Nutrition for Premature Babies

Nutrition for premature babies or otherwise nicknamed ‘preemies’ is essential for growth and development. Their nutritional needs differ to full-term babies and it’s essential that they receive the right nutrition to gain weight and develop normally, like as if they were inside the womb developing to full-term.

WHAT ARE PREMATURE BABIES?

Preemies are babies born before 37 weeks of gestation, which is around 8% of babies born each year in Australia. Full term babies are born between 37-42 weeks of gestation. Most preemies depending on age and weight have good chances of survival thanks to modern technology. Preemies when born weigh in at anywhere from 500-2500 grams. They usually start their life after delivery in a neonatal intensive care unit (NICU), which is an atmospheric incubator designed to limit stress, as well as meet all the baby needs i.e. warmth to reduce excess calorie needs, humidified air to maintain body temperature and avoid fluid loss, protection from the environment, and importantly nutrition. The NICU is where preemies can be carefully monitored to make sure they get everything they need including fluid and nutrition, until their bodies mature.

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HOW ARE PREMATURE BABIES FED?

Preemies that are very small i.e. 25-29 weeks, or sick, are fed nutrients intravenously as they have immature digestive systems, and are unable to coordinate feeding actions i.e. sucking, swallowing and breathing. When they are bigger and stronger and able to digest breastmilk or fortified formula, they are then fed via a tube from the nose or mouth to the stomach. This feeding process means the babies are fed very slowly because of the high risk of developing necrotizing enterocolitis (NEC), which is a serious inflammatory bowel disease. From about 35 weeks on, most babies can be breastfeed or bottle fed directly.

MILK FOR PREMATURE BABIES

Once a preemie is old enough, and it’s digestive system has matured, preemies require breastmilk, which may need to have human milk fortifier added to it, or premature infant formula, as their main source of nutrition. Breastmilk has extra benefits over formula as it contains proteins that strengthen the immune system and helps fight infection, as well as promotes growth, and protects against sudden infant death syndrome (SIDS). But not every mother is able to breastfeed so premature infant formula is designed with additional energy and mineral content, suitable for preemies up to 36 weeks of gestation. Then from 37 weeks, premature babies can be fed regular formula. Most premature babies when discharged from hospital, require to be fed at least every 2-3 hours or 8-10 feeds per day. Babies have very small stomachs that fill up very quickly, hence the importance for regular feeds. As well, they need to stay hydrated.

FOOD FOR PREMATURE BABIES

The introduction of solid food should be introduced at 4-6 months past the baby’s due date of birth, like full-term babies. And cow’s milk as a drink, should be introduced after 12 months past the baby’s due date.

VITAMIN AND MINERAL SUPPLEMENTATION FOR PREMATURE BABIES

Premature babies should receive vitamin and mineral supplementation for at least the first year of life, even though vitamin deficiencies are rare. They include Vitamin D, iron, probiotics and possibly zinc and copper.

• 400IU of vitamin D is required daily. Usually we get vitamin D from the sun. But it’s not very likely that a premature baby is going to exposed to the sun, and without sunscreen. Therefore supplementation is the best way to go especially if the baby is exclusively breastfed, as formula is fortified with vitamin D. Vitamin D is important for calcium absorption, which is important for bone formation, as well as the prevention of rickets, a softening of the bones. Vitamin D is also required for cell growth, neuromuscular and immune function, as well as reduction of inflammation.

• 2-4 mg of liquid iron per kg of body weight is required daily for breast-fed babies or babies on low-iron formulas. Premature babies are at high risk of iron deficiency. Iron has various roles in the body, including the transport of oxygen around the body in the blood. If the body lacks iron, there is less oxygen, which then makes it harder for the brain to concentrate, remember and learn. This can have an impact in later life. Lack of iron can also cause tiredness and irritability.

• According to a research, probiotics added to feeds can help preemies gain weight faster, increase survival rates, and decrease NEC by more than 50%, all with no side effects. Probiotics improve the balance of flora (microorganisms) in the digestive system, which can prevent overgrowth of bad bacteria, improve digestion, increase resistance to infections, regulate the immune system, produce vitamins and much more. Probiotics given to preemies in hospital care is not yet common practice in Australian hospitals, due to more research needing to be done. Trials are currently been run in hospitals though.

• 750 mcg of zinc per kg of body weight is required daily. Zinc is required for almost every chemical reaction in the body, cell division, DNA and protein, foetal growth, the immune system, tissue growth and maintenance, proper thyroid function, bone mineralisation, blood clotting, cognitive function, wound healing and so much more.

• 100mcg of copper per kg of body weight is required daily. Copper is required for foetal development, nerve function, antioxidant function, bone growth, blood cell formation, movement of the heart muscle, development of the brain and nervous system. Copper also plays a critical role in certain enzymes, as well as helps the body effectively use iron in the body.

All vitamin and mineral supplementation, as well as feeding and care, needs to be discussed with neonatal intensive care doctors, paediatricians and nursing staff whilst in hospital care. Then followed up with healthcare practitioners eg GP, paediatricians, lactation consultants and nutritionists/dieticians to suit you a premature baby’s needs, once discharged from hospital.

Nutrition is just one of the many requirements that a premature baby needs to develop normally like a full-term healthy baby.

By Cherie Lyden – nutritionist and mother – www.lydenvitality.com.