Premature feeding

What is important to know about premature nutrition

During the hospitalization at Fegia, your children receive new feeding instructions every day, according to their health condition and according to their ability, according to the doctors' instructions.
When you are released, the follow-up is no longer as close as a premature baby, but the needs and abilities of your children are very different from each other, and therefore there are no blanket guidelines that are correct for all released premature babies.
However, there are guidelines that can greatly help and reduce the worry surrounding the issue of nutrition:

• The discharge letter will usually have instructions for the first days/weeks/weights, and these instructions are the determining instructions for this time.
• It is important to monitor laboratory indicators and to monitor growth (weight/height/head circumference) arranged in a drop of milk and with the attending physician, the child's development, according to the preterm guidelines.

If possible, breast milk is the recommended diet for premature babies who thrive well

• Breastfeeding: Unlike prematurity, at home there is no need to weigh before and after breastfeeding. The follow-up is less close, if necessary it is possible and advisable to consult with a certified lactation consultant with experience in premature babies.
• In some cases, instructions will be given in the release to enrich Mother milk In a special supplement, HMF, human milk fortifier, which can be bought directly from the company (Mead Johnson, phone: 1-800-226470) or ordered through the pharmacy (Similac), on the recommendation of a doctor (it must be taken into account that this supplement is expensive, and there is no participation The health insurance funds. It's worth comparing prices before buying).

For premature babies who are not fed breast milk/fortified breast milk

• For premature babies whose weight corresponds to the corrected age, they thrive well and there is no special recommendation, they can be fed with a normal baby food substitute.
• For premature infants who are discharged at a weight that does not correspond to the corrected age or need enrichment for other reasons, it is recommended to use a special follow-up formula for premature infants after discharge (Similac Neosure/Materna Sensitive continuation for premature infants) until the age of about 6 months or, if necessary, until the age of 9-12 months, according to the staff's recommendation the therapist

For premature babies, it is recommended to "feed on demand" (breast milk/enriched breast milk/Taml)

• When there are no more special recommendations regarding feeding times (feeding every 3-4 hours, etc.) and you can feed on demand, you should start getting to know your children's hunger and satiety signals.
  This stage may be accompanied by concerns since it is a stage in which the control of quantities passes from the parent to the baby.
• Giving the meal when the hunger signals start, and stopping the meal when the baby shows signs of satiety (stopping eating, turning the head away from the bottle/breast, trying to move away from the bottle/breast).
• In order to reduce the concerns, it is possible to carry out regular weight monitoring at the clinic/ a drop of milk/ with the help of a dietician. At the same time, you should pay attention to whether your baby is vital, responsive, and there is no significant decrease in the need to change diapers.
• Feeding against the baby's will is not recommended and may even lead to unwanted results.

If there is concern about the amount eaten or the rate of growth, it is recommended to consult a doctor/dietitian in the community who, if necessary, can help enrich the food without the need for an increase in quantities.
food tasting

• For premature babies, the recommendation to start tasting food in the age range of 4-6 months is often not relevant. Usually the start of the tasting will be more towards the corrected age.
• Don't change a breastfeeding/breastfeeding meal before the age of 6 months (chronologically or in the corrected direction). Tastings are in the amount of up to 2 teaspoons a day (you can use your finger, you don't need a spoon), in the morning/afternoon, each new food separately and at least 3 times Before making sure that there is no allergic reaction (if we give a number of foods at the same time and there is a reaction, we will not know to which of the foods!!!).
• When there are no instructions to the contrary, the signs of readiness for tasting are:
• Control of the head (when the baby is held by the parent/caregiver, the head does not swing, the head and upper back are stable).
• Bringing your hands to your mouth, reaching for an object and putting it in your mouth.
• Expressing curiosity, inquiry and interest in eating when food is approached by the baby using the parent's/caregiver's fingers.
• The baby is able to move the food in his mouth from side to side.
• For children with special needs or various developmental delays, you should consult with the care team about starting solid foods.

enjoy your meal,
Yael Shemaya, dietician
HaEmek Medical Center Pegait, Afula
and the premature follow-up clinic at the Child Development Institute,
Sheba Tel Hashomer