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. 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.

Although feeding premature babies isn't always easy, it is important for development and brain growth. Here's what parents should know about feeding preemies as well as some tips for encouraging your baby to eat.

Importance of Feeding Premature Babies Enough Milk

Premature babies are small at birth and might not tolerate milk feedings right away. Although IV feeding provides important nutrients your baby needs to grow stronger, babies grow much better from milk feedings than from IV fluids.

Sometimes, 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 bodies grow. Milk feedings also help your baby's brain grow. Research has shown that premature babies who get better nutrition early in life have larger brains and fewer developmental delays as they get older.

Preemies need 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.

In other words, by three months after a baby's original due date, a preemie should be within the average range for height, weight, and head circumference.

How Much Milk Should My Baby Drink?

When you're trying to determine how much you should be feeding your premature baby at home, it can help to ask the NICU staff 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 they won't discharge a baby until they are eating at least that much. If your baby is drinking at least as much in the early days at home as they were in the hospital, they should grow well.

Most breastfed newborn babies breastfeed about eight to 12 times per day (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, they will show signs of dehydration, such as:

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

Whether you are breastfeeding or bottle-feeding with formula or breast milk, your baby will be healthy and grow well if they are getting enough to eat.

Make sure to take your baby for regular pediatrician visits. Your baby's doctor will weigh them, measure their length, and assess their head growth.

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

Breast milk is best for most babies, including preemies. To ensure that your baby is getting enough protein and calories for catch-up growth, your baby's doctor might recommend that you add human milk fortifier (HMF) to some or all of your milk.

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.

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. 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

Encouraging Your Preemie to Eat More

If your baby is taking 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:

  • Feed your baby as soon as they are 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 their fist or gumming their blankets, offer a feeding.
  • 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 to bottle feed, or play with their toes during breastfeeding. If your baby falls asleep but you think 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. Burp your baby midway through a feeding, or whenever they start to slow down.
  • 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.
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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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