1. Team up With the NICU and Your Pediatrician
Preterm babies are commonly admitted to the neonatal intensive care unit (NICU) to receive the specialized care they need to best develop after birth. This time is a great opportunity for you to learn the skills you'll need once your baby comes home.
"During this time watch what the doctors and nurses are doing and ask a lot of questions," recommends Michelle Johnson, RD, an expert in premature infant nutrition at Abbott and a NICU clinical nutritionist with nearly two decades of experience. She adds that depending on the stage of development, the NICU staff will help you practice feeding, changing and bathing your baby, as well as giving medications.
To help in those early days in the hospital and when you first get home, here are seven tips for feeding and caring for your new bundle of joy.
2. Tailored Feeding For Baby
In the NICU, you will decide if your baby is fed breast milk or formula. Breast milk is the best form of nutrition as it carries important nutrition and antibodies for baby’s growth and immune system development. However, even as nutritious as it is, breast milk often has to be boosted with extra protein, vitamins, and minerals to meet the high nutritional needs of premature babies. This is done by mixing breast milk with a human milk fortifier, a specialized nutrition product made to promote healthy growth in premature babies.
"Human milk fortifiers and premature formulas are made to help preterm babies grow on the inside in ways that we can't see," explains Johnson. "For instance, a greater percentage of calories in preterm formulas come from protein, as compared to formulas made for infants born at term. That's because protein allows the body to continue important tissue and organ growth. Meanwhile, higher concentrations of phosphorus, magnesium, vitamin D, and calcium help promote babies' bone growth and strength," she says.
Related: Human Milk Fortifiers Explained (PDF)
3. Follow (Frequent) Feeding Cues
In the hospital, premature babies, depending on their level of prematurity, learn to coordinate sucking, swallowing and breathing to eat safely. In those early days, tiny feedings of five milliliters — about the equivalent of a single teaspoon — every three hours around the clock are typical. Only once a baby has had plenty of practice and can breast or bottle feed with ease will they be on the path to home.
Once your baby comes home, you may need to adjust timing and quantities depending on feeding cues. Over time, your preemie's tummy will grow enough to hold one or two ounces (roughly the size of a medicine cup) of formula, eight to 12 times per day. That's about the rate at which most full-term babies feed at birth, Johnson notes.
4. Keep Things Clean
Even once you're home from the hospital, it's likely that your baby's immune system is still not fully developed. Johnson emphasizes that it's important to take extra precautions to protect your baby.
Make sure that all visitors wash their hands with warm water and soap before holding your baby, and that you do the same before preparing feedings. If you are formula feeding, learn how to safely store and prepare baby formula.
5. Be Careful With Comparisons
Your preemie baby will grow and develop quickly after returning home, and it can be easy to expect that they'll "catch up" right away. However, it's important to remember that development will likely be delayed by the same number of weeks or months that your baby was prematurely born. A baby born eight weeks premature can be expected to develop about eight weeks behind babies born at full-term, says Johnson.
Keep this in mind both when it comes to feedings, introduction of baby foods and when your pediatrician shares your baby's growth measurements with you. If you have any concerns, pediatrician appointments are the perfect time to raise them.
6. Stay Warm and Cozy
Once you are settled in at home, to ensure comfort, dress your baby as you would dress yourself given the season and the temperature of your home — and then add a cute hat! We all lose a significant amount of body heat through our heads, and babies' heads are much larger relative to their overall body size than those of adults.
7. Enjoy This Time
Remember that jitters are a normal part of parenthood and with the help and expertise of your baby's healthcare team, you have all the tools you need to give your baby an amazing future.
"We can all recognize that parents of a preterm baby have more to worry about than those of full-term babies, but don't forget to enjoy your baby," Johnson says. This isn't just time to catch up on growth and development — it's time to catch up on cuddles, kisses and memories, too.
To keep track of all your baby's milestones, growth progress and development check out these helpful charts and resources from Similac® available for download.
- Milestone Tracker - It's helpful to track your preemie baby's growth and development progress, especially over his or her first few months at home.
- Corrected Age Calculator - Corrected age reflects your baby's "developmental age" based upon due date, rather than date of birth.
- Catch-Up Growth Tracker - This chart helps to track your baby's measurements at visits with your doctor, who has the training and equipment to take accurate readings.