Welcoming a new baby into the world is one of the most beautiful moments in life. But when your baby arrives earlier than expected, everything can feel a little more intense. Feeding a premature baby (also called a “preemie”) is one of the biggest worries parents have, and it’s completely normal to feel overwhelmed, anxious, or even scared. This guide is here to give you clear, calm, and helpful advice to help you feel more confident as you feed your little one.
What Is a Premature Baby?
A premature baby is one born before 37 weeks of pregnancy. The earlier the birth, the more support your baby might need, especially with feeding. Preemies may be small, sleepy, and not yet strong enough to suck and swallow properly on their own. This makes feeding a step-by-step process that requires time, patience, and love.
Why Feeding a Preemie Is Different
Full-term babies are usually born with the ability to suck, swallow, and breathe in a coordinated way. But in preemies, especially those born before 32–34 weeks, this process is not yet developed. They may:
- Get tired quickly while feeding
- Have trouble latching onto the breast or bottle
- Need help getting enough calories to grow
Feeding your premature baby is not just about nutrition. It also helps with bonding, brain development, and learning the rhythm of being outside the womb. That’s why we take a gentle and supportive approach.
How Do Premature Babies Get Fed in the Beginning?
1. Tube Feeding (Gavage Feeding)
In the first few days or weeks, many preemies are fed through a soft tube that goes from the nose or mouth to the stomach. This is called a nasogastric or orogastric tube. It lets your baby get milk safely while they are still learning to suck and swallow. Don’t worry, this is a very common method, and it’s not painful for the baby.
You can still provide breast milk for tube feeding by pumping. The milk can be frozen or stored until it’s time to use. If breast milk isn’t available, donor milk or preemie formula is used.
2. Parenteral Nutrition (IV Feeding)
For very tiny or sick preemies, feeding may start with nutrition through a vein. This gives their body the energy and nutrients it needs while their digestive system is getting ready for milk. As they get stronger, they slowly switch to tube feeding.
Is Breastfeeding Possible for a Premature Baby?
Yes, and it’s encouraged whenever possible. Breast milk is especially powerful for preemies. It contains nutrients, antibodies, and growth factors that protect your baby from infections, help their gut mature, and support brain development.
Even if your baby can’t breastfeed directly at first, you can start pumping your milk early, ideally within 6 hours of delivery, and pump regularly every 2–3 hours to build up your supply. This milk can be stored and given through the tube or bottle.
Benefits of Breast Milk for Preemies –
- Reduces risk of serious infections like NEC (necrotizing enterocolitis)
- Easier to digest than formula
- Supports brain and eye development
- Promotes bonding even if baby is not feeding at the breast
How Can I Start Breastfeeding Later On?
As your baby grows stronger and closer to their original due date, they may be ready to try breastfeeding. A lactation consultant or nurse will help you recognize signs of readiness:
- Baby stays awake during feedings
- Shows rooting or sucking behavior
- Has enough strength to latch
Skin-to-skin contact (kangaroo care) helps a lot with this transition. Even if your baby just licks or nuzzles the breast, it’s a step in the right direction. Be patient. This process can take days or even weeks. It’s not about doing it perfectly, it’s about learning together.
What If I Can’t Breastfeed or Don’t Want To?
That’s okay. While breast milk has many benefits, formula feeding is also a valid and healthy choice, especially when it’s medically needed or the best fit for your family. There are special preemie formulas that are higher in calories and protein to support faster growth.
Feeding your baby with love, attention, and consistency matters more than how the milk gets to them. Whether you choose to breastfeed, bottle feed, or use both, you’re doing a great job.
How Often Should I Feed My Premature Baby?
Preemies usually need to eat every 2–3 hours, just like full-term babies. But their feeding schedule might be more structured in the hospital. Nurses often keep a close eye on how much your baby eats, how they tolerate feeds, and how much weight they gain.
Once your baby is home, you’ll start to learn their hunger cues:
- Sucking on fists or fingers
- Smacking lips or rooting
- Waking up and becoming more alert
- Crying (a late sign of hunger)
Follow your baby’s lead, and try not to watch the clock too much. Over time, they’ll develop a natural routine.
How Much Should My Premature Baby Eat?
This depends on how early your baby was born, how much they weigh, and how fast they’re growing. Your doctor or dietitian will guide you based on your baby’s needs. On average:
- Tiny preemies (under 1500g) may need 120–150 mL of milk per kg of body weight daily.
- Larger preemies may need slightly less or more, depending on how well they’re growing.
Don’t be surprised if your baby takes small amounts at first. Their tummy is tiny, about the size of a marble in the beginning. Frequent small feedings work best.
What Are Fortifiers, and Why Are They Used?
Breast milk is amazing, but sometimes preemies need a little extra boost of protein, calories, calcium, or vitamins to catch up on growth. Doctors may recommend adding a special fortifier to pumped breast milk. These are carefully designed to meet the needs of premature babies.
You can think of it as a vitamin shake added to your milk, temporary, helpful, and tailored to your baby’s early development.
What Are Common Feeding Challenges with Preemies?
Feeding preemies isn’t always smooth. Here are some common issues parents may face:
1. Slow Weight Gain
This is very common. Preemies burn a lot of energy just growing and staying warm. Doctors may adjust feeding amounts or add fortifiers or formula to support better growth.
2. Reflux or Spitting Up
Premature babies often have immature digestive systems. Some milk may come back up after feeds. Holding the baby upright after feeding and smaller, frequent feeds can help. In some cases, medication might be needed.
3. Tiredness During Feeds
Feeding takes a lot of energy. If your baby falls asleep mid-feed, try gentle burping, changing a diaper, or undressing them a bit to wake them up.
4. Latching Difficulties
Some babies take time to learn how to latch onto the breast. A lactation consultant can help with techniques, nipple shields, or alternate feeding positions.
When Can My Premature Baby Go Home?
One of the biggest milestones is when your baby can feed on their own and gain weight consistently. Before discharge, most hospitals will want to see that your baby can:
- Take most or all feeds by breast or bottle
- Gain weight regularly
- Maintain body temperature
- Breathe without oxygen support
Don’t rush this stage, every baby is unique, and safety always comes first.
How Can I Keep Feeding Safe at Home?
Here are some tips for a smooth transition to feeding at home:
- Keep a feeding log for the first few weeks – how much your baby eats, how often, and any signs of trouble
- Use clean bottles or pumping equipment – follow your hospital’s guide on sterilizing
- Watch for signs of hunger and fullness rather than sticking strictly to the clock
- Burp your baby during and after feeds
- Hold your baby upright for 20–30 minutes after feeding to reduce reflux
- Call your pediatrician if your baby seems unusually sleepy, is not gaining weight, or shows signs of trouble breathing during feeds
What Questions Should I Ask My Doctor?
Here are some helpful questions many parents ask:
- How much milk should my baby be taking each day?
- Should I use breast milk, formula, or a mix of both?
- Does my baby need fortifiers or supplements?
- What signs should I watch for during or after feeding?
- How do I know if my baby is gaining weight properly?
- How often should I feed or wake my baby at night?
- When should we come in for a weight check or feeding assessment?
Your baby’s doctor or nurse will be happy to walk through these with you. Never hesitate to ask, even if the question feels small. This is all new, and no one expects you to know it all at once.
Feeding as a Bonding Time
Feeding isn’t just about filling a tummy, it’s also about building a bond. Whether you’re breastfeeding, bottle-feeding, or using a feeding tube, hold your baby close, talk or sing to them, and enjoy the moment.
Even if things don’t go as planned, your love and attention are the most powerful things you can give.
You’re Not Alone
Many parents have gone through the journey of feeding a premature baby. It can feel like a long road at times, but each small step, each extra gram of weight, each successful feed, is a victory.
Ask for help when you need it. Talk to your medical team, join a preemie parent support group, and take breaks to care for yourself too. You’re doing something incredible, and your baby is lucky to have you.
Conclusion
Feeding a premature baby can be a challenge, but it’s also a beautiful, rewarding process. With time, support, and love, your baby will learn to feed, grow, and thrive. Trust your instincts, take it one feed at a time, and remember that every drop of milk and every cuddle counts.
If you ever feel unsure or worried, your pediatrician, nurses, and lactation consultants are just a phone call away. You are not alone, and you are doing great.
