Premature babies

National guidelines and information on weaning are based on healthy full term babies. First solids for premature babies and low birth weight babies pose even more of a challenge. The information below are guidelines only and before weaning you should really discuss it with your health visitor first.

Low birth weight and premature babies often miss out on some of the normal and vital nourishment that is passed from mum to baby in the womb in the latter weeks of pregnancy. This means that some prem babies may need additional nutrition later on to help them catch up. It’s also common for the process of weaning to take a little longer than with term babies due to slightly slower development.

When to wean

Bliss, the special care and premature baby charity, recommends that weaning starts between 5 and 7 months old, being the actual aged based on date of birth, not the due date. It isn’t a good idea to wean any earlier than 5 months as the digestive track is less likely to be fully developed to be ready to take solid food.

The signs that your baby is ready to wean are the same as with a full-term baby.

  • he/she shows interest in other people eating
  • milk doesn’t seem to fully satisfy
  • your baby puts things into their mouths regularly
  • they can be easily supported in a sitting position

How to wean

Again this is mainly the same as with full term babies, although preterm babies may not be able to support themselves as well. They need to be sitting as upright as possible without their head wobbling around. A rolled up towel behind their necks can help with this. You can feed them in your arms to begin with but to help development they need to be sitting independently as quickly as possible.

Although you may need to take weaning a little more slowly, you can follow the general guidelines to wean your preterm baby. You may want to hold back on the fingerfoods until they’re fully supporting themselves in a high chair, to reduce the risk of choking. They should be able to sit up and bring both their hands together in front of them without falling forward before letting them feed themselves. Baby lead weaning isn’t appropriate for preterm/low birth weight babies. NB Learning to feed themselves is a crucial part of development so it’s good to encourage this as soon as possible

Premature babies can be more prone to constipation when introduced to different types of food, due to a slower digestive track. Give them plenty of fluids and fruit will help keep them regular. If your concerned please speak to your health visitor.

Drinks

Preterm babies should continue to drink formula or breast milk for at least 12 months after their DUE date. Full term babies can drink cow’s milk from their first birthday but preterm babies digestive system may not be ready for it by their actual first birthday. It’s important to speak to your health visitor or pediatrician about moving your baby onto cows milk. Babies on breast milk as their main drink will probably need to take vitamin D and iron supplements beyond their first birthday.  If you’re child is taking a specialised milk your medical team will be able to give you specific advice.

Other drinks can be offered to your baby once they are on 3 meals a day. Cooled boiled water, particularly in hot weather, is the best bet, and very diluted fruit juice with meals. However, don’t let your baby fill themselves up on liquids so they don’t have room for proper solids. It’s best to offer the drink after they’ve eaten a substantial part of their meal.

Sterilising

Premature and low birthweight babies may often have a less developed immune system than full term babies, for this reason it may be sensible to sterilize feeding equipment beyond 6 months and bottles for milk up to a year. However, as with all babies, a few germs are good for building immunities so don’t over do the sterilizing! If you’re concerned about what is adequate speak to your health visitor.

Relax

Having a baby with health problems from birth for whatever reason, is understandably very worrying and stressful. When starting to wean your baby, try and keep yourself relaxed and anxiety free. If you’re anxious, your baby is more likely to be anxious and this may create problems with feeding. Mealtimes should be a fun and happy time for you both. If you’re feeling stressed, take a few deep breaths and try another time.

For more information on feeding your premature baby please refer to www.bliss.org.uk

References

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