Feeding premature newborns. Nutrition of a premature baby in the first year of life

Christmas
29.09.2019

Few parents are prepared for the birth of their child prematurely. Most often, the birth of a premature baby becomes a difficult experience for the whole family. This happens because everyone is waiting for the birth of a plump, rosy-cheeked little one, counting on returning from maternity hospital in a maximum of 5 days, and in general, as a rule, they make optimistic plans for the future. A huge amount of information for expectant and young parents, including the Internet, television, and print publications, is devoted to a normal pregnancy, childbirth without complications and caring for healthy newborn. When something starts to go wrong, parents find themselves in an information vacuum, which sometimes aggravates an already difficult situation.

For the first time in Russia, a resource has been created that is entirely dedicated to the problem of premature birth and prematurity. This resource was created by parents for parents who are expecting or have already given birth to a child prematurely. We experienced from our own experience a lack of information during the period of maintaining pregnancy, nursing the baby in the maternity hospital and perinatal center. We felt an acute shortage of funds for specialized care, which is so necessary for the full physical and mental maturation of a child outside the womb. I have more than one month behind me, spent at the incubator, then at the crib in endless waiting, fear and hopes for recovery. As the baby grew, everything was needed more information about the care, development, education of a child born prematurely, which would be adapted to our situation and which is very difficult to find. This experience gives us reason to believe that the information posted on our website will help young mothers and fathers be more prepared for the birth of their dearest baby, and therefore go through this difficult period in life easier and more calmly. Knowledge and experience will make you more confident and help you focus on the most important thing - the health and development of your baby.

As materials for creating the site, we used medical and pedagogical literature, reference books, practical guides, opinions of specialists in the field of obstetrics, gynecology and neonatology, child psychology and pedagogy, materials from foreign resources, as well as the invaluable experience of parents whom we met and became close friends thanks to our children.

We draw your attention to the fact that the materials presented here are not a “recipe” for you and your child, but are only intended to help you understand the situation, dispel some doubts and orient yourself in your actions. Mention of any medicines, equipment, brands, institutions, etc. is not advertising and cannot be used without the consent of specialists.

We hope that we will be useful to you from the moment your baby is born and grow with you. If you have any questions, wishes or suggestions, This e-mail address is being protected from spambots. You need JavaScript enabled to view it!

Sincerely yours,

About feeding premature babies. Irina Ryukhova

Source: our website

Premature babies are special creatures. No longer in mom's belly, but are not yet mature enough for the normal start to life of a newborn baby... They need increased care and attention so that they can grow and get stronger. They also need mother’s milk, which allows them to quickly catch up.

Who are premature and low birth weight babies?

According to statistics, premature babies are born 15-20% of all children. If we strictly follow medical terminology, prematurity does not always represent some kind of special problem: The term itself means that the baby was born before spending 38 weeks in the mother’s tummy. Sometimes it even happens that a baby born after the 36th week has complete normal health and good weight, suckles well and is actively developing. But, alas, it happens differently: most often, prematurely born babies have signs of immaturity and require special care.

But the main concern of both doctors and mothers is babies with low birth weight. Low body weight means less than 2500 g. If the baby is born much earlier than expected and weighs less than 1500 g, doctors will say about extremely low body weight. As soon as such a baby is born, he ends up in intensive care. Alas, it is not always possible to produce such babies. But it still turns out: today, in maternity hospitals with well-equipped neonatal intensive care units, babies weighing from 500 g are cared for. And the smallest child to survive after premature birth was Amilia Taylor from the USA: she was born at the 22nd week of pregnancy and At the time of birth, she weighed only 280 grams!

Low birth weight babies are also at greater risk of infection. That's why World Organization Health officials say they need breast milk even more than larger babies. Unfortunately, they are still more often fed formula from a bottle. But the situation in Russia has already begun to change with the spread of the “Baby-Friendly Hospitals” initiative and the participation of many institutions in the “Mother and Child” training project. Finally, the mother of a premature baby should also know what exactly she can do to help her baby grow and get stronger faster.

Common problems of premature babies

In the first time after birth, a premature baby will have to be carried to term, literally. First, he is placed in an incubator: this is a special apparatus that tries to maximum accuracy reproduce the conditions of a child’s stay in the mother’s womb and has a number of additional functions– they may be needed to help the baby. Then, when the danger to life has passed, the baby is transferred to the mother’s care. Usually the baby spends quite a lot of time in the maternity hospital (sometimes, if guaranteed safe transportation is not possible, even several weeks), and then is sent to a children's hospital that specializes in caring for newborns. It is optimal if it is possible to stay in a “mother and child” ward, but, unfortunately, not all hospitals yet have such conditions.

