Choosing Infant Feeding for Preemies

By
Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.
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Updated on January 11, 2021
Medically reviewed by
Alisa Baer, MD
Alisa Baer
Medically reviewed by Alisa Baer, MD
on January 04, 2021

Alisa Baer, MD, is a board-certified pediatrician, nationally certified child passenger safety instructor, and co-founder of The Car Seat Lady.

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mother bottle feeding her premature baby in the hospital nurseryview images from the same series:

Christian Wheatley / E+ / Getty Images

Infant feeding, including feeding a premature baby, requires skill, information, and patience. Parents must decide whether to feed their preemies breastmilk, formula, or a combination of the two.

Sometimes premature babies aren't able to take their feedings by mouth in the beginning, or aren't strong enough to take in enough milk to grow. One of the criteria for discharge from the neonatal intensive care unit (NICU) is being able to tolerate feedings and gain weight. Some babies may go home with a feeding tube, but for most preemies, by the time they go home, they are taking all of their feedings by mouth and demonstrating that they can gain weight while doing so.

When premature babies begin taking their food by mouth (either by bottle or breast), they may need help learning how to eat. While most full-term babies know how to suck, swallow, and breathe—the three skills involved in breast- or bottle feeding successfully—many preemies need to learn these skills.

Success Tips for Bottle Feeding a Preemie

Bottlefeeding a preemie is very different from feeding a term infant. Unlike a baby born at term, a premature baby may be very sleepy at feeding times, may not be strong enough to drink enough milk to sustain growth, and may have a hard time swallowing and breathing at the same time. NICU nurses will help you learn how to bottle feed your preemie, using some time-tested tricks.

Breastfeeding Benefits for Preemies

Although breastfeeding a preemie is not always easy, following these tips and suggestions will help get your preemie breastfeeding experience off to a good start.

One of the biggest benefits of breast milk (either from their mother or a donor) for preemies is a reduction in the risk of necrotizing enterocolitis (NEC), an often devastating complication where the intestines do not get enough oxygen for a period of time. This can make babies extremely ill and can result in the child losing a part of their intestines or even dying.

Not only does breastfeeding a premature baby offer all of the same benefits of breastfeeding that a term baby receives, but a premature baby also receives several preemie-specific benefits of breast milk.

Increasing Milk Supply While Pumping

Pumping milk for a premature baby can be a challenge, especially if you feel like your milk supply is lower than it should be. Most moms can pump enough milk to nourish their babies by using these techniques.

Choosing the Best Formula for Your Preemie

With the many infant formulas on supermarket shelves, parents of preemies may be confused about the best type of formula for premature babies. Choosing a formula is definitely a decision that should be made with your neonatologist or pediatrician, but learning about the different products can help you and your doctor make an informed decision.

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  1. Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeed Med. 2014;9(4):184-190. doi:10.1089/bfm.2013.0121

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