Babies who are born very early (preterm/premature) cannot feed themselves yet. If your baby is very sick or very premature, he/she will likely be started on an IV right after birth.
The IV contains fluids and total parenteral nutrition (TPN). TPN has all
the nutrients that your baby needs to grow:
- Vitamins and minerals
Feeding Through a Tube Into the Stomach
A baby will stay on TPN until he/she can get enough nutrition from milk
that goes into the stomach:
- An orogastric (OG) tube is placed from the baby’s mouth to the stomach.
- Small feedings of milk go through the tube into the stomach
- The baby slowly gets more milk through the tube and less TPN.
- Finally all nutrition the baby needs comes from the milk.
Babies who are very premature and small get extra protein, calories, and vitamins in their milk.
This is so the baby’s brain and body get everything needed to grow.
Can I Breastfeed My Preterm Baby?
Breast milk greatly helps premature babies. Things to know, so your baby can get breast milk:
- You may not be able to breastfeed your baby right after delivery.
- You can still pump your milk for your baby.
Ask our nursing staff or lactation (breastfeeding) staff to help you.
If we can’t use your breast milk, talk to your doctor about milk from a donor.
The first milk you will pump is very important for your baby. It has special benefits.
- This milk is called colostrum, or early milk.
- We will help your baby get the colostrum right away. Small amounts can be absorbed through the baby’s cheek.
When Will My Baby Gain Weight?
What is normal:
- All babies lose weight in the first few days after birth. This is from changes in body fluids and loss of extra water.
- Some preterm babies take up to 2 weeks to regain their birth weight.
How the NICU helps your baby gain weight:
- Every night, NICU babies are weighed. Once a week, their head size and length are measured.
- NICU doctors and nutrition staff check to make sure your baby is growing as he/she needs to.
- They will change your baby’s feedings, if needed.
When Will My Baby Learn to Breast- or Bottle-feed?
Feeding takes a lot of energy and body coordination. Most babies need to be at least at 33-34 weeks before they can breast- or bottle-feed. Each baby is different. Some start as early as 32 weeks to begin to learn to suck on the breast. Some are not ready until much later. These things need to happen first:
- The baby’s lungs must be developed enough so they are breathing more on their own.
- The baby must be able to suck, swallow, and breathe in a way that is safe for feeding.
Our NICU has a team that can help you and your baby learn how to breast- or bottle-feed. The team includes:
- Occupational and speech therapists
- Lactation experts
- Experienced nurses
Cue-Based Feeding for a baby in the NICU
Cue-based feeding means watching for your baby to show you when he/she is hungry.
Feeding your baby only when you see these signs helps them reach full feeds sooner. For that reason, we focus on the quality of the feed not the amount. Your baby’s cues or signs may also show times in the day that the baby is more alert allowing us to plan ahead. Once your baby is ready there are things that we all need to look for when deciding if your baby is hungry and ready to eat. The nurse will score the baby based upon the cues shown and a breast or bottle feed will be offered when the baby is ready.
Some of the cues your baby may show are:
- Sucks on pacifier
- Turning head
- Seeking and rooting for food
- Fingers in mouth
- Stable vital signs
During the feeding, there may be some signs that your baby is stressed or needs to stop feeding. Some of these signs are:
- Pulling away from bottle
- Arms extended or floppy
- Frowning or looked stressed
- Poor seal on the nipple
- Holding their breath
- Breathing events
- Aspiration concerns: watery eyes, coughing/choking etc.
If your baby loses weight, cannot maintain temperature, or there are concerns of aspiration their feeding plan will be changed. If you have any questions or concerns, please let your baby’s nurse or doctor know.
If you have lactation questions please call the ANGELS Call Center at 501-526-7425. This is a hotline, answered by a nurse, 24/7.
Questions about medications and mother’s milk? Call the Infant Risk Center At Texas Tech University Health Science Center at 806-352-2519.
You may also call UAMS Lactation Services at 501-526-3558. This is a warm-line, so you can expect a returned phone call within 48 hours.