If there are no other complications, then caring for a healthy low birth weight baby comprises:

  • prevention and treatment of hypoglycemia ( reduced level blood glucose);
  • ensuring heat conservation;
  • directly feeding.

The latter usually turns out to be the most difficult, because low birth weight babies usually cannot suckle effectively at their mother's breast, and the mother herself often has difficulty producing enough milk at first due to premature birth. This has led to the fact that it is common to feed low birth weight babies without mother's milk, A special mixture for newborns. However, this situation can and should be changed, because the composition of any mixture is much less perfect than the composition mother's milk! However, we will tell you about all the features of care separately.

Risk of hypoglycemia

In general, this area lies entirely within the competence of doctors, but some mothers worry if they do not know what exactly is being done to their child - the medical staff, alas, is not always inclined to give explanations. Therefore, let's briefly talk about this. If your baby's blood glucose levels drop below a certain level, these symptoms may occur. unpleasant symptoms, such as convulsions, intermittent breathing, decreased overall tone, sleep disturbances up to lethargy. Hypoglycemia occurs in 15 out of every 100 premature babies. Hypoglycemia is treated by intravenous administration of glucose, which is accompanied by regular blood sampling for tests. To mothers who are worried about discomfort children from all these procedures, it is worth remembering that this is really necessary, otherwise the consequences can be very serious. A the best prevention Hypoglycemia is ensured by feeding as early and as often as possible - breastfeeding is best, but if the baby is still too small, then through a gastric tube.

Heat preservation

All newborns have an imperfect thermoregulation system. But premature babies have virtually no fat, so it is very difficult for them to stay warm. And the danger of hypothermia even in a seemingly warm room becomes very real.

When a premature baby is born, one of the first things doctors do is measure the temperature. If it turns out to be below 32 degrees, then the baby is immediately placed either in an incubator or on a mattress with thermostatic control. And if the temperature is 32-36 degrees, then it is best to warm the baby on the mother’s body; a cot or heated bed is used if this is not possible. The temperature will be taken 3-4 times per hour until it reaches a normal level.

Abroad and in advanced Russian hospitals, nursing of low birth weight newborns is used. kangaroo method. Its meaning is that the baby is constantly in skin contact with the mother’s body, and from time to time – with the father. Medical studies, which were carried out not only abroad, but also in Russia, have confirmed that kangaroo care provides the baby with the maximum protection of all. possible ways caring for a low birth weight baby without serious health complications.

In addition to the absence of significant health problems, the following criteria are important for kangaroo care: gestational age is more than 30 weeks; birth weight more than 1100 g; at least partial ability to suck. If these requirements are met, then a competent doctor will help organize skin-to-skin contact immediately after birth. Even babies weighing only 1200 g, once on their mother’s belly, breathe better. The beating of the mother’s heart, the rhythm of the mother’s breathing, the feeling of the mother’s smell at least partially returns the baby to the usual conditions of intrauterine existence. The warmth of the mother's body allows the baby not to waste extra energy to keep warm. The baby, as it were, continues to remain part of the mother, so it is much easier for him to maintain a stable state of the body.

When the baby, naked or in a diaper, is on the mother's stomach or in the middle between her breasts, he can be covered with an additional blanket or just clothes. Professionals experienced in this method of care can even, without interrupting the beneficial skin-to-skin contact, give the child intravenous infusions, oxygen therapy, or insert a nasogastric feeding tube. In the future, the mother simply carries the baby on herself all the time, sometimes passing it to the father.

Of course, for kangaroo care in the hospital there must be appropriate conditions. Besides necessary training medical staff, this also means the presence of “mother and child” wards. If mom goes somewhere, the baby should be wrapped in several layers warm diapers, covered with a blanket and laid in a warm place. Nurses must constantly monitor the mother and baby; the mother must have good food and the possibility of at least a short rest. Therefore, alas, in most Russian hospitals nursing of low birth weight babies is used “the old fashioned way” - the child spends almost all the time in the incubator, and the mother is only allowed to visit him in the nursery and pass on expressed milk to best case scenario- breastfeed...

