Caring for preemies

Having a baby arrive early can be a difficult experience, not least so if the baby is unwell. Preterm babies are especially vulnerable to poor growth and high risk of developing various disorders since they are born with significantly insufficient nutrient stores.

When a baby is born too early, her major organs are not fully developed, which may possibly lead to various health problems. The condition becomes critical if the baby is born before the 32nd week of gestation. Since less time has been spent in utero (i.e. inside the uterus), the baby’s nutritional status has been invariably compromised.

Most often, preemies are born with depleted stores of key nutrients, such as proteins, zinc, iron, calcium, vitamin A, sugar, and have no subcutaneous fat.

A preterm baby grows faster in the weeks after birth and therefore needs higher amounts of energy and protein to meet her nutritional requirements.

Babies born with extreme low weight are more likely to experience high rates of mortality and morbidity. Preterm babies are also at a risk of developing respiratory distress as their lungs are not fully formed. In-utero growth restriction is associated with impaired neurodevelopment as well as vascular disease, diabetes and obesity in later life. Such babies may continue to have short stature well into childhood and adolescence, and may have less than typical intellectual and developmental outcomes due —  in part — to nutritional deficiencies.

Nutritional requirements of preemies differ, depending on the degree of prematurity, size, weight, etc. Breast milk is the best choice for preterm infants as it bestows key nutrients which are essential for the growth of the baby.

But, most often, preterm infants are found with impaired ‘suck-swallow-breathe’ pattern and are not able to absorb sufficient milk to meet their nutritional requirements. In such cases, it becomes necessary to supplement breast milk with human milk fortifiers or preterm formula.

While exclusive breastfeeding is the gold standard for term babies, for preterm babies who cannot suck expressed breast, milk fortified with human milk fortifiers along with breastfeeding is a very good option. It is important to recognise that nutrient supplementation in addition to breastfeeding could help preterm babies.

However, any decision in this regard must be taken under proper medical guidance.