The Importance of Optimal Nutrition for Premature Babies

Why are the nutritional needs of preemies different from those of full-term babies? What’s the link between good nutrition and a preemie’s brain and bone development? The answers to these questions and more can be found in this article.

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Proper nutrition is so important for the healthy growth and development of all newborn babies, with research showing a positive correlation between good nutrition during infancy and adult health.

However, preemies’ nutritional needs will almost always be more complicated than those of a full-term baby’s. This is because the third trimester of pregnancy sees the accumulation of important nutrients such as iron in the liver, DHA which is channelled to the brain and eyes, calcium stores for strong bones and storage of body fat for temperature regulation etc.

The compromise of the crucial phase means that preemies have a lot of catching up to do in terms of development as compared to a full-term baby.

To do so, a preemie needs to receive more nutrients that a term baby in order to reach weight, body composition and body stores of nutrients close to what he would have gained if he were still in your womb, and for his overall physical and mental development.

So, if you are currently pregnant, or the mum of a premature baby, it’s good to arm yourself with information on their nutritional needs —and we are here to help you with this.

A premature baby’s nutritional needs will almost always be more complex than a term baby’s.

Nutritional challenges of preemies versus term babies

As compared to term babies, preemies born prematurely have inadequate nutrient stores such as calcium, phosphorous, protein, essential fatty acids etc. to support growth.  In addition, other medical conditions faced by preemies increases their energy and nutrient requirements.

To top off the higher nutrient needs, preemies are relatively less efficient and effective in their nutrition intake due to feeding challenges which include:

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  • Sucking muscles have not developed
  • GI tract is not fully developed and not all nutrients are absorbed
  • Restricted feeding volume is often needed
  • Infants in NICU have weak immune systems and are more susceptible to infection therefore restricting the frequency of feeds and achievement of targeted feed volumes each day

Even at discharge, your little one may still have some or all of the following nutritional issues:

  • Less growth than a full-term baby of the same gestational age
  • Decreased bone density
  • Deficiencies in energy and protein levels
  • A compromised antioxidant status
  • Reduced iron and zinc levels

Nutrition for premature babies: the importance of your preemie’s first year of life… read more about this on the next page.

Your little one has a lot of catching up to do in terms of growth and development in his or her first year.

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First-year of life represents a critical opportunity for growth and development

During the first year of life, your preemie’s progress is assessed by measuring and monitoring the gains in weight, length and head circumference. All three measurements are indicators of physical and mental development, with weight gain being a key parameter.

Let’s take a closer look at the implications of weight gain on preemies’ brain development and the higher nutrient needs for brain and bone development.

Your preemie’s brain development

Most of a baby’s brain development occurs in the final eight weeks of pregnancy, with cerebral cortex (the brain centre for thinking, remembering, feeling) almost tripling in weight. Being born premature may have an impact on brain development as indicated by research.

Therefore, the first year of your preemie’s life in particular is crucial for the catch up growth of his brain. For this, it is so important that he gains appropriate amounts of weight. Neonatology experts point out that in infants with very low birth weight, the failure to catch up in weight by eight months of age may be associated with:

  • Lower Bayley Development quotients. This is a series of measurements assessing the motor, language and cognitive development of infants and toddlers, ages 0-3 years old.
  • Smaller head circumferences which increases the risks for neurologic and cognitive problems
  • Higher rate of neurosensory impairment such as cerebral palsy (CP), deafness, blindness

However, there is a solution to this issue. You guessed it: optimal and personalised nutrition for preemies.

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Protein, especially, is one nutrient that can help your little one with his brain development. Leite (2011) points out that “an increased protein-energy intake during the first week of life” in premature babies results in “improved neuromotor development scores” when they are around 18 months old.

Your preemie’s bone development

Your little one’s bones are another part of his body that may be affected due to his premature birth. This is because most bone mineralisation happens in the last three weeks of pregnancy, where large amounts of calcium and phosphorus are transferred from you to your baby for his bone growth.

Research has shown that with optimal nutrition supplementation early on in life can improve bone mineral content in preemies.

“Neonatologists could recommend a supplement called human milk fortifier mixed into mothers’ expressed breast milk for feedings for in-hospital as well as post-discharge use.”

Optimal and personalised nutrition

Depending on the gestational age of the baby, medical condition and weight, babies could have very different nutritional challenges. Therefore, personalised nutrition recommended by healthcare professionals in hospital and post-discharge is crucial to support growth development of preemies.

Neonatologists could recommend a supplement called human milk fortifier mixed into mothers’ expressed breast milk for feedings for in-hospital as well as post-discharge use. This gives preemies extra protein, calories, iron, calcium, and vitamins to support overall development, including that of their brain and bones.

However if breastfeeding is inadequate and mix feeding is required, then milk formulas specially designed for preemies will be recommended. Such formulas are usually higher in nutrient levels compared to formulas for term babies.

Parents, be rest assured that with personalized nutrition and careful monitoring and support, you can help your little preemie catch up with the rest of his peers.

Also, do keep in mind that while at hospital, your baby’s healthcare team will monitor your baby’s weight very carefully. If they think he is not gaining weight appropriately, they will change his nutrition accordingly.

And, as always, check with the healthcare team about tailoring an appropriate nutrition plan to suit your little one’s needs once he is ready to go home.  After all, it takes a village to raise a child, they say.  So don’t hesitate to ask for help with your preemie’s nutrition when you need it.

With all this support, your little can one thrive and blossom into a healthy, active child.

Nearly 1 in 10 babies in Singapore are born premature. Support prematurity awareness by sharing this with other mums and mums-to-be. Continue to follow DreamBig series, especially for parents of premature babies and pregnant mums-to-be. The next article will discuss taking care of emotional wellbeing—especially for mums of preemies.

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About Abbott

Abbott is a global healthcare company devoted to improving life through the development of products and technologies that span the breadth of healthcare. With a portfolio of leading, science‐based offerings in diagnostics, medical devices, nutritionals and branded generic pharmaceuticals, Abbott serves people in more