Babies who arrive earlier than 37 weeks of pregnancy often have special
health needs. If you're the parent of a preterm infant, you may have concerns about growth milestones they need to meet before safely settling in at home.
There's a lot to know about caring for your premature baby, and nutrition plays an essential part. Recent news headlines about the risks and benefits of different feeding options may have added to your worries. What's the best way to make healthy choices for your child? Here are science-based insights that can help you partner with their medical team to make informed decisions.
Nourishing premature babies to help them grow & thrive
Because babies born early often have challenges not faced by full-term babies, they may need specialized medical care. Premature infants often need help with breathing, staying warm, eating by mouth and gaining enough weight.
Good nutrition is essential to helping premature babies overcome the extra challenges they face. It helps them gain weight and provides fuel for little lungs, kidneys, hearts and other body systems to develop.
Premature infants need special nutrition designed specifically for them, including:
More calories than full-term infants
Extra fats and proteins that nourish the brain and other organs
The right levels of vitamins and minerals
Enzymes to digest and absorb nutrients
Feeding options for preterm infants
Breast milk (human milk)
Before your baby arrived, you may already have decided to breastfeed. If so, congratulations! Breast milk is the
healthiest food for all babies, and there's good evidence that
premature babies gain extra benefits from it.
A birth parent's breast milk can make sure babies get a "custom blend" of nutrients that match their unique needs.
Colostrum, the first milk produced during pregnancy, is rich in protein, vitamins, minerals and antibodies. These help build the
immune system, which is extra important for preemies. As babies grow, the nursing parent's milk also changes, giving them the nourishment they need at the right time.
Donor human milk
Parents of some premature infants aren't able to provide breast milk for a variety of reasons. For these infants, the hospitals caring for them may have access to
pasteurized human milk from healthy donors. Pasteurized donor milk provides many (although not all) of the benefits of breast milk from parents. Many hospitals work with human milk banks to help premature babies get the rich nutrition human milk can provide.
What are human milk fortifiers?
As healthy as human milk is for preterm infants, many need even more nutrition than it alone provides. This is particularly true for smaller and younger preterm infants. If this is the case for your baby, your pediatrician or hospital team will use a
human milk fortifier. Added to your breast milk or donor human milk, these fortifiers provide extra calories, protein, calcium, iron and vitamins to support your baby's growth.
Most fortifiers for premature babies come in powder form or liquid that can easily be mixed with human milk. Liquid fortifiers are only used when added to human milk; they are not used alone, since they are not a complete nutritional product.
Preterm infant formulas
In addition to breast milk and donor human milk, there are also preterm baby formulas. These formulas are designed specially to meet the specific nutritional needs of preterm infants and do not require fortification.
When preterm infants are not able to receive breast milk or donor milk, these special formulas can deliver the calories and nutrients they need. Some preterm infants who are receiving human milk will also need formula to reach their growth targets.
So, some premature infants will only receive breast milk; some will receive a mix of breast milk and formula, and some will only receive formula. Because every premature infant's health situation is unique, the advice of your baby's health care team is essential.
Talk with caregivers in the neonatal intensive care unit (NICU) or hospital nursery, as well as your pediatrician, for advice on the healthiest feeding plan for your baby.
What about claims that preemie formulas are harmful to babies' health?
Some recent lawsuits claim that preterm infant formula is linked with
necrotizing enterocolitis (NEC). NEC is an intestinal illness that can be life-threatening for babies. Here are facts that preemie parents should know about NEC and infant nutrition:
Nearly all babies who get NEC are born early. Preterm birth is the biggest risk factor for babies developing NEC.
Breast milk is strongly recommended for premature babies to protect against NEC, but it does not prevent it 100% of the time. While studies show that feeding preterm infants human milk is protective against NEC, it does not entirely eliminate the risk.
More research is needed to get to the root causes of NEC and how to prevent it. At present, babies who consume only breast milk still may develop NEC.
Preterm formula is necessary for many infants. This includes preterm infants whose parents are not able to provide breast milk and who may choose not to use donor milk. Some preterm infants may need preterm formula in order to gain weight as they should. In addition, not all hospitals are able to provide pasteurized donor human milk.
Supplementing breast milk with formula may offer benefits for some premature infants. But it depends on the unique health challenges they face, and the advice of their medical teams. The vast majority of preterm infants who receive formula do not develop NEC.
Remember
More research to prevent preterm births and NEC. Childhood nutrition can be complicated, especially for infants born early. If you're confused about what's safe and what's not, talk with your child's pediatrician. In partnership with NICU or hospital caregivers, they can answer questions and help you make decisions that feel right for you, your baby and your family.
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