How Much Should a Premature Baby Eat at Home?

Father Feeding Baby

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Feeding premature babies can be challenging, both in the neonatal intensive care unit, and at home. Health problems may interrupt early feedings, and even older preemies may not be strong enough to take in enough milk to grow well. Although feeding premature babies isn't always easy, it is important for development and brain growth.

Importance of Feeding Premature Babies Enough Milk

Premature babies are small at birth, and may not be able to tolerate milk feedings right away. Although IV feeding provides important nutrients that help your baby grow stronger, babies grow much better from milk feedings than from IV fluids. Because of this, many preemies don't grow well in the NICU and are small for their age when they are discharged from the hospital.

Good nutrition does more than just help preemies to grow longer and heavier. Milk feedings help preemies' brains to grow. Premature babies who get better nutrition early in life have bigger brains and fewer developmental delays as they get older.

To help their brains grow, it's important for preemies to have good catch-up growth in their first months of life. Ideally, catch up growth should happen by the time a baby is 3 months corrected age. This means that, by 3 months after a preemie's original due date, he or she should be somewhere in the average range for height, weight, and head circumference measurements.

How Much Milk Should My Baby Drink?

When you're figuring out how much you should be feeding your premature baby at home, talk to NICU staff about how much your baby was eating in the hospital. Neonatologists use complex equations to figure out how many calories a preemie should be eating for good growth, and won't discharge a baby until he is eating at least that much. If your baby is drinking at least as much in the early days at home as he was in the hospital, he should grow well.

Most breastfed newborn babies breastfeed about eight to 12 times per day or about every 1 1/2 to 3 hours.

Bottle-fed newborn babies drink about 1 1/2 to 3 ounces of milk every 2 to 3 hours.

If your baby is not getting enough milk, he or she will show signs of dehydration, including:

  • Fewer than 6 wet diapers in a 24-hour period
  • Sunken eyes
  • Sunken fontanelles (soft spots)
  • Crying with no tears

Regardless of whether you are breastfeeding or bottle feeding with formula or breast milk, your baby will look healthy and will grow well if he or she is getting enough to eat. Take your baby in for regular pediatrician visits so your baby's doctor can weigh him and measure his length and head growth.

What Type of Milk Should I Be Feeding My Premature Baby?

Breast milk is best for babies, including preemies. To help make sure your baby is getting enough protein and calories for catch-up growth, your doctor may recommend that you add human milk fortifier (HMF) to some or all of your milk. Once your baby has a good catch up growth, talk to your doctor about switching to exclusive breastfeeding or regular breast milk.

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

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

Encouraging Your Preemie to Eat More

If your baby seems to be taking in less milk at home than he or she was in the hospital or isn't growing well, talk to your pediatrician about how to get your baby to eat more. Whether you're breastfeeding or bottle feeding, the following tricks may help:

  • Feed your baby as soon as he's hungry: Crying is a late hunger sign. Babies may breastfeed better or drink more milk if you feed them as soon as they begin to look hungry. If your baby is sucking on his fist or gumming her blankets, offer a feeding.
  • Make sure your baby is fully awake: If your baby tends to fall asleep during feedings, try to keep him awake and interested. Sit your baby up to bottle feed, or play with his toes during breastfeeding. If your baby falls asleep but you think he's still hungry, wake him 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. Burp your baby midway through a feeding, or whenever he starts to slow down.
  • Use breast compression: If you're breastfeeding, compress the breast at the end of a feeding to encourage your baby to drink every drop of high-calorie milk.
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  1. Sullivan MC, Msall ME, Miller RJ. 17-year outcome of preterm infants with diverse neonatal morbidities J Spec Pediatr Nurs. 2012;17(3):226-41. DOI: 10.1111/j.1744-6155.2012.00337.x

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