Nutrition in Preterm Babies

Since low-birth weight infants are in a precarious situation, nutrition is even more critical for growth, metabolism, and immunity.

Studies have shown that poor nutrition is associated with poorer head growth; persistent smaller head size results in poor psychomotor and mental skills, higher rates of cerebral palsy, and autism. Impaired weight and growth in preterm infants are significantly associated with adverse neurodevelopmental outcomes in later life. Barker’s hypothesis also states that infants with LBW (low-birth-weight) are at a higher risk of coronary heart disease, hypertension, and type 2 diabetes in adulthood.

Get Aggressive in Nutrition

It has been noted that better nutrition in the early postnatal phases in preterm infants results in higher verbal intelligence quotient (IQ) scores and improved cognitive function in the long term. Higher protein and energy intake during the first week after birth in extremely LBW (low-birth-weight) infants is associated with higher mental development index scores and lower risk of growth retardation at 18 months after birth. Early and higher protein and energy intake have also been correlated with faster head growth and an increase in head circumference in preterm infants ; increase in head circumference has been positively correlated with improved cognitive outcomes. Therefore, the administration of early aggressive nutritional enteral and parenteral support may help improve growth and developmental outcomes in preterm newborn LBW (low-birth-weight) infants.

What are preemies and low-birthweight babies nourished with?

Whether fed through gavage or nipple, your tiny baby will get either breast milk, fortified breast milk, or formula.

Breast Milk

Yes, breast milk, like for full-term babies, is also ideal for preterm babies. Mum’s body prepares a different kind of milk when she delivers before pre-term! Her milk contains more protein, sodium, calcium, and other nutrients than full-term breast milk does.

This composition prevents tiny babies from losing too much fluid, which helps them maintain a stable body temperature. It’s also easier to digest and helps babies grow faster.

In addition, Colostrum (early breast milk) is extremely rich in antibodies and cells that help fight infection.

This is especially important when babies are sick or premature and may have a higher chance of developing an infection.

Research has shown that breastfed preemies have a lower risk of developing necrotizing enterocolitis, an intestinal infection unique to preemies. They also tolerate feedings better, have a lower risk of allergies, and receive all the benefits that a full-term baby gets from breast milk. Don’t worry if you are getting only tiny quantities of milk - it is enough for the baby.

To ensure your baby is still getting enough nutrition in the early stages of breastfeeding (when baby’s suck may still be weak or your breasts are not producing sufficient amounts of milk), talk to the doctor about the following supplemental feeding methods that don’t interfere with nursing.

Supplemental Nutrition System

If you’re nursing, you can, nurse with the gavage still in place and also tape a tube near your nipple (called the supplemental nutrition system) if your doctor advises.

Pumping

If, for some reason, you choose to pump and feed, the options you can choose from are using a bottle with the gavage still in place, using a feeding system taped to your finger (finger feeding), feeding the milk using a syringe or choosing a special bottle that has slow-flow milk,

In the final analysis, it is clear that evidence indicates that human milk (HM) is the best form of nutrition uniquely suited not only to term but also to preterm infants giving health benefits in both the short and long-term. However, HM does not provide sufficient nutrition for the very low birth weight (VLBW) infant when fed at the usual feeding volumes leading to slow growth with the risk of neurocognitive impairment and other poor health outcomes such as retinopathy and bronchopulmonary dysplasia. HM should be supplemented (fortified) with the nutrients in short supply, particularly with protein, calcium, and phosphate to meet the high requirements of this group of babies.