Most premature babies have low birth weight.

Your preemie will probably need to gain some weight in the hospital before she can go home. Her doctors want her to eat enough volume to assure that she gains the weight she needs to become stronger and healthier. Breastfeeding is best for babies. If a baby is too premature to breastfeed, moms are encouraged to pump their milk. Sometimes, doctors will recommend adding a commercially-prepared human milk fortifier to your expressed breast milk to give your baby more protein, vitamins, calcium and other nutrients at this early stage. As she gets more mature, and her ability to coordinate suck and swallow improves, your doctor may tell you that she is ready for direct breastfeeding.
If your baby is on formula, your baby's doctor will probably recommend a special formula for premature babies, fortified with more protein, vitamins and minerals than regular term formula.

Premature babies need to eat at least every three hours.

Tinier babies have tinier tummies. This means she'll have to eat a lot of small meals in order for her to gain weight.

Their mouths are often extra-sensitive.

If your baby has spent her first few days with tubes and respirators in her mouth, she may assume that anything that goes into her mouth is painful, including a breast or a bottle.

Premature babies take longer to feed.

Chances are, her feeding skills haven't fully developed, so it is important to take your time when feeding her. Feeding her too fast by mouth may result in a feeding aversion or spitting up. Furthermore, premature infants are born with a less-developed digestive system than a full-term infant, so, digestive problems are common.
Here are some things that your baby's doctor or nurse may suggest you do to be able to successfully breastfeed your premature infant:

  • Hold your baby next to your skin so she can listen to your heart. This is called kangaroo care and it will help your baby get ready for breastfeeding.
  • First, let your baby practice on an almost empty breast. This is called non-nutritive nursing. You will pump right before putting your baby to your breast. Your baby can practice, but will not swallow much milk. This also gives you time to learn how to put your baby to your breast and how to latch your baby on.
  • While your baby is practicing, breast milk will most likely be given through a feeding tube.
  • Your doctor or nurse will tell you when your baby is ready for nutritive nursing.
  • During nutritive nursing, you do not pump before putting your baby to your breast.
  • At first, most babies will take very little and that's ok. Your baby is still learning. Your baby's nurse will estimate the amount your baby took from the breast and subtract this from the amount she needs. This difference will be given by feeding tube or bottle.
  • Over several days, your baby will take more from the breast and less from the feeding tube or bottle. It is important to be patient, most babies will learn to breastfeed given enough time.

Try these tips on feeding your premature infant:

  • Each baby is unique. Follow the advice of your baby's doctor.
  • Make sure your baby is fully awake before feeding.
  • Ask the nurses to watch you during feedings to be sure you are holding the baby in a comfortable position and feeding her correctly.
  • Introduce your baby to a nipple. Even if she is still feeding by tube, this will help her adjust to bottle-feeding when she's ready. You may need to try different nipples at first.
  • Keep a record of your baby's feedings.
  • Get growth charts, specially designed for premature babies, from your baby's doctor to help monitor her progress.

When you get home:

  • Keep your baby on a regular schedule, to help her eat better.
  • Don't force your baby to eat. If she's not sucking as fast, sealing her lips or turning away, she may be full.
  • Feed her on demand, not a schedule. Studies have shown that premature babies grew at a faster pace when fed on demand.
  • Enlist the help and support of family and friends, to give yourself a break.

When your baby leaves the hospital, talk to your baby's doctor about Enfamil EnfaCare A+, a post discharge formula designed to meet the increased nutritional needs of low birth weight or premature infants with extra calories, protein, vitamins and minerals. Enfamil EnfaCare A+ may be available through provincial drug benefits programs. Ask your doctor or pharmacist if you qualify for Alberta Health and Wellness, Programme de médicaments de l'Ontario, Regie de l'assurance Maladie du Quebec or the SaskatchewTan Aids to Independent Living programs.

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