How to Provide the Right Nutrition for Premature Babies

October 27, 2019
The best source of nutrition for premature babies is the mother's breast milk. Maternal breast milk offers numerous benefits when it comes to a baby's health and weight gain.

Premature babies require a specific level of care. For example, providing proper nutrition for premature babies is extremely important. Doing so allows these tiny newborns to continue growing at a rate close to that of babies who remain in the womb.

What defines preterm birth?

The term “preterm” refers to any birth that occurs before the baby reaches 37 weeks of gestation. This is counting from the first day after the date of the mother’s last menstruation. Babies who are born preterm are considered premature.

Despite the fact that there is a unanimous definition regarding preterm birth, there is some controversy regarding preterm subgroups. The terminology that refers to these subgroups is a follows:

  • Extremely preterm: less than 28 weeks.
  • Very preterm: 28 to less than 32 weeks.
  • Moderately preterm: 32 to less than 34 weeks.
  • Late preterm: 34 to 37 weeks.

Proper nutrition for premature babies

The Committee of Nutrition of the American Academy of Pediatrics provides a definition of the proper nutrition for premature babies. According to the Committee, proper nutrition is that which allows premature babies to grow at intrauterine levels. Furthermore, the right nutrition shouldn’t place stress on a premature baby’s immature metabolic and excretory functions.

Premature babies born between 34 and 37 weeks often have a hard time breastfeeding or drinking from a bottle. This is because they have difficulties when it comes to coordinating their suction, breathing and swallowing.

Premature babies are usually smaller than other babies.

Therefore, it’s possible for premature newborns to need to take in their liquids and nourishment intravenously. As they become stronger, they can begin to receive maternal breast milk or formula by way of a nasogastric tube. 

Medical professionals introduce nasogastric tubes down to the stomach through the nose or mouth. The amount of milk a baby receives will increase very slowly, especially in the case of very premature babies. This reduces the risk of contracting an intestinal infection called necrotizing enterocolitis.

Maternal breast milk

Maternal breast milk is the source of nutrition that newborn babies tolerate the best. They can receive it with a faster tube and fewer retentions than when they receive artificial formulas. Maternal breast milk has a low osmolality, is specific to our species, and possesses defensive qualities. Perhaps this gives it the ability to protect premature babies from necrotizing enterocolitis.

Furthermore, studies have shown that feeding breast milk to babies who undergo the kangaroo care method suffer fewer nosocomial infections. With the Kangaroo Care Method, babies are in permanent skin-to-skin contact with their mothers. This takes place as soon as medically possible and should be as continuous and prolonged as possible.

Mothers secrete specific immunoglobulin A antibodies against the germs on their skin and those they incorporate from their newborns. In this way, they protect their little ones from the germs that are responsible for causing nosocomial infections.

The composition of breast milk

The composition of breast milk varies depending on whether the child was born premature or full term. During the first 24 weeks, a premature baby’s mother produces milk whose composition adapts to the estimated nutritional needs of her child. Only calcium (Ca) and phosphorus (P) are somewhat lacking.

Once premature babies reach 4 to 6 weeks of age, they should receive a supplement in addition to breast milk. At this point, they are “mature” and can receive supplements that contain minerals and proteins.

Others supplement calcium and phosphorous. This minimizes the low bone density and biochemical rickets that exist during the first weeks of life in premature babies who receive their mother’s breast milk.

How to Provide the Right Nutrition for Premature Babies

The milk of a premature baby’s mother contains a series of amino acids that are necessary for the development of the little one’s central nervous system. Furthermore, because of the series of substances breast milk contains, maternal breasts are actually considered part of the immune system.

Breast milk also contains medium-chain and long-chain fatty acids that contribute to a higher intellectual coefficient. It has more cholesterol than “mature” milk and much more than artificial formulas.

Other important factors regarding nutrition for premature babies

Controlling the water requirements of premature babies is fundamental. These children have a harder time maintaining the right balance of water in their bodies. As a result, they’re prone to both dehydration and overhydration.

Some premature babies will need to continue taking nutritional supplements even after they leave the hospital. For nursing babies, this may mean one or two bottles of fortified maternal breastmilk per day, as well as iron and vitamin D supplements.

Some babies need more supplements than others. This includes babies that aren’t able to ingest enough milk to obtain the calories they need to grow properly.

  • Gómez Papí. (1997).  “Lactancia materna en prematuros.” Bol pediatr 37: 147-152.
  • Martínez, Eduardo Doménech. (2011). “Avances en la alimentación del prematuro.” Canarias Pediátrica 35.2: 77-90.
  • Dirección Nacional de Maternidad e Infancia, Ministerio de Salud de la Nación República Argentina. (2015). Nutrición del niño prematuro, Recomendaciones para las unidades de Cuidado Intensivo Neonatal.
  • Romero-Maldonado, Silvia, Leyla María Arroyo-Cabrales, and Edna Rocely Reyna-Ríos. (2010). “Consenso prematuro tardío.” Perinatol Reprod Hum 24.2: 124-130.