Tips and advice for feeding your preemie

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Highlights
  • Feeding a preemie, whether breastfeeding or formula feeding, may present special challenges.
  • There are many ways to help you and your preemie have successful feedings.
  • Learn how to look for signs that your baby is ready for solid foods.

Many preemies are still working on their feeding skills weeks after they go home from the NICU. You may need to wake your baby to feed, and he may be too tired to drink very much at one time. He may also have other feeding-related obstacles to overcome, such as: 

  • Reflux 
  • Poor suck/swallow/breathe patterns
  • Frequent crying and fussiness with feeding
  • A slow pace of eating

 

Different babies have different needs, so your NICU team will send your baby home with a special feeding plan. The plan will be monitored after you leave the NICU and changed, as needed, based on your baby’s growth and development.

Breastfeeding

Breastmilk is the gold standard for infant feeding, but many preemies are unable get the extra nutrients they need from breastmilk alone. Breastmilk supplements or special infant formula may be recommended by your baby’s doctor or dietitian to help him get the nutrition he needs to grow. 

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Pump after each feeding to fully empty each breast and build a good milk supply. This pumped milk can be stored in the freezer for several months. It’s never too early to build a breastmilk reserve, especially if you plan to return to work. 

Formula feeding

Many preemies need more nutrients than what is provided in formulas designed for full-term infants.  Special formulas are available to help meet the nutritional needs of babies born prematurely after they leave the hospital. These formulas have levels of calories, protein, vitamins and minerals that fall between regular and preterm formulas. This nutritional insurance helps bridge the gap between the needs of preterm and term infants.

Feeding tips

The following tips can help your baby have a successful and nurturing feeding time.

  • Cuddle “kangaroo” style — hold your baby skin-to-skin while feeding.
  • Create a calm and quiet environment and try to limit interruptions.
  • Support your baby’s head while feeding and keep it higher than his belly.
  • Burp him frequently to reduce spit-up.
  • Be patient. It may take 20 to 30 minutes for him to finish a feeding. 
  • Gently wake him and encourage him to eat a little more if he finishes after only around 15-20 minutes.  
  • Carefully follow all preparation and storage directions for the formula or stored breastmilk you might be bottle-feeding. 
  • Clean all supplies well, for both bottle-feeding and pumping, to reduce contamination. 
  • Always wash hands thoroughly before preparing bottles 

Is he eating enough?

Some preemies come home on a good feeding schedule and are happy to let you know when they’re hungry. Others would rather sleep than eat, which means you may need to gently wake him for feedings. Still, other infants are working to build the endurance they need to complete a full feeding. Preemies tend to eat more frequently, but take less at each feeding than a baby born at term. 

  • Expect him to eat 8 to 10 times a day (possibly 10 to 12 if he’s breastfed), which will be about every 2 to 3 hours for the first several weeks after he is home.
  • If he goes longer than three hours between feedings, offer him the breast or bottle. 
  • If he has fewer than 6 wet diapers in 24 hours, or if his feedings are more than four hours apart, talk to your pediatrician, as he may be at risk for dehydration.

Starting your preemie on solid foods

Since your preemie didn’t spend a full 40 weeks in your womb, he needs extra time to catch up on both growth and development before starting solids. Most babies born prematurely should start solid foods at four to six months corrected age (number of weeks since birth minus the number of weeks he was born premature). However, knowing when to start your premature baby on solid foods is less about his age and more about where he is developmentally. 

Here are some signs that your baby might be ready for his first solid food:

  • Sits with help or support
  • On tummy, pushes up on arms with straight elbows
  • Moves pureed food or infant cereal forward and backward in mouth with tongue to swallow
  • Cries or fusses to show hunger
  • Smiles and looks at you while feeding
  • Opens mouth and leans toward spoon


Talk to your baby’s doctor before starting any solid foods to ensure that he is developmentally ready.

Good to know

Iron-rich infant cereal is a great choice for your baby’s first solid food.

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