important to help him catch up on his growth. He needs a higher intake of energy, protein, minerals and vitamins.
You probably know the benefits of omega-3 and omega-6 polyunsaturated fatty acids such as docosahexaenoic acid (DHA) and arachidonic acid (AA); they are important for eye and brain development.
Although many milk formulae contain these nutrients, breast milk is superior as it has the correct ratio for your preemie’s individual needs.
In larger preemies, exclusive breastfeeding alone may be enough. However, follow-up in clinics is recommended for periodic checks to ensure that your preemie has sufficient nutrients to support bone growth.
To keep in mind
Breast milk is still the best choice for all infants.
If your preemie’s growth is satisfactory, your doctor may recommend that you switch to exclusive breastfeeding and stop adding HMF.
If not breastfeeding, PDF use may be substituted with a normal milk formula.
At six months corrected age, start complementary feeding to meet your preemie’s nutritional and growth requirements.
Importantly, continued breastfeeding within the first year is strongly encouraged.
Note that while good and adequate nutrition is necessary for proper growth and development, an excess of nutrition can lead to obesity.
This will have a negative impact on your preemie’s health later in life.
Lastly, do not miss any clinic appointments!
These visits will allow your doctor to monitor your preemie for proper growth and development.
You can also consult with your doctor for advice on providing the right nutrition, at the right amount, at the right time for your precious child’s healthy growth.
Professor Dr Cheah Fook Choe is a senior consultant neonatologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email email@example.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.