Life After the NICU—Nutrition
The feeding and nutrition of your baby is an important part in making the transition from hospital to home. Just like for any other baby, the best source of nutrition for your premature baby is breast milk. It is easier to digest, sterile, warm, and inexpensive. Also it provides excellent immune factors that aren’t in formulas.
If your baby cannot breastfeed, you can store expressed breast milk for up to two weeks in the freezer compartment of your refrigerator, or for up to six months in a deep freeze. If extra nutrients (i.e., protein, calcium, phosphorus) are being added to your breast milk, this will usually be stopped before you go home.
If you are not breastfeeding, you’ve probably been feeding your baby with a premature formula. Premature formulas contain extra protein, vitamins, and minerals. They’re also modified to be more easily digested in an immature bowel. Usually, by term (i.e., your original due date) or by discharge, your baby will be changed over to regular formula.
Vitamin and Mineral Supplementation
Breastfed babies need a vitamin D supplement. Iron supplements might be needed for preemies. Baby formulas are already supplemented with iron and vitamins, so no additional supplements are necessary.
Is your baby drinking enough?
Growth is very important for the preterm infant. You, your dietitian, and your doctor will be following the growth of your baby by keeping track of weights and lengths on a growth chart using corrected age (if applicable).
Signs your baby is dehydrated may include: soaking less than 5 diapers and day and having strong smelling urine.
Regular formula and breast milk contain 20 calories per ounce, but your baby may require 24, 27, or even 30 calories per ounce. This is done by adding less water to the formula concentrate or by adding extra fat or carbohydrate to formula or breast milk. The dietitian will give you the proper mixing instructions. You should not give you baby whole cow’s milk (homogenized) until 12 months corrected age (c.a.).
When you’re successful:
- There is a comfortable latch.
- There are long, slow jaw movements during the suck.
- You can hear swallows.
- Even when you baby fusses at first, he’ll settle into a calm latch and focus on feeding.
- Your baby is full and settles after feeding.
- Your baby sleeps 1 ½–3 hours after feeding.
- Your baby soaks at least 5 diapers a day.
- Your baby has soft yellow bowel movements that might be every few days or more often.
- Your baby shows regular weight gains when you visit your doctor, midwife, or breastfeeding clinic.
When you need help:
- You have painful nipples or breasts, with or without the latch.
- Your baby is always making fast sucking movements when she is latched.
- You don’t hear swallows.
- Your baby feeds for a few minutes, comes off the breast often, and is very fussy. He may just fall asleep without feeding.
- Your baby seems more tired and less energetic than “normal”.
- Your baby never settles into that calm, focused feeding position.
- The baby soaks less than 5 diapers a day and urine may look darker than usual.
- His bowel movements might look dry or hard.
- Your baby is not gaining weight regularly.
Signs That Your Baby is Hungry or Full
In early infancy, babies fuss, make sucking movements, put their mouths on anything close, and turn their heads toward the food source, opening the mouth as the cheek is touched. The young baby tells us he is full by falling asleep and pulling off the nipple. The baby may have a calm look on her face and look away from the caregiver. Occasionally, she may actually spit up or choke and cough.
Within several months, the baby will suck on his hand and lean forward to the breast or bottle when hungry. When full, the maturing baby will let go of the nipple and pull the head away. He may bite the nipple, arch his back and look around at his surroundings.
Now, read about promoting development.
“The Next Steps? Caring for your Preemie at Home” with permission from the Canadian Institute of Child Health.