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.

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. Feeding premature babies isn't always easy, but it is important for their development and brain growth.

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.

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.

Doctors who specialize in treating babies (neonatologists) use a preemie's corrected gestational age until they are about 2 years old to allow for catch-up growth.

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. During this time it will be important for you to have regular check-ups with your pediatrician or follow-up with the NICU clinic to make sure that your baby is consistently gaining weight.

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.

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. 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)

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 check-ups.

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

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.

Supplementing should only be done with the recipe given to you by the NICU staff. You should never try to prepare it at home on your own without guidance.

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.

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. 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 look hungry.
  • 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. Burp your baby midway through 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. The hindmilk of each feeding also has more fat.
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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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