Premature infant's inability to feed orally

Before the gestational age of 32 to 34 weeks, a premature infant cannot feed by mouth because of:

• Poor coordination (or lack) of sucking, swallowing, and gag reflex.
• Weakness of both the oral and stomach muscles.
• Small stomach capacity.

Until the premature infant becomes stronger and more mature, gavage feeding is used to feed milk, formula, or a combination of the two directly into the stomach. For the infant whose gastrointestinal tract cannot yet digest properly or is affected by necrotizing enterocolitis, intravenous (parenteral) feedings are given through a tube into the umbilical site (umbilical catheter) or into a vein.

When the infant is mature enough to feed from a nipple, oral feedings are introduced. As the infant grows stronger, oral feedings are gradually increased over a period of days or weeks. Many infants born at about 34 gestational weeks are able to feed completely by mouth.

The premature infant has higher-than-usual energy demands on his or her system after birth. Whether an infant is breast-fed, bottle-fed, tube-fed, or fed parenterally, a high-calorie supplement may be added to his or her diet to maximize growth and healing.