Babies who arrive earlier than 37 weeks of pregnancy often have special
health needs. If you're the parent of a preterm infant, you may have concerns about growth milestones they need to meet before safely settling in at home.
There's a lot to know about
caring for your premature baby, and nutrition plays an essential part. Recent news headlines about the risks and benefits of different feeding options may have added to your worries. What's the best way to make healthy choices for your child? Here are science-based insights that can help you partner with their medical team to make informed decisions.
Nourishing premature babies to help them grow & thrive
Because babies born early often have challenges not faced by full-term babies, they may need specialized medical care. Premature infants often need help with breathing, staying warm, eating by mouth and gaining enough weight.
Good nutrition is essential to helping premature babies overcome the extra challenges they face. It helps them gain weight and provides fuel for little lungs, kidneys, hearts, intestines and other body systems to develop.
Premature infants need special nutrition designed specifically for them, including:
More calories than full-term infants
Extra fats and proteins that nourish the brain and other organs
The right levels of vitamins and minerals
Enzymes to digest and absorb nutrients
Feeding options for preterm infants
Mother's own milk (human milk)
Before your baby arrived, you may already have decided to breastfeed. If so, congratulations! Mother's own milk is the
healthiest food for all babies, and there's good evidence that
premature babies gain extra benefits from it.
A birth parent's breast milk can make sure babies get a "custom blend" of nutrients that match their unique needs.
Colostrum, the first milk produced during pregnancy, is rich in protein, vitamins, minerals and antibodies. These help build the
immune system, which is extra important for preemies. As babies grow, the nursing parent's milk also changes, giving them the nourishment they need at the right time.
Donor human milk
Parents of some premature infants aren't able to provide breast milk for a variety of reasons. For these infants, the hospitals caring for them may have access to
pasteurized human milk from healthy donors. Pasteurized donor human milk provides many (although not all) of the benefits of breast milk from parents. Many hospitals work with human milk banks to help premature babies get the rich nutrition human milk can provide.
What are human milk fortifiers?
As healthy as human milk is for preterm infants, many need even more nutrition than it alone provides. This is particularly true for smaller and younger preterm infants. If this is the case for your baby, your pediatrician or hospital team may use a human milk fortifier. Added to your breast milk or donor human milk, these fortifiers provide extra calories, protein, calcium, iron and vitamins to support your baby's growth.
Fortifiers for premature babies come in liquid or powder form that can be mixed with human milk. The type of fortifier used may depend on your baby's special medical needs. There are different fortifiers in current use. Some are human milk based and some are bovine (cow's milk) based. Either can be used to optimize a baby's nutritional needs.
Preterm infant formulas
In addition to mother's own milk and donor human milk, there are also preterm baby formulas. These formulas are designed specially to meet the specific nutritional needs of preterm infants and do not require fortification.
When preterm infants are not able to receive mother's own milk or donor human milk, these special formulas can deliver the calories and nutrients they need. Some preterm infants who are receiving mother's own milk may also need preterm formula to reach their growth targets.
This means that preterm infants may receive:
Because every premature infant's health situation is unique, the advice of your baby's health care team is essential.
Talk with caregivers in the neonatal intensive care unit (NICU) or hospital nursery, as well as your pediatrician, for advice on the healthiest feeding plan for your baby.
What about claims that preemie formulas are harmful to babies' health?
Some recent lawsuits claim that certain preterm infant formula and/or fortifiers are linked with
necrotizing enterocolitis (NEC). NEC is an intestinal illness that can be life-threatening for babies. Here are facts that preemie parents should know about NEC and infant nutrition:
Many babies who get NEC are born early. Prematurity is the biggest risk factor for babies developing NEC.
Mother's own milk and pasteurized donor milk are strongly recommended for premature babies to decrease risk of NEC, but do not prevent it 100% of the time. While studies show that feeding preterm infants human milk may decrease risk of NEC, it does not eliminate the risk.
Preterm formula is necessary for many infants. This includes preterm infants whose parents are not able to provide breast milk and who may choose not to use donor milk. In addition, some hospitals may not have pasteurized donor human milk available.
Supplementing mother's own milk with fortifiers or formula may offer benefits for some premature infants, but it depends on the unique health challenges they face and the advice of their medical teams.
Remember
Research into optimizing the nutritional and health of preterm babies is ongoing. If you have questions about your baby's nutritional needs, talk with your baby's doctor. In partnership with NICU or hospital caregivers, they can answer questions and help you make decisions that feel right for you, your baby and your family.
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