Meanwhile, the advantages of the kangaroo method include not only reducing the risk of hypothermia, but also, for example, reducing the risk of hospital infection, and improving general development. The mother produces milk faster and more actively. The baby's heart works better and he breathes more regularly. Your baby usually sleeps well, is more active when awake, cries less, gains weight faster, and is ready to leave the hospital sooner. So the future lies with this method. But what can a mother do for her baby, whose hospital conditions do not allow such close communication?

Ways to feed a premature baby

Perhaps the most serious problem represents precisely feeding a low birth weight baby. Many of these babies have an insufficiently developed sucking reflex, while others, even if they can suck, get tired very quickly. To feed such a baby you need to master some special skills. At the same time, children with extremely low body weight need additional nutrition for some time: some need additional calcium, others need protein or energy (what exactly is determined by a specialist). Because of all these difficulties, sometimes breastfeeding ends before it has even begun. However, even if the baby cannot breastfeed immediately, breast milk (if necessary, along with additional food) provides the best protection from infections and contains many necessary for the child substances that are not present in any mixture.

Therefore, if the baby cannot breastfeed, he is offered to be given expressed breast milk (and the first days of life - colostrum). If mom doesn't even have colostrum, the best option is supplementing the baby with pasteurized milk from another woman. Some maternity hospitals have the practice of collecting excess milk in order to pasteurize it and use it for supplementary feeding, while others do not. But in any case, the mother can check with the doctors whether there is such an opportunity in the maternity hospital. Even the milk of a woman who is feeding an older child (for example, a friend or sister) will be healthier for the baby than a formula, even a specialized one!..

The way you feed a premature baby depends greatly on its age. Thus, most newborns under the age of 32 weeks can only be fed through a gastronasal tube, and children with extremely low body weight often receive intravenous nutrition for the first few days. When gestational age reaches 30-32 weeks, the baby is usually already able to eat from a spoon or cup. From 32 weeks, some children can already suckle at their mother's breast, albeit for a short time, and breastfeeding can be combined with other methods. And from 36 weeks, most babies are able to get required amount

milk straight from the breast. Important note: bottle feeding is not necessary step for a premature baby, and even vice versa: bottle feeding can make it difficult to learn proper sucking and even lead to breast refusal. It is generally believed that bottle feeding is easier for a baby, but special studies have shown that it is easier for a baby to suckle from the breast than from a bottle. And even if the medical staff offers the mother a bottle with a nipple, the mother can always clarify whether she can’t use alternative methods

supplementary feeding

Expressing milk

Even if the baby is too small to breastfeed, even expressed mother's milk is very important for him. Breast milk from mothers of premature babies is different from milk from other women. In particular, it contains more protein, and the “extra” amount of it is precisely an anti-infective protein. Other components are also balanced to ensure successful growth and protection for the baby. That is why, even if maternity hospital collection of surplus is practiced breast milk

, in case of premature birth, the mother needs to start pumping as early as possible. Even if nothing at all comes from the breast at first, let the mother remember that milk is produced in response to stimulation of the breast. And in order to establish stable milk production, from the very first day after birth you need to express each breast every 3 hours (except for night rest) as long as milk is released from the breast, and another 3 minutes beyond that. Then every day the amount of expressed milk will increase. Best for this regular pumping Clinical breast pumps are suitable - ask if they are available in the maternity hospital or children's hospital. If the clinic does not have such equipment, next choice

The baby will benefit from any amount of mother's milk, even if it is just a few milliliters. But if a mother expresses more milk than her baby needs, then it is better to divide it into different portions. The so-called hind milk, which is released towards the end of feeding, has a much higher fat content, which is now very useful for the baby. Therefore, when expressing milk, of which there is a lot, it is worth using two dishes: one to use in the first two minutes of expressing each breast, and the second to collect the fattier hind milk. The baby should be offered hind milk first so that he gets more extra energy. And the front portion of milk can be put in the refrigerator as a reserve or given to the children's department.

To determine the amount of milk for supplementary feeding, the following principle is used:

  • if the baby still weighs more than 2500 g, then the total amount of milk per day is calculated at the rate of 150 ml of milk per kilogram of weight per day. The resulting amount is divided into 8 feedings and given every 3 hours;
  • low weight babies less than 2500 g at birth, on the first day they receive 60 ml of milk. Then the total volume increases by 20 ml per kg of weight every day until the child begins to receive 200 ml per kg of weight per day. For example, a baby weighing 2 kg should receive 60 ml of milk on the first day of life, 100 ml on the second, 140 ml on the third, and so on until the total volume of nutrition reaches 400 ml. This amount is divided into 8-12 feedings, which occur every 2-3 hours.

