A Premature Baby's Nutritional Needs & Feeding Habits
Quick Answer
Your premature baby needs more calories, protein, and nutrients than a full-term baby, but has a smaller stomach and weaker feeding reflexes. Breast milk (maa ka doodh) is the best nutrition for preemies - it's specially designed to protect against infections and support rapid growth. With small, frequent feeds, proper supplements, and regular monitoring, most premature babies catch up to their peers by age 2. Your baby can absolutely thrive with the right care.
What Makes a Baby Premature?
Watch: Benefits of Breast Milk for Baby & Mother | Why Breastfeeding is Important? #breastfeeding #newmom
A baby is considered premature if born before completing 37 weeks of pregnancy (a normal pregnancy is 40 weeks). India has a high preterm birth rate, with about 35 lakh babies born prematurely each year.
Reasons for premature birth include:
Multiple pregnancies (twins, triplets)
Infections during pregnancy
Maternal health conditions (high BP, diabetes)
Previous premature deliveries
Placental problems
Sometimes, no clear reason
For first-time preemie parents: Having a premature baby is emotionally overwhelming. It's okay to feel scared, sad, or anxious. But know that medical advances mean even very early babies have excellent survival rates. Focus on what you can do: provide breast milk, do kangaroo care, and be present.
Why Preemies Need Special Nutrition
Your premature baby's body is still developing the systems that full-term babies have ready at birth:
Challenge
What It Means
Tiny stomach
Holds only 1-5 ml initially
Weak suck-swallow reflex
Tires easily, may need tube feeding
Immature digestive system
Needs easily digestible milk
Higher metabolism
Requires more calories per kg
Low nutrient stores
Missed third-trimester nutrient buildup
Weak immune system
Needs antibodies from breast milk
The good news: Your breast milk is perfectly adapted to meet these needs.
Breast Milk: Nature's Perfect Food for Preemies
Your Preterm Milk is Special
If you deliver prematurely, your body knows it. Your milk is different from the milk of mothers who deliver at term:
Preterm breast milk contains:
20% more protein
Higher fat content
More infection-fighting antibodies
Better absorption of nutrients
Perfect digestibility for immature gut
Critical Protection
Breast milk provides crucial protection against:
NEC (Necrotizing Enterocolitis): A dangerous intestinal disease; breast milk reduces risk by up to 77%
Sepsis: Blood infections common in preemies
Respiratory infections: Your antibodies protect baby's lungs
Developmental delays: Long-term brain development benefits
Feeding Your Preemie: Step by Step
While in NICU
If baby cannot feed directly:
Start pumping within 6 hours of delivery
Use a hospital-grade double electric pump
Pump for 15-20 minutes every 2-3 hours
Even a few drops of colostrum (peela doodh) are valuable
NICU staff will feed baby via:
Feeding tube (gavage)
Cup/paladai when baby is stronger
Eventually bottle or breast
Tips to boost milk supply for pumping:
Pump next to baby's incubator when possible
Do kangaroo care (skin-to-skin) before pumping
Look at baby's photo while pumping
Stay hydrated - keep water bottle handy
Don't stress about quantity initially; it will increase
Transitioning to Direct Breastfeeding
Most babies can start trying to breastfeed around 32-34 weeks corrected gestational age:
Step 1: Non-nutritive sucking
Baby practices sucking on emptied breast
Builds coordination and stamina
Step 2: Short nursing sessions
5-10 minute feeds
Still supplemented with expressed milk
Step 3: Gradual increase
Longer feeds as baby shows readiness
Weight monitored to ensure adequate intake
Step 4: Full breastfeeding
Some preemies achieve this in NICU
Others need more time after discharge
Feeding at Home
Once home, establish a routine:
Feed on demand or every 2-3 hours
Watch for hunger cues (rooting, mouthing, fussiness)
Keep feeding sessions calm and quiet
Burp gently after feeds
Track wet diapers and weight gain
Essential Supplements for Preemies
Breast milk may need support for very early babies:
Human Milk Fortifiers
Added to expressed breast milk to boost:
Protein
Calories
Minerals
Prescribed for babies born before 32 weeks or with very low birth weight.
Required Supplements
Supplement
Purpose
Typical Duration
Iron
Prevent anemia (preemies have low stores)
12+ months
Vitamin D (400 IU/day)
Bone development
1-2 years
Calcium
Strong bones
As per doctor
Multivitamins
Overall nutrition
First year
Important: Give supplements exactly as prescribed. Don't stop without consulting your pediatrician.
Tracking Growth: Corrected Age Explained
This is one of the most important concepts for preemie parents:
Corrected Age Formula:
Actual age in weeks - Weeks born early = Corrected age
Example: Your baby is 6 months old but was born 2 months early
6 months - 2 months = 4 months corrected age
Use corrected age for:
All developmental milestones
Growth chart plotting
Deciding when to start solids
Any comparison with other babies
Use actual age for:
Vaccinations
Medical history
Growth Expectations
Normal patterns:
Initial weight loss (up to 15%) in first week
Weight gain starts after 7-14 days
Expect 15-20 grams/day once feeding is established
"Catch-up growth" continues after discharge
Most preemies catch up to peers by 2 years
Growth monitoring:
Weekly weight checks initially
Monthly length and head circumference
Plot on preemie growth charts using corrected age
Starting Solid Foods (Weaning)
For premature babies:
Use corrected age (around 6 months corrected)
Baby should show readiness: head control, sitting with support, interest in food
Start with iron-rich foods: ragi porridge, dal ka paani, mashed banana
Continue breast milk alongside solids until at least 2 years
Hygiene for Your Vulnerable Baby
Preemies are more susceptible to infections:
Essential precautions:
Strict hand washing for everyone
Limit visitors, especially those with colds
Sterilize all feeding equipment
Keep baby away from crowded places initially
Ensure vaccinations are up to date
Celebrating Milestones
Every small achievement matters:
First successful latch
Gaining birth weight back
Moving from tube to oral feeding
Coming home from NICU
Each gram gained
Reminder: Your preemie's journey is unique. Don't compare with full-term babies. Celebrate your baby's individual progress.
When to Seek Help Immediately
Call your doctor if your preemie shows:
Refusal to feed
Persistent vomiting
Bloody stools
Fever (above 100.4°F/38°C)
Breathing difficulties
Unusual lethargy
No wet diapers for 6+ hours
Poor weight gain over 2 weeks
Expert Insight: Dr. Sumitra often reminds parents: 'Breastfeeding is a skill that takes time to master. Don't be hard on yourself.'
FAQs
Q: My preemie is 2 months old but was born 6 weeks early. Should I compare development to a 2-month-old or 2-week-old?
A: Use corrected age for development comparisons. Your baby should be meeting 2-week-old milestones, not 2-month-old ones. This continues until age 2-3 for most developmental assessments.
Q: How often should I feed my preemie at home?
A: Initially every 2-3 hours, including at night. This may mean 8-12 feeds in 24 hours. Your pediatrician will guide you based on weight gain. Don't let your preemie sleep more than 4 hours without feeding in the early months.
Q: My milk supply dropped after leaving NICU. What can I do?
A: This is common due to stress and schedule changes. Try: pumping after every breastfeed, power pumping (20 min pump, 10 min rest, 10 min pump), galactagogues like fenugreek (methi) if doctor approves, and most importantly, stay hydrated and rest when possible.
Q: Can I give formula if I don't have enough breast milk?
A: Yes. Special preterm formulas are designed for premature babies. Many mothers combine breast milk and formula. Discuss with your pediatrician about the right formula choice for your baby.
Q: When will my preemie sleep through the night?
A: Preemies need frequent feeds for optimal growth, so night feeds continue longer. Use corrected age expectations. Most preemies can go 4-5 hour stretches by 4-6 months corrected age, but continue to follow your baby's hunger cues.
Q: Family members want to give gripe water and janam ghutti. Is this safe?
A: No. Preemies have immature immune and digestive systems. Traditional remedies can contain harmful ingredients, bacteria, or cause allergic reactions. Stick to breast milk, prescribed formula, and doctor-recommended supplements only. Your baby's safety comes first.
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This article was reviewed by a pediatrician. Last updated: January 2025
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