Feeding and Nutrition

Feeding and Nutrition

FEEDING AND NUTRITION

CONTENT

How will my premature baby get nutrition

When will my baby gain weight

Can I breast feed my baby

How do I provide breast milk

When can my baby nipple or breastfeed

HOW WILL MY PREMATURE BABY GET NUTRITION

IV Fluids:

  1. If your baby is sick or very small he will receive his nourishment by a vein. Initially your baby’s IV will be glucose (sugar) water.
  2. Within a few days, your baby is started on total parenteral nutrition (TPN) with or without lipids.
  3. TPN is a yellowish liquid that contains the protein, sugar, vitamins, minerals and electrolytes your baby needs each day
  4. Lipid is a thick white liquid that provides the fat your baby needs each day.
  5. TPN, with or without the lipid, is all the nutrition your baby needs to grow at first. However, as your baby tolerates feedings, the TPN is decreased.
  6. TPN and lipid are discontinued before your baby is discharged.

Feedings:

  1. Your baby may be started on tube feedings.
  2. A tube is passed through the mouth or nose into the baby’s stomach.
  3. Breast milk or formula is put through the tube.
  4. The feeding may be a constant slow feeding, called a continuous feeding, or the feeding may be an ordered amount every few hours, called a bolus gavage feeding.
  5. Either way, the feeding amount is very small and increased slowly.
  6. Usually there is a time when both TPN and tube feedings are given to your baby. As the baby tolerates the tube feedings and we are able to increase the amounts, the TPN will be decreased and finally stopped.

WHEN WILL MY BABY GAIN WEIGHT

  1. Almost all babies lose weight before they begin to gain weight.
  2. This initial weight loss is generally 5-15% of the baby’s birth weight. Much of the weight loss is loss of water.
  3. Usually a baby does not regain his or her birth weight until about 2-3 weeks of age.
  4. Sometimes very sick babies gain weight the 1st few days. This is not a real weight gain; it is retention of water.
  5. As the baby’s condition improves, the baby will lose the water weight and begin to have a real weight gain.

CAN I BREAST FEED MY BABY

  1. YES, just because your baby is sick or premature does not mean you must formula feed your baby.
  2. At first a small baby is not able to suckle at the breast but you can provide breast milk. In fact we encourage you to provide breast milk for your baby even if you do not wish to breastfeed.
  3. Additional nutrients may be added to the breast milk.

HOW DO I PROVIDE BREAST MILK

  1. You will be asked to start pumping your breasts as soon after delivery as possible.
  2. The nurse on your floor will provide you with a breast pumping kit. Keep this kit and take it home with you when you are discharged.
  3. While you are still in the hospital, your nurse will bring the breast pump to your room.
  4. Bring the breast pumping kit with you each time you visit your baby in the NICU.
  5. Talk with your baby’s nurse about:
  6. Using the breast pump when you visit your baby (you must bring your kit with you)
  7. How to save your breast milk
  8. Getting the supplies to save your breast milk
  9. Bringing breast milk to the NICU
  10. Any medications you are taking while pumping or breastfeeding.

WHEN CAN MY BABY NIPPLE OR BREAST FEED

  1. When babies are sick or are a “preemie” they are not able to coordinate their sucking & swallowing with their breathing.
  2. This suck-swallow-breathe pattern usually isn’t coordinated enough to safely breast or bottle feed until about 34 weeks of gestation. However, all babies are different and some are ready a little earlier and some are ready a little later.
  3. The nurse can often tell when a baby is getting ready to nipple or breastfeed by the way he acts during the tube feeding.
  4. Some breastfeeding mothers participate in non-nutritive nursing. During a tube feeding, mom holds the baby close to her breast or actually puts the baby to breast. She continues to hold the baby close or to remain at breast as long as the baby remains latched-on or sucking or until the tube feeding is finished. This may help to stimulate the mother’s milk supply and provide closeness for the baby. Please talk with your baby’s nurse about this.
  5. Your baby’s nurse and the nurse practitioner and doctor will decide when it’s time to start bottle or breastfeeding your baby.
  6. At first your baby will have only 1 or 2 bottle or breast feedings a day.
  7. We slowly increase these feedings as your baby gets used to the extra work needed to bottle or breastfeed.
  8. Again, each baby is different and will advance on bottle or breast feedings at his own pace.

Reviewed/Revised:

4/03, 6/05, 4/07, 1/10

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