If your premature infant was born before the gestational age of 32 to 34 weeks, he or she cannot feed by mouth. This is because of:
- Poor coordination (or lack) of sucking, swallowing, and gag reflex.
Weakness of both the oral and stomach muscles.
- Small stomach capacity.
Until your infant becomes stronger and more mature, tube 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 your infant is mature enough to feed from a nipple, oral feedings are introduced. Over a period of days or weeks, you can gradually replace more tube or IV feedings with breast-feedings.
Premature infants, including those born at 34 to almost 37 weeks, often have trouble with oral feedings and may need extra help.
In some cases, doctors advise adding a thickening agent to a baby's milk. Talk to your doctor about the risks and benefits before using one. If at any time you are having trouble feeding your baby, talk to your doctor or nurse about it.
Breast-feeding your premature baby
Your infant will probably need to start slowly with breast-feeding. Usually, one or two breast-feedings a day are enough to start. As your baby gains strength and weight, you can start to feed from the breast more often. When your baby is stronger, try to feed your baby directly at the breast for all feedings. If needed, you can use a syringe, cup, or other device to feed breast milk to your baby.
Premature infants can have trouble learning to breast-feed. If you find yourself feeling frustrated or worried about it, get help. Both the nurses and your lactation consultant have years of experience with feeding problems.
As your infant feeds more by mouth, you may not be there for all of your baby's oral feedings. So your infant may need to bottle-feed too. Work with the nurses and lactation consultant to decide whether and when to introduce a bottle. This may help your baby avoid nipple confusion, which is a baby's preference for an artificial nipple over the breast.