Parental and enteral nutrition in preterm infants

Enteral nutrition

• Feeding via a tube
• Often used to feed premature and sick babes as they can be too small or sick to breastfeed or bottlefeed first
• In babies born premature, the coordination of sucking, swallowing and breathing needed for effective feeding is usually not fully established until about 32 to 34 weeks’ gestation
• Nasogastric tube feeding: baby is fed through a small soft tube placed in the throat and runs down the back of the throat, through the oesophagus and into the stomach
• Orogastric tube feeding: baby is fed through a small soft tube, which is placed in the mouth and runs down the back of the throat, through the oesophagus and into the stomach

Parenteral nutrition

• Nutrition in a liquid form that is given directly into baby’s bloodstream intravenously
• Very premature babies are usually fed using PN at first, as they have an immature digestive system that needs time to develop enough so they can tolerate enough milk to meet their nutritional needs

Advantages of breast milk for preterm infants

• Helps protect baby from infections, particularly of their gut - preterm infants are particularly predisposed to infections
• Contains hormones, nutrients, and growth factors that help baby to grow and develop
• Easier for baby to digest than formula milk

Challenges for mothers on establishing lactation and breastfeeding in preterm infants

• Late pre-term babies are often sleepy after birth and can be more difficult to breastfeed
• Keeping baby warm, their blood sugars level, and providing skin-to-skin care improves feeding
• Many pre-term babies need a combination of breast feeds with some extra top-ups of expressed breastmilk in the first days and weeks
• Some hospitals can provide donated breast milk for the baby to have until the mother's supply is established