At the same time, the baby may well eat a different volume of milk at each feeding, and the feeding dates themselves may shift if the baby is clearly already hungry. If possible, do not allow a low birth weight baby to cry - this is too serious an energy expenditure for him. If the child has eaten very little, let the mother offer more than the norm at the next feeding or start feeding earlier. If the daily amount of milk turns out to be less than normal, you must inform the medical staff about this so that the missing amount is given through a nasogastric tube.

Features of breastfeeding

Many babies begin to breastfeed already at a weight of 1300-1500 g. Some babies can completely switch to breastfeeding, gaining a weight of 1600-1800 g. Therefore, as soon as the baby’s condition stabilizes, it is important to start putting him to the breast.

It often comes as a surprise to mothers when their premature babies do not latch on immediately. The mother usually expects the baby to take the nipple into his mouth and at least try to suck. But for low birth weight babies, it is common to first find the nipple and simply lick it, as if trying to get used to a new way of getting food. You should not assume that if the baby does not suckle effectively, then feeding is unsuccessful - on the contrary, the more time the baby spends at the mother’s breast, the greater the chances of establishing adequate breastfeeding. The mother herself can express milk into the baby’s mouth directly from the breast, and between these “training sessions” she continues to feed as before.

When your baby does begin to suck effectively, he usually pauses during feedings. For example, after several sucking movements, he can rest for 4-5 minutes. It is very important for the mother to be patient and not immediately tear the baby off the breast. You can, for example, set aside time in advance for feeding for about an hour, and all this time keep the baby at your breast, giving him the opportunity to rest and get back to work that is so important to him. And after breastfeeding, if the mother is not sure that the baby is full, you can additionally offer expressed milk from a cup or spoon. If the baby is full, he will not drink supplementary food. Yes, it often seems difficult for a mother to devote so much time to not particularly effective feeding, but this is a very serious investment in the future health of her child.

To improve breastfeeding as quickly as possible, you can use special techniques , taking into account the characteristics of premature babies.

  1. A low birth weight baby's muscles are very weak, which makes it difficult for him to even just hold the breast in his mouth. Therefore, one of the most effective positions for attaching such a baby is the “under the arm” position, when the mother provides good support shoulders and neck of the baby, helping to more conveniently grasp the nipple. For some babies, the best option is the most common “cradle” position at the breast, supported by the hand opposite the nursing breast. In this case, the baby’s body lies along the mother’s forearm, and the hand supports the shoulders.
  2. Often premature babies swallow a lot of air, and then choke and cough due to imperfect regulation of breathing and swallowing and decreased muscle tone. A mother who has noticed such a problem in her baby needs to lean back when feeding so that the baby is more likely to lie on top of her chest: this will reduce the pressure of the milk and allow the baby to better regulate its flow. For mom's comfort, you can use several pillows placed under her back and arms.
  3. A premature baby has difficulty keeping the nipple in his mouth because he has not yet developed special structures in his mouth that help a normal newborn suck: these are the ribs on the palate and the fatty pads of the cheeks. To compensate for this, mom can use support for her baby's cheeks and jaw, known as a "dancer's hand." When placing the baby to the breast, the mother seems to be holding thumb one of his cheeks, the index one - the other, middle finger ends up under the chin, and the remaining two hold the chest itself. This system allows the baby to slip off the nipple much less when feeding.

After maternity hospital

As a rule, when a mother finds herself in a hospital after maternity hospital, she is already dealing with the established system of care for low-birth-weight newborns. In some cases it is very effective, and the mother is discharged home with a cheerful, breastfeeding baby. And somewhere they don’t consider it necessary to “overload the staff” with help in establishing breastfeeding. There is no point in going into conflict health care The child may really need it, but it never hurts to try to agree on something peacefully - especially if the doctors understand that the mother has a clear idea of ​​​​what she is going to do.

But home is still better than in the best hospital, and mothers usually can’t wait to find out when they can be discharged. Modern clinics use the following criteria for discharge of low birth weight babies:

  • good health;
  • stable weight gain (at least three days in a row);
  • good thermoregulation;
  • good sucking reflex;
  • The mother is able to care for the baby at home herself.

And remember that with the help of experienced consultants natural feeding It’s not too late to start breastfeeding even if the baby was bottle-fed throughout the beginning of his life. If the main health danger has passed, then everything depends only on how much effort the mother is ready to put into best development your baby!

Sorry, the page you requested was not found.

"I don't know best medicine for asthma..." Nicholas Culpeper, 1653 Climbing honeysuckle (L. periclymenum) was once widely used in Europe for the treatment bronchial asthma, urinary disorders and during childbirth. Pliny recommends adding it to wine for diseases of the spleen. A syrup is traditionally made from an infusion of flowers of honeysuckle (L. periclymenum), which is taken as an expectorant for severe cough […]

By mid-summer, fireweed blooms, covering large areas of forest burnt areas and clearings with a pinkish carpet. Flowers and leaves are harvested during flowering, dried in the shade and stored in tightly closed jars and boxes. Fireweed angustifolia, fireweed or Koporye tea is a famous herbaceous plant with a spreading cluster of pink flowers. This is one of the few wild plants that are used as food [...]

“This is one of the most amazing herbs for wounds, highly valued and expensive, used as a medicine internally and externally.” Nicholas Culpeper, 1653 Own Russian name the herb got its scalloped leaves, reminiscent of the trimmings of medieval dresses, and its Latin name comes from the word "alchemy", which indicates miraculous properties plants. The grass is collected during flowering. Character: cool, dry; taste […]

“The nature of this plant is so amazing that just touching it stops bleeding.” Pliny, 77 AD. Horsetail is a botanical relic, close to the trees that grew on Earth 270 million years ago, during the Carboniferous period. There were 15 species of horsetails that grew in the USSR. Horsetail (E. arvense) is of greatest practical interest. Horsetail (E. arvense) is a perennial spore-bearing herbaceous plant […]

The ephedra plant (Ma Huang, in Chinese) contains the alkaloids ephedrine, norephedrine and pseudoephedrine. Alkaloids from 0.5 to 3%. Ephedra horsetail and ephedra algae contain more ephedrine, and ephedra media contains more pseudoephedrine. In autumn and winter months alkaloid content is maximum. In addition to alkaloids, ephedra contains up to 10% tannins and essential oils.

Ephedrine, norephedrine and pseudoephedrine are similar to adrenaline - they stimulate alpha and beta adrenergic receptors.

This book is intended for beginning ginseng growers who grow the plant on personal plots, and ginseng growers who are starting to work on industrial plantations for the first time. Growing experience and all recommendations are given taking into account the climatic characteristics of the Non-Black Earth Region. Preparing to describe my experience in growing ginseng, I thought for a long time about where to start presenting the accumulated information, and came to the conclusion that it makes sense to briefly and consistently talk about the entire path of the ginseng grower that I have traveled, so that the reader can weigh his strengths and capabilities in this labor-intensive in fact.

Dr. Popov about folk remedies against Crohn's disease and nonspecific ulcerative colitis (UC): Chronic colitis is very easy to cure if you take a teaspoon of plantain seeds in the morning on an empty stomach, and a teaspoon of horse sorrel seeds in the evening.

It's time to get rid of bleeding gums and strengthen your gums. In spring, a unique grass grows called sverbiga. If you eat it for at least a week, your gum bleeding will go away forever.

My feet are sweating! Horror! What to do? And the solution is very simple. All the recipes we give are tested primarily on ourselves and have a 100% guarantee of effectiveness. So, let’s get rid of sweaty feet.

There is much more useful information in a patient's life story than in all the encyclopedias in the world. People need your experience - “the son of difficult mistakes.” I ask everyone, send recipes, don’t be sorry for advice, they are a ray of light for a patient!

ABOUT medicinal properties pumpkin Ingrown toenail I am 73 years old. Sores appear that I didn’t even know existed. For example, a nail suddenly began to grow in on your big toe. The pain prevented me from walking. They suggested surgery. In “Healthy Lifestyle” I read about pumpkin ointment. I peeled the pulp from the seeds, applied it to my nail and bandaged it with plastic so that the juice […]

Fungus on the feet Fungus on the feet Pour hot water into a basin (the hotter the better) and rub the laundry soap with a washcloth in the water. Keep your feet in it for 10-15 minutes to steam them properly. Then clean your soles and heels with a pumice stone, and be sure to trim your nails. Wipe your feet dry, dry and lubricate them nourishing cream. Now take the pharmaceutical birch […]

My foot hasn't bothered me for 15 years. Corn on my foot. For a long time, I was bothered by a corn on my left foot. I cured it in 7 nights, got rid of the pain and began to walk normally. You need to grate a piece of black radish, put the pulp on a cloth, tie it tightly to the sore spot, wrap it in cellophane and put on a sock. It is advisable to do the compress at night. To me […]

A young doctor prescribed a recipe for his grandmother. Gout, heel spurs. I am sending you a recipe for the treatment of heel spurs and bumps near thumb legs. A young doctor gave it to me about 15 years ago. He said: " Sick leave I can’t write out about this, it’s not allowed. But my grandmother was treated for these troubles like this...” I took the advice […]

Let's start with gout, which is caused mainly by metabolic disorders. Let's listen to what Vinnitsa doctor D.V. NAUMOV says about padagre. We treat gout according to Naumov Gout “Healthy lifestyle”: There are a lot of questions about the dissolution of salts in the joints. You claim that the table salt that we ingest has nothing to do with insoluble salts such as urates, phosphates and oxalates. And what has […]

On the advice of Antonina Khlobystina Osteomyelitis At the age of 12, I fell ill with osteomyelitis and almost lost a leg. I was admitted to the hospital in serious condition and was operated on the same day. He was treated for a whole month, but was deregistered only after 12 years. I was cured in a simple way folk remedy, which was suggested to me by Antonina Khlobystina from Chelyabinsk-70 (now [...]

Features of feeding premature babies are associated, on the one hand, with immaturity gastrointestinal tract and low enzymatic activity, and on the other hand with an increased need for nutrients, vitamins and microelements, because the baby needs strength to grow and get stronger. The ability depends on the degree of its maturity.

Very premature babies weighing up to 1500 grams and those born at 29 cannot suck and swallow independently, so they are fed through a tube. These babies usually begin to breastfeed or bottle feed by the end of the first month of life. Children weighing 1500-2000 grams (II degree of prematurity - 32-34 weeks) can independently receive nutrition from a bottle or suckle at the breast. But often such babies do not have enough strength to suckle, and they are initially bottle-fed with expressed milk or formula, and then gradually try to switch to exclusive breastfeeding. Babies with the first degree of prematurity, born at 35 and weighing 2000-2500 grams, are quite capable of breastfeeding and develop well.

Since the acidity of gastric juice is reduced, slow intestinal perilstatics, dysbiosis, then during this period they need to be fed exclusively either breast milk or special adapted mixtures For premature babies , they usually have the word Pre in their name. Studies of breast milk from mothers of premature babies showed that depending on the degree of prematurity, their milk changed composition. This milk has an increased content of proteins, which are so necessary for the increased growth of a baby, as a building material, an increased content of essential amino acids, a higher degree of fat content, the breakdown of which does not require additional energy costs. In addition, mother's milk contains prebiotic substances that promote the growth of beneficial intestinal microflora, antibodies to various infections to which premature babies are especially susceptible, and enzymes that improve milk absorption. The energy value of “premature” milk is higher than that of “full-term” milk. Therefore, a woman should make every effort to preserve milk and eventually establish full breastfeeding.

Although, with all the desire to feed, many women who have had premature birth, hypogalactia is observed, that is, a lack or absence of breast milk. That's why from the first days, the mother should express milk and try to let the baby suckle. Because of their weakness, babies often have difficulty breastfeeding. If you see that the baby is tired and has a blue appearance around his mouth, then stop feeding and supplement with expressed milk from a bottle. Usually, by the 2nd - 4th week, children become stronger and are already able to switch to pure breastfeeding. To avoid losing milk, be sure to express every 3 hours, including at night, and after each feeding.

To prevent aspiration the first feeding premature baby carried out 3-6 hours after birth with sterile water. Subsequently, the child begins to receive a 5% glucose solution and already from the 5th-6th feeding (premature children of the 1st-2nd degree of prematurity) he is transferred to breast milk and a special milk formula. Babies with severe prematurity are transferred to breast milk for only 18-36 hours. Children are fed every 3 hours, with more frequent feedings(every 2 hours) the volume of nutrition received is carefully calculated so as not to overload the infant’s immature gastrointestinal tract. With severe prematurity (IV degree), sick children receive continuous feeding through a tube, like an IV. If the baby regurgitates or for other reasons cannot receive nutrition through the mouth, then nutrient solutions are administered intravenously - parenteral nutrition.

If the baby cannot receive breast milk for any reason, then he is fed with a special formula, which does not change until it reaches a weight of 4-5 kg. This mixture has a balanced composition of proteins, fats and carbohydrates for premature babies, contains increased amount taurine for brain development, calcium and phosphorus, necessary for the mineralization of the child’s skeleton and bones, vitamins and other microelements, prebiotics and probiotics to prevent the development of intestinal dysbiosis.

The amount of formula or breast milk is calculated based on caloric needs small organism. On the first day, the child receives 5 ml of mixture (nutrient solution) per feeding, the amount increases to 15-20 ml by the 3rd day of life. Next, the diet is calculated based on daily norm for premature babies 130-140 kcal per 1 kg of weight (for full-term babies this figure is 115 kcal). The calorie content of breast milk is 70 kcal per 100 ml, and the formula is 80 kcal per 100 ml.

Premature babies are especially prone to rickets and anemia. Therefore, even if the baby is on breastfeeding, he needs additional vitamin D in the form of special drops from the first month (from 2-3 weeks). Also, these babies have very poor iron reserves in the body, which are usually depleted by the 1st month. Breast milk does not contain enough iron for children, despite the fact that it is absorbed very well from it, so the doctor, after assessing the baby’s condition, may decide to take additional iron-containing medications.

The first complementary foods for premature babies are usually introduced earlier at 4-4.5 months. To prevent the development of anemia and rickets, fruits and vegetables are introduced to premature babies earlier than to full-term ones. vegetable juices, puree, meat, yolk. Complementary feeding in the form of porridge is also important for a premature baby, as it helps him quickly gain the weight required for his age. Monitoring the effectiveness of feeding a premature baby and the state of his health should only be carried out by a doctor, who will, depending on the child, change or supplement the diet.

Now every mother uses diapers to care for her newborn. One of the good, proven diapers is Libero. The baby will be dry and comfortable in them. You can buy Libero without leaving your home by going to the Merci.ru website.

The issues of nutrition of premature infants remain controversial and unresolved. Even now, the issues of the time of the first feeding, methods of feeding, as well as what is the amount of food needed, what is the need for any nutrients and energy, etc. are being discussed.

There are many different opinions in the literature regarding the time of the first feeding of a premature baby. Some authors believe that feeding such children should begin early - 6-12 hours after birth. At the same time, the possibility of developing various conditions (such as hypoglycemia, hyperbilirubinemia, etc.) is reduced, and a fairly rapid increase in body weight occurs. Another argument in favor of early feeding is the fact that with late feeding, the initial loss of body weight is greater, while the nitrogen balance increases slowly, acidosis may develop, etc.

Supporters of late feeding(36-72 hours after birth) it is believed that earlier feeding contributes to the appearance of regurgitation, as well as aspiration of food with the subsequent development of pneumonia and vomiting. In case of severe condition of a premature baby ( frequent vomiting, previous asphyxia, neurological symptoms) the first feeding can be carried out after 36-48 hours. In these cases, it is necessary to strictly observe drinking regime or resort to infusion therapy.

Children with severe prematurity usually do not have a sucking or even a swallowing reflex. Due to the risk of food aspiration, it is not recommended to feed a premature baby with a pipette.

When feeding through a tube, it is necessary to remember that as the condition improves, sucking activity also appears, when the child should be transferred to bottle feeding and then gradually applied to the breast. Long-term use of the probe has its own negative sides, since this method of feeding can interfere with the normal development of digestive processes, inhibits the production of the sucking reflex, and reduces physiological activity during feeding.

Transition to breastfeeding gradually, first the baby is latched for 1-2 feedings, and during the remaining feedings milk is given from a bottle. Then it is applied to the breast during each feeding, strictly taking into account the amount of milk sucked (by weighing before and after feeding). If the baby is tired and cannot suck the required amount of breast milk, he is supplemented with bottle feeding.

Babies weighing 1,500 g or less tend to breastfeed poorly and become very tired and are best bottle-fed.

If the baby's body weight at birth is about 2000 g, then he usually takes the breast well and sucks out the required amount of milk.

The number of feedings of a premature baby is calculated based on indicators such as weight, total physical state, functional maturity of the digestive system.

It is often necessary to introduce 7 feedings a day with a break of 6 hours at night. Only in case of extreme prematurity, as well as in any pathological conditions of the child, the frequency of meals can be increased to 10. The child can be transferred to 6 meals a day at 2-3 months, when his body weight reaches 3500-4000 g. Subsequent feeding regimen for premature infants children is not much different from the feeding scheme for children in the first year of life.

When determining the amount of food needed premature baby, as a rule, come from it individual characteristics, such as birth weight and general physical condition.

Premature has increased energy growth compared to full-term, so he needs an amount of food that would satisfy his energy needs. At the same time, food tolerance in premature infants is reduced due to the functional immaturity of the gastrointestinal tract. The capacity of the gastrointestinal tract in such children is small, and the digestive activity of juices is significantly reduced. All this requires a very precise and precise determination of the amount of food.

On the 1st day after birth, a premature baby usually receives 5-10 ml of milk per feeding, on the 2nd day - 10-15 ml, on the 3rd - 15-20 ml. Over the next 10 days, the amount of food required for a premature baby can be approximately calculated according to Rommel's formula:

where V is the amount of milk in ml for every 100 g of the child’s body weight;

n is the number of days of life.

However, it is necessary to consult a doctor on this issue.

A premature baby needs a certain amount of fluid. A child's fluid requirement is approximately 200-250 ml/kg body weight. This amount includes the liquid contained in milk (100 ml of milk contains about 87.5 ml of water). Liquid is administered in small portions between feedings and during the night break in an amount equal to one feeding.

Due to the intensity of growth and enhanced metabolic processes, premature babies require additional feeding. Therefore, in the first month the baby needs to add ascorbic acid in the amount of 30 mg per day for breastfeeding and 100 mg per day for artificial feeding. Vitamins B1, B2, B6 are prescribed 1 mg 2 times a day. Vitamin B is prescribed from 2 weeks of age, since premature babies are at high risk of developing rickets. Since vitamin D is not stored in significant quantities in the body, it is necessary to ensure its regular intake in doses corresponding to physiological needs (you should also consult your doctor about this).

In the diet of premature babies it is important to provide for the early introduction of complementary foods and juices in order to satisfy the increased need for vitamins and minerals. Juices usually begin to be administered to children from 3-4 weeks of life, and the dosage increases. Start giving juices with 3-5 drops, increasing this amount daily to 1-2 tsp. At 2 months the child should receive 20 ml of juice, at 3-4 months - up to 30 ml, at 6 months - up to 50 ml. Juices are given after meals. The set of juices may be the same as in full-term babies.

At 2 months premature baby you need to get fruit puree (first apple, then others) in the following quantity: with 0.5 tsp. up to 50 g in the first half of the year and up to 90-100 g by the end of the year.

From 2 months of age, premature babies can be recommended baker's yeast paste as a source of B vitamins and complete protein. They start giving this paste with small quantities, gradually bringing to 1-2 tsp. from dry brewer's yeast.

Egg yolk is given from 3 months of age, just like full-term babies, but they start with small doses - 0.5 pcs. in a day. In the absence of special indications, cottage cheese should be introduced into the diet of premature babies in the 3rd month of life, starting from 5-10 g and increasing to 20-30 g per day (all this is under the control of calculating the main food ingredients in the child’s daily diet).

From 4 months, the first complementary foods are prescribed in the form of vegetable puree made from various vegetables. Vegetable puree is given with vegetable oil. In order to prevent anemia in premature babies, pureed liver can be administered from 5 months in the following ratios: 5-10 g 2-3 times a week. At the same age, they begin to introduce a second complementary food, which includes various milk porridges (buckwheat, oatmeal). From 6-7 months, the baby’s diet includes minced meat, which consists of boiled, double-turned meat in the following quantities: from 1 tsp. up to 2 tbsp. l. (together with vegetable puree). At the same age, you can give meat broth (in the absence of allergic manifestations) up to 20-30 ml, crackers (10 g).

From about 7-8 months, a third complementary feeding is introduced, which includes fermented milk products (Biolact, etc.).

The nutrition of a premature baby requires constant adjustment based on physical development and improvement of general condition. If the child’s body weight increases unsatisfactorily and there are threats of weight loss, correction and calculation of nutrition should be carried out every 7-10 days.