Once you’ve arrived home with your premature baby, feedings will be as challenging and time-consuming as they were in the hospital. You’ll need to experiment with different teats, bottles, nursing positions, and so on. As a general rule, premature babies need to be fed smaller amounts and more often than full-termers. They feed slowly and tire easily. Depending on your baby’s progress, you may or may not need to continue using formula specifically designed for premature babies. Often parents continue to use the same small bottles that were used in the hospital. But keep in mind that what worked in the hospital might not work as well once you’re home and your baby continues to grow in both size and maturity.
You can expect to encounter one or all of the following feeding concerns at home (though some lucky parents experience none at all):
- Sleepy baby: Many premature babies tire easily and the desire to sleep sometime overrides the desire to eat. But since all babies, especially those born small, need regular feeding, it is all the more important that you make sure your baby doesn’t sleep through feedings.
- Breath holders: Some premature babies, especially those who were born without good suck-breath coordination, will forget to breathe when feeding. This is tiring for your baby and anxiety-producing for you. If you notice your baby hasn’t taken a breath after a number of sucks or looks pale while feeding, remove the nipple from baby’s mouth and let him or her take a breath. If your baby seems to be holding his or her breath all the time during feedings, regularly remove the nipple after every three or four sucks.
- Oral aversion: Babies who have spent a lot of time in the NICU may have come to associate the mouth with unpleasant experiences (feeding tube, ventilator tubes, suctioning, and so on) and often develop a strong aversion to having anything in or around their mouth once they are home. To combat this, try to replace the unpleasant oral associations with more pleasant ones. Touch your baby around the mouth in a soothing manner, give your baby a dummy or your finger to suck, or encourage your baby to touch his or her own mouth or sucks on his or her thumb or fist.
- Reflux: Many premature babies are prone to excessive spitting up or GER because of their immature digestive systems.
- Starting solids: Like full-term babies, premature babies should start receiving solids somewhere between four and six months. But for premature babies, the date is based on their corrected age rather than chronological age (which means a premature baby wouldn’t be ready for solids until 6 to 8 chronological months). Because some premature babies experience delays in development, solid feedings should not be started until the baby shows signs of readiness, even if the corrected age says ‘it’s time’ for solids. Some have a more difficult time with solids – specially once they graduate to chunkier foods.