When can I feed my preemie solids?

As parents of preterm babies, it is only natural to have questions around each milestone. Here are all the answers to weaning for preterms!

Like full-term babies, preemies should start receiving solids at about 6 months. But for preemies, that date is based on adjusted age rather than chronological age. Based on how many weeks earlier the baby was born, you can calculate the corrected age. Here is how:

The corrected age is your baby's chronological age minus the number of weeks or months they were born early. For example, a 6-month-old baby who was born 2 months early would have a corrected age of 4 months. That means they may only be doing the things that other 4-month-olds do.

At the first birthday, here is an example: 12-month old born three months early, their corrected age is 9 months (12 months – 3 months = 9 months)

Most paediatricians recommend correcting age when assessing growth and development until your child is 2 years old.

Nutrition Needs of Preterms

The general guidelines on starting solids at around six months do not apply to preterm babies. Your baby doesn’t need to have teeth for starting solids. It is recommended to start solids when your baby is around 5 – 7 months of their actual age.

Here are some indicators you should note before starting the baby on solids:

• The baby is able to sit with support and hold her head steady.
• The baby watches others eat with great curiosity!
• The little one is already making a lunge for your food.
• The baby is doing a lot of mouth exploration of his toys.
• Overall, the baby appears to be alert and ready to experiment.

Don’t Start too Soon

You might be eager to step up on nutrition but please don’t start unless the baby is more than 4 months of their actual age, or before 3 months of their corrected age. The risks of starting too soon are:

• The baby’s digestive system may get irritated and he might develop allergies.
• The baby may not have good control over his tongues and mouth muscles.
• The tongue-pushing reflex might still be strong.

This tongue-pushing reflex helps babies when they are breastfeeding or drinking from a bottle. It goes away on its own with age.

Don’t Start too Late

Your baby should be ready to start solids by 7 - 8 months of actual age.

• Your preterm baby is not born with enough iron stores to last 6 months and so they need iron rich foods.
• If it's too late, the baby won’t want to taste anything other than milk.
• The baby’s openness to new flavours will also diminish with time.

Getting Preemies Started on Solids: Some Golden Rules

• It’s important to select a time of the day when baby is feeling alert and active.
• Prop up the baby comfortably.
• Using a baby-feeding spoon, place a small portion on the middle of the tongue.
• Make sure the food is runny and has NO lumps.
• Don’t force. If baby is shaking head or fussing, try another time.
• Give an infant formula/ breast milk feed first and offer solids as a top up.

What foods should I start with?

What do preemies need the most? It’s iron! Iron is needed to make red blood cells, which carry oxygen throughout the body. Iron also plays an important role in immunity, brain development and growth.

This makes iron supplementation and choosing iron-rich foods very important with starting solids.

• Baby rice/ infant cereals are a good first food because they have extra iron added.
• Try these veggies and fruits: mushroom, cauliflower leaves, beetroot, potatoes, broccoli, spinach, watermelon, pomegranate, apples, strawberries.
• Soybeans and lentils are good sources. Try very small quantities to begin with.

Preparing the Food

• Always wash your hands and utensils before preparing food.
• Try to adapt family meals to a suitable texture for your baby.
• If extra fluid is needed to blend food add infant formula, breast milk for babies less than 1 year of age.
• Cook fresh and feed. Avoid freezing food. If unavoidable, you can freeze occasionally as cubes in ice-trays.
• If the baby refuses to eat certain foods, take a break and re-introduce after a few days. It is important that the baby gets used to different textures and tastes for his own health.

Ready-Made Baby Food

• If you are travelling or have any such constraint, occasional use is fine.
• These foods are low in nutritional value and are expensive, so best avoided.
• Definitely read the label for use of preservatives.

How do I know when my baby has had enough?

• Looks disinterested in the food.
• Turns away head or body from food.
• Pushes your hand or spoon away.
• Closed mouth.
• Looks distressed or cries.
• Closes lips tightly.
• Hiccupping/ sneezing.

Watch your Baby while they are Eating Solids

All babies need protection from the risk of choking. More importantly, preemies. Here are some guidelines:

• Never offer foods that are a choking risk like thinly sliced carrot, popcorn, potato wafer, ice lollies, nuts.
• Do not add any solid food to the drinking bottle.
• Cooking, chopping, mashing and grating foods can help make foods easier to eat.