How Much Should a Premature Baby Eat at Home?

Feeding premature babies can be challenging, both in the neonatal intensive care unit and at home. Preemie health problems can interrupt early feedings, and even older preemies might not be strong enough to take in the amount of milk needed for good growth. Here's what parents need to know about feeding preemies as well as some tips for encouraging your baby to eat.

Overview

Premature babies are small at birth and might not tolerate milk feedings right away. Feeding premature babies isn't always easy, but it is important for their development and growth. But good nutrition does more than just help preemies' bodies grow. Milk feedings also help your baby's brain grow. In fact, research has shown that premature babies who get better nutrition early in life have larger brains and fewer developmental delays as they get older.

You might hear the terms "corrected age" or "adjusted age" used when discussing your preemie's growth and development. This is the age that your preemie would be had they been born on their due date. Adequate feedings help your baby to make up the distance between their corrected age and their birthday, but understand that your baby may need extra time to meet developmental milestones.

How Much Milk Do They Need?

When you're trying to determine how much you should be feeding your premature baby at home, it can help to ask the neonatal intensive care unit (NICU) staff how much your baby was eating in the hospital. Use this amount as your gauge for the amount (at a minimum) to offer your baby at home.

Neonatologists use complex equations to figure out how many calories a preemie should be eating for good growth—and they won't discharge a baby until they are eating at least that much. Once you're at home, it will be important for you to have regular checkups with your pediatrician or follow-up with the NICU clinic to make sure that your baby is consistently gaining weight.

Whether you are breastfeeding or bottle-feeding with formula or breast milk, your baby will be getting the nutrition they need to grow well if they are getting enough to eat. If your baby is not getting enough milk, they will show signs of dehydration, such as:

• Crying with no tears
• Dry mouth, tongue, and skin
• Fewer than six wet diapers in a 24-hour period
• Sunken eyes
• Sunken fontanelles (soft spots on the head)

It's important that you keep all your scheduled follow-up visits with your baby's pediatrician. They will weigh them, measure their length, and assess their head growth at your regular checkups.

Optimal Types of Milk

Breast milk is best for most babies, including preemies. When they are in the NICU, they might have received human milk fortifier (HMF). You won't be able to get this at home, but before you leave the hospital, you might be instructed to supplement your baby's feedings with a higher-calorie formula or add a higher-calorie formula powder to your breast milk.

If you are formula feeding, your baby might need a special preemie discharge formula. Preemie discharge formula has more protein and calories than regular formula. It's available at most supermarkets and through WIC with a doctor's note.

Brands of preemie discharge formula include:

• Cow & Gate Nutriprem 2
• Enfamil Enfacare
• Similac Neosure

Once your baby has a good catch-up growth, you might want to ask your doctor about switching to exclusive breastfeeding or regular breast milk.

Tips

If your baby is taking in less milk at home than they were in the hospital or they are not growing well, talk to your pediatrician. Whether you are breast or bottle feeding, the following tricks might encourage your baby to eat more:

• Feed your baby as soon as they are hungry. Crying is a late hunger sign. If your baby is sucking on their fist or gumming their blankets, offer a feeding. Babies may breastfeed better or drink more milk if you feed them as soon as they begin to exhibit signs of hunger.
• Make sure your baby is fully awake. If your baby tends to fall asleep during feedings, try to keep them awake and interested. Sit your baby up for a bottle feeding or play with their toes during breastfeeding. If your baby falls asleep but you think that they are still hungry, wake them up with a diaper change.
• Burp your baby during feeding. If your baby's belly is full of air, there won't be room for milk. Burping your baby midway through feeding or whenever they start to slow down can keep them going for longer.
• Use breast compression. If you're breastfeeding, compress your breast at the end of the feeding to encourage your baby to drink every drop of your high-calorie milk. The hindmilk (the last milk to be expressed) of each feeding also has more fat.