When a preemie is born, their tiny body hasn’t yet fully developed, especially their digestive system and feeding skills. As a result, most preemies need to stay in the NICU (Neonatal Intensive Care Unit) for observation and specialized care, which includes feeding. As a parent, you may be wondering, "How are they feeding my baby? Is my little one getting enough?" Here's an overview of the three main feeding stages preemie babies go through in the hospital.
1. Parenteral Nutrition (IV Feeding)
In the first stage, many premature babies aren't yet able to feed orally due to underdeveloped digestive systems and weak sucking reflexes. Instead, they receive parenteral nutrition—a form of IV feeding. This method delivers essential nutrients like glucose, amino acids, vitamins, and minerals directly into the bloodstream.
Typically, this stage starts within the first 24 hours after birth and helps stabilize the baby’s condition until they can tolerate other feeding methods. Once the baby shows signs of improvement, feeding progresses to the next stage.
2. Tube Feeding (Gavage Feeding)
As the preemie grows stronger, the next stage is tube feeding. This involves inserting a soft tube through the baby’s nose or mouth into their stomach to deliver expressed breast milk, formula, or specialized nutrients. Gavage feeding is not just for providing nutrition—it also helps stimulate the baby’s developing digestive system.
In the first few days of life, babies often can’t yet suck effectively, so tube feeding provides a safe way to nourish them without overtaxing their tiny bodies. If the baby tolerates tube feeding without vomiting, bloating, or other issues, doctors will gradually increase the volume of milk until the baby no longer needs IV nutrition.
For moms who can't breastfeed directly, donor milk or preemie formula can be used. In some cases, even babies born as early as 34 weeks may not yet be able to nurse directly, so moms are encouraged to start pumping as early as possible. Donated milk from other preemie moms is often available to help bridge the gap until direct breastfeeding is possible.
3. Direct Breastfeeding (or Bottle Feeding)
The final stage of feeding involves direct breastfeeding or bottle feeding, once the baby has gained strength and coordination. Preemies can typically start attempting direct breastfeeding around 34 weeks gestation. Babies need to be able to perform three crucial actions at once: suck, swallow, and breathe. If they can manage this, they are ready to start the transition from tube feeding to direct feeds.
At first, your baby may struggle to latch or may tire quickly, and it’s normal for them to nurse only briefly. It may take several days or weeks for your baby to develop the stamina to nurse for a full session. In many cases, the baby will still need tube feeding or supplemental milk until they can feed effectively from the breast or bottle.
Understanding the Process
It’s important to note that these feeding stages are not always linear. Sometimes, babies might move back to tube feeding if they’re not yet able to fully coordinate sucking, swallowing, and breathing. However, with time and practice, preemies often progress to exclusive breastfeeding or bottle feeding, typically when they are stable enough to feed within 20–30 minutes without difficulty.
Final Thoughts
Every preemie is different, and feeding schedules and milestones may vary. The medical staff at the NICU work closely with parents to monitor your baby’s progress and make sure they are nourished in the best way possible. As a parent, your support—whether by pumping, providing donor milk, or offering comfort—is crucial during this time. Over time, your preemie will grow stronger, and feeding will become more natural for both of you.
Remember, while it may take time for your little one to reach these milestones, with patience and consistent care, your preemie will soon be thriving!
