Nourishing Preterm Infants and Nutritional Monitoring
The time has come and you head home from the neonatal intensive care unit and the hospital. At discharge, you will be provided, among other things, directions on continuing your infant’s growth and development follow-up, at a family health center. Even if you have been provided a detailed explanation on feeding that applies to your infant, it Is natural not to remember everything, for you to have questions and the first few days with your infant, who were provided full care in the neonatal intensive care unit until now, will be confusing and full of questions. Attenttive feeding of infants is a key question that many parents of preterm infants ask.
Nutrition of the preterm infant in the first days at the hospital
During the stay in the neonatal intensive care unit, your infant was provided a nutritional plan according to their vital statistics, all of which were taken into account:
-
Course of pregnancy -
Reason for preterm delivery -
Week of birth -
Birth weight -
Growth rate -
Medical condition -
Medications administered at the neonatal intensive care unit
By definition, a preterm infant is any infant born before week 37 of pregnancy. Of course, there are various types of preterm infants, from those born in the 24th week to ‘late preterm’, which is the definition for infants born in weeks 34 to 36+6 of pregnancy.
The earlier the preterm infant is born, the less stores of fat, protein, iron and minerals they have. These stores are highly important for normal functioning of the body: respiratory functioning, regulating heat, building bones and more. Therefore, the nutritional goal during the hospital stay is to provide the required nutrients in sufficient quantities to simulate the rate of storage and growth that would have occurred had your infant been born at full term. This goal is usually achieved by enriching the preterm infant’s nutrition.
Note
Note
In preparation for discharge, you will be provided an exact briefing of your infant’s nutritional needs and the frequency of follow up they need.
Nutritional recommendations after hospital discharge
After being discharged from the hospital, you can consult nurses and lactation consultants at a family health center about the preterm infant’s nutrition, breastfeeding, infant formula or a combination of these. The nurses and consultants may help provide guidance on maintaining breastfeeding, help in pumping of milk and transition from pumped milk to direct suckling from the breast. If your infant was discharged with directions about enriched breast milk or using preterm infant formula, it is important to arrange a later meeting with a pediatric nutritionist in the community for continuing nutritional follow-up.
Meal intervals
The directions provided at discharged must be followed, while you learn your infant’s signs of hunger and satiety.
For further reading on attentive feeding and signs of hunger and satiety in infants
Use of nutritional supplements
According to the Ministry of Health’s recommendations, preterm infants start to get supplementary vitamin D during their stay in the neonatal intensive care unit, once they reach full feeding volume. Also, from two weeks’ age, most preterm infants will start to get an iron supplement to prevent anemia. The family health center nurses will provide an explanation on taking iron and dosage by body weight.
- Vitamin D supplement: the standard dosage is 400 international units (IU) per day.
- Iron supplement: the standard dosage is 2-3 mg per kg per day (equivalent of 1 drop / kg per day), unless you have been instructed otherwise by a professional.