Feeding Your Preemie While In The Neonatal ICU
What Babies Need!
Premature babies need feedings and nourishing just like any other baby. It is just that they need to be fed in different ways until they are able to coordinate their sucking, swallowing, and breathing. One or many of these types may be given to your preemie before they can take their milk from a breast, or from a bottle for themselves. They also need a special milk mixture until their digestive systems and kidneys reach the "term baby" stage.
Types of Feedings
Your preemie may experience different levels of feedings depending on their maturity.
Intravenous (IV) feedings
- IV feeding involves giving special liquid by way of a fine tube, into a vein. The baby receives his nutrition by avoiding the digestive system directly entering the blood stream. At first, the liquid food will be a mixture of sugar (glucose), salts and water. Later, some amino acids (protein building blocks), plus some fats and minerals may be added. It may be given for the first few hours or even the first few days after birth.
Tube Feeding or Gavage Feeding
- This method feeds milk through a fine plastic tube, and is used when your baby's digestive system is ready for food by mouth but he cannot yet suck or drink properly. The tube usually threads down via the baby's nose or mouth, then into his stomach. The OG tube or oro-gastric goes through the mouth and the NG tube or naso-gastric goes through the nose. There is also another sort of feeding tube that goes straight through the stomach and down into the small intestine. This is called a transpyloric tube. It gives small amounts of milk continuously.
- This painless method involves a tube that is surgically placed into a vessel of the umbilical cord. However, there are risks associated with this method that include infection and blood clots. Therefore, this method is normally used only in the most critical cases and where the baby might need this type of feeding for several weeks. For these preemies, it is the safest and most effective way to receive nutrients.
- If your baby is able to do a little practice sucking every time he has a tube-feed, this is very good for him. It is best if he can practice sucking on your nipple, but many units also use a pacifier.
- With cup feeding, you hold your baby cuddled comfortably upright on your lap, and gently lift a small cup of milk (like a little medicine cup with rounded edges) to his mouth, tilting it very slightly so a tiny bit goes against his lips. Your baby will be able to smell and taste the milk. By doing this, your baby is in control of his own drinking, and is unlikely to choke or become stressed by the fear of choking.
- Once your premature baby is mature enough to manage sucking, swallowing and breathing at the same time, you can begin to feed him using a specially made small bottle which holds 1-2 ounces of milk and a special nipple that is as small, soft and flexible as possible. Premature babies are bottle fed sitting up, not cradled in your arms. Sit your baby on your lap, supporting his or her head and shoulders in your non-dominant hand. Try not to be discouraged if, initially, it seems that the nurses can get your baby to feed more than you can. An neonatal ICU nurse will teach you how to bottle feed your preemie, using some time-tested tricks.
- Breast milk can do many things for your baby that formula milk cannot. Research shows that the breast milk mothers make for their premature babies is different from the milk that mothers make when their babies are born at term. And the milk slowly changes too, to cater for a premature baby's changing needs. Breast milk is not just a food, it is a powerful medicine that can help protect against infections, help your baby's digestion so that he puts on weight more easily, and encourages brain development. If you do choose to breastfeed, there will be times when feedings will be supplemented by a bottle, most likely at night. There is a lot of controversy on whether this will encourage nipple confusion. If your baby needs anything special or extra, perhaps more iron, more calories if he has lost weight, or more water if he is becoming dehydrated, the staff at the NICU will, with your permission, add whatever extra is needed to your breast milk.
A baby's feeding cycle will be monitored each step of the way. By the time your preemie is ready to go home you will be very familiar with his feeding routine. There is no perfect way to feed your preemie. With time and patience, you will be familiar with your baby's feeding needs.