Feeding your premature infant
Breast milk has proven benefits, especially for the fragile premature infant. Benefits of breast milk over formula include better immunity to dangerous infections, nutrient absorption, digestive function, and nervous system development. So your hospital is likely to strongly encourage you to provide breast milk for your infant during the first weeks of life, at a minimum. A lactation consultant can be very helpful with pumping and breast-feeding questions and problems, both before and after the birth.
Your infant will probably need to start slowly with breast-feeding. Usually, one or two breast-feedings a day are enough to start. As he or she gains strength and weight, you can gradually replace more tube feedings with breast-feedings.
Premature infants can have trouble learning to breast-feed. If you find yourself feeling frustrated or worried about it, get help. Both the NICU nurses and your lactation consultant have years of experience with preemie feeding problems.
As your infant feeds more by mouth, you may not be there for all of your baby's oral feedings. So your infant may need to bottle-feed too. Work with the NICU nurses and lactation consultant to decide whether and when to introduce a bottle. This may help your baby avoid nipple confusion, which is a baby's preference for an artificial nipple over the breast.
If you are undecided about breast-feeding, consider keeping your options open. You can pump to keep your milk supply going until you've had time to decide. Any amount of breast milk offers your premature infant greater protection from infection than no breast milk at all. But keep in mind that anything you put in your body can be passed to your baby in breast milk. If you are breast-feeding, do not drink alcohol, take drugs, or smoke. And before you take any kind of medicine, herb, or vitamin, ask your doctor if it is safe.
You can give your baby pasteurized breast milk from another woman. But donated breast milk may be costly. And it's not proved to prevent more illness than preterm formula does.1
Babies whose birth weight is very low [less than 1500 g (3 lb)] usually need extra nutrients to help them grow. You may need to mix a powder supplement (fortifier) with breast milk or formula.
You may have to start by pumping your milk to tube-feed to your premature infant. Regular pumping keeps up your milk production for when your infant is ready to breast-feed. (Your premature infant may not be able to feed by mouth right after birth. If your infant can't digest milk yet and requires intravenous feedings, your milk will be frozen for future use.)
While you are still in the hospital, talk to a lactation consultant and become familiar with the double electric breast pump.
Like most new things, pumping for your infant will get easier with practice. Pump as often as your infant feeds, about every 2 to 3 hours, and at least once at night. Bring your labeled bottles or bags of milk with you to the NICU to feed your infant or to freeze for later use.
For more information about pumping and breast-feeding, see the topic Breast-Feeding.
There are formulas made just for premature infants. They provide most of the nutrients your baby needs. Soy protein-based formulas are not recommended for premature infants.2 For more information, see the topic Bottle-Feeding.
- Schanler RJ (2007). Evaluation of the evidence to support current recommendations to meet the needs of premature infants: The role of human milk. American Journal of Clinical Nutrition, 85(2): 625S–628S.
- Bhatia J, et al. (2008). Use of soy protein-based formulas in infant feeding. Pediatrics, 121(5): 1062–1068.
Last Updated: May 5, 2009
Author: Debby Golonka, MPH