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Special feeds for special infants: 2. Feeding the preterm baby
Insights
Introducing milk feeds to preterm infants requires individualized approaches due to developmental variations. Specialized preterm formulas are recommended over standard ones for optimal nutrition and growth.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Infant Feeding
Background:
- Preterm infants exhibit immature sucking and swallowing reflexes before 32-34 weeks gestation.
- Respiratory illness frequently delays the initiation of milk feeding in premature neonates.
- Individualized feeding strategies are essential due to variations in infant needs and tolerance.
Purpose of the Study:
- To outline key considerations for introducing milk feeds in preterm infants.
- To highlight nutritional requirements and feeding methods for premature neonates.
- To differentiate appropriate feeding options for preterm versus term infants.
Main Methods:
- Review of current practices and recommendations for neonatal feeding.
- Emphasis on individualized assessment of infant's readiness and requirements.
- Discussion of appropriate milk choices, including breast milk and specialized formulas.
Main Results:
- Sucking and swallowing difficulties are common in preterm infants due to immaturity.
- Hypoglycemia prevention and adequate fluid provision are immediate feeding goals.
- Preterm infants have significantly higher energy and nutrient demands compared to term infants.
Conclusions:
- Mother's breast milk is the optimal initial feeding choice for preterm infants.
- When formula is necessary, preterm, low birth weight formulas are recommended for their enhanced nutritional content.
- Standard term formulas are inadequate for meeting the specific needs of preterm infants.
Abstract:
Individual babies may differ considerably in the way in which feeds can be introduced, the problems they encounter while this is going on, their final feed requirements and the need for supplementation. Sucking and swallowing reflexes are poorly developed before 32-34 weeks' gestation. Respiratory illness is probably the main reason for delay in the start of milk feeding. Immediate aims are to prevent hypoglycaemia and provide normal fluid requirements, if necessary by IV infusion or tube feeding. Preterm babies have large energy requirements. The mother's breast milk is the best milk with which to begin feeding. If a formula milk is given, it should be a preterm, low birth weight formula which supplies extra energy, protein and minerals, not a standard formula intended for babies at term.