A baby born before 37 weeks of gestation is considered a preterm or premature baby. Health conditions in the mother such as diabetes, heart disease, kidney disease, etc, may contribute to preterm labor resulting in premature birth.

In preemies, swallowing is unachieved and this puts them at disadvantage since they do not have a completely developed oral cavity and required oral motor skills and reflexes.

Acquiring oral feeding is the primary focus of early Intervention. Management begins with establishing suckling and sucking. Feeding ability is achieved when overall stability in the environment is provided to them. Stability also begins from the caregiver – the way in which they are available and receptive to the needs of the babies.

Why is caregiver support important?

It has been observed that preemies are unable to achieve milestones as per norms due to reluctance in caregiver support.

What can the caregiver do?

Swaddle the baby since it gives them a feeling of support – of having someone around them who cares.

Support them by touching/ stroking often with love.

Helping preemies learn feeding

• It is not about forcing calories, rather it is about achieving voluntary consumption of food and understanding satiation.
• Feed during demand feeding or semi-demand feeding
• Slower the pace of oral feed – Use nipples with slow flowing rate over faster ones
• When feeding with the tube, hold them in your arms, it reduces their behavioral stress and provides more physiological stability
• Incorporate social interaction during feeding. One such posture which helps facilitate both bottle- feeding and interaction is where you can hold the baby in your lap facing you with desirable eye- contact
• Stimulate the baby orally and provide non-nutritive sucking to prepare them for feeding
• Make sure respiratory support is at ease during oral feeding time
• Provide oral support during feeds to improve baby’s inborn physiological skills, this way it will also improve volume consumption.
• Reduce noise and light in the environment to keep distractions away during feeding.

Transition from tube feeding to oral feeding

Transition of a premature baby who has been on tube feeds to oral feeding needs extra efforts. Since, they do not get any opportunity to develop oral – motor skills, it is even more difficult for them to understand the feeling of hunger and/satiation at such an early stage. A good schedule should be established between feeds so that balance is achieved between empty and full stomach.

Understanding preemie cues

Pre-verbal communication in preemies is underdeveloped. Observe and respond to their cues and take steps to support and stimulate them.

What can you do?

• They benefit from frequent adult talk for speech and language development. Sing a song to them with rising and dropping pitch variation. Remember your baby recognises your voice and is comforted by it
• Give oodles and oodles of Kangaroo Mother Care (KMC), touch, love and hugs

Remember that they may be slow in responding to your cues. However, this doesn’t mean they aren’t receptive to it. Be patient and give them the care they need and deserve.

– Article posted at Baby chakra on October 19th 2018