How Can Healthy Nutrition Be Ensured for Preterm Babies?

How Should Preterm Babies Be Fed?

Preterm babies are defined as babies born before the 37th week of pregnancy. Since their organ systems are not yet fully developed, their nutritional needs are more sensitive and specific compared to full term babies. Proper nutrition in preterm infants plays a vital role in growth, immune system development, brain function, and long term health.

This article explains the nutritional journey of preterm babies in a clear and comprehensive way, from the first days after birth to the transition to complementary foods.

Why Is Nutrition Different for Preterm Babies?

Preterm babies have smaller stomach capacities, underdeveloped sucking and swallowing reflexes, and immature digestive systems. At the same time, their energy and protein requirements are higher relative to their body weight. For this reason, feeding plans must be carefully tailored.

Inadequate or improper nutrition may lead to poor weight gain, weakened immunity, and developmental delays. Nutrition for preterm babies should therefore focus not only on feeding but on supporting optimal development.

Feeding During the First Days After Birth

Most preterm babies are monitored in a neonatal intensive care unit after birth. During this period, feeding methods are determined based on the baby's gestational age, birth weight, and overall health condition.

Some preterm infants may be too small or weak to feed orally. In such cases, nutrition is provided intravenously parenteral nutrition or through a thin feeding tube placed in the stomach. The goal is to meet nutritional needs without overloading the digestive system.

The Importance of Breast Milk for Preterm Babies

Breast milk is the most valuable source of nutrition for preterm babies. It is easy to digest, rich in antibodies that protect against infections, and supports intestinal health. In fact, breast milk produced after a preterm birth often contains higher levels of protein and immune components than milk produced after a full term birth.

If the baby is unable to breastfeed directly, expressing breast milk and providing it via tube or bottle is extremely beneficial.

When Are Breast Milk Fortifiers Needed?

In some cases, breast milk alone may not fully meet the nutritional needs of a preterm baby. Under medical supervision, breast milk fortifiers may be added to increase protein, calcium, phosphorus, and overall energy intake.

Breast milk fortifiers should always be used based on healthcare professional recommendations and should never be introduced without guidance.

Use of Formula in Preterm Babies

When breast milk is unavailable or insufficient, formulas specially designed for preterm babies may be used. These formulas contain higher energy and protein levels and are formulated for easier digestion.

Standard infant formulas may not meet the needs of preterm babies, so formula selection should always be made under medical supervision.

Feeding Frequency and Portion Sizes

Preterm babies are typically fed small amounts at frequent intervals. Due to their limited stomach capacity, large volumes can cause digestive discomfort.

Feeding volumes and intervals are gradually adjusted according to the baby's tolerance, weight gain, and overall development, aiming for steady and healthy growth.

Nutrition After Hospital Discharge

After discharge, nutrition should continue to be closely monitored. Some preterm babies may need to continue with fortified breast milk or preterm formula for a certain period.

Regular monitoring of weight, length, and head circumference is essential, and feeding plans may be adjusted accordingly.

When Do Preterm Babies Start Complementary Feeding?

The transition to complementary foods in preterm babies is based on corrected age rather than chronological age. In most cases, complementary feeding begins around the corrected age of six months, provided the baby shows developmental readiness.

Key readiness signs include good head control, the ability to swallow properly, and interest in spoon feeding.

Important Points During the Transition to Complementary Foods

The transition to solid foods should be slow and carefully monitored in preterm babies. Foods should be introduced one at a time, and any signs of allergies or digestive issues should be observed.

Pureed textures should be preferred initially, and salt, sugar, and processed foods should be strictly avoided.

Common Feeding Mistakes in Preterm Babies

• Increasing feeding amounts too quickly
• Forcing the baby to eat
• Changing formula or supplements without medical advice
• Starting complementary foods too early

Such mistakes may lead to feeding refusal, digestive problems, and unnecessary stress for both baby and parents.

Conclusion: Patience, Monitoring, and Informed Care

Feeding a preterm baby requires patience, attention, and close follow up. Each baby develops at a unique pace, and feeding plans should be individualized. While breast milk remains the first choice, additional nutritional support may be necessary in some cases.

When transitioning to complementary foods, developmental cues should guide the process, and families should avoid rushing. With proper nutrition and careful monitoring, preterm babies can grow and thrive healthily.

For more detailed guidance on the transition to complementary foods, you may also want to read our article: First Tastes Guide for Introducing Complementary Foods to Babies .