Prematurity Awareness Topic: NICU Feedings

...Fight for Preemies Nov 17th

Full term babies can breast or bottle feed easily within minutes of birth. Preterm babies cannot. NICU feeding is different than feeding a full term baby, yet another complication of prematurity. Most NICU babies get their first feedings thru a tube in their mouth or nose. Not the bonding moment most moms dream of when they picture feeding their newborn the first time.

This is a topic that is near and dear to my heart for two reasons:

I had a sweet baby boy, born 7 weeks too early and a lot the information in this great article of this applies to him and the path he was on only a few months ago.

I am extremely proud to be a human milk donor to our local NICU, so not only my son has benefitted from the gift of breast milk, but other babies whose mom's choose not to or cannot breastfeed as well. I have donated over 1600 oz to date, that in gallons is roughly 12. Considering when my son was released from the NICU he was only taking about 2 1/2 oz. that amount will feed a ton of babies!

The Boston's Children's Hospital explained it quite well on their page:

Nutrition for babies in the NICU:

Feeding babies in the NICU is quite different from feeding healthy babies. When babies are sick or premature, they are often not well enough to breastfeed or take a bottle. Premature babies may not be able to suck effectively, or their gastrointestinal tracts may not be mature enough to digest feedings. Babies who are medically unstable are often unable to take regular feedings. Babies with umbilical catheters and those on mechanical ventilators may not be able to be fed because of the risk of aspiration (breathing food into the lungs).

Intravenous (IV) Fluids and Parenteral Nutrition

Many babies in the NICU receive essential fluids and electrolytes through a tube in a vein called intravenus (IV) fluids. Some babies may need a special preparation called parenteral nutrition, which contains nutrients they need until they are able to take milk feedings.
The contents of IV fluids and perenteral nutrition are carefully calculated for each baby. Calories, protein, fats, and electrolytes including sodium, potassium, chloride, magnesium, and calcium are all important components. Babies need calories, protein, and fats for adequate growth and development. Fluids, electrolytes, and vitamins are necessary for functioning of body systems.

Blood tests help determine how much of each component a baby needs and the amount of each nutrient can be increased or decreased accordingly. Daily weights and keeping track of a baby's urine output also help monitor fluid needs.

Sick babies may not be strong enough to suck effectively. Premature babies may not be physically mature enough to coordinate sucking, swallowing, and breathing, or they may be too weak to suck for long periods of time. Special pacifiers designed for premature babies are sometimes used to teach them how to suck properly before they begin to breastfeed or bottle feed.

A mother's breast milk is the preferred milk for all babies, even the most premature babies. Breast milk contains all the nutrients needed for growth and development. Although commercial milk formulas are designed to be close to breast milk, most are based on cow's milk. The fats in breast milk are more easily digested. Formula is digested more slowly than breast milk and may not be as well tolerated. In addition, breast milk contains antibodies from the mother to help protect babies from infection, something commercial formulas do not have. This protection is especially important when babies are sick or premature and may have higher chances of developing an infection.

Premature babies, especially those younger than 32 to 34 weeks gestation, often cannot be fed from the breast or bottle. Gavage or tube feedings may be needed until the baby learns to suck effectively. For gavage feedings, a small flexible tube is placed into a baby's nostril or mouth and passed down into the stomach. The tube is sometimes removed, but may be left in place if feedings are frequent.

As you can see, Gunner had feeding tubes in two different locations. They started in his mouth and moved to the nostril when he became more interested in breast feeding. He then graduated to bottle feeds. None of this was in the plans, but prematurity changed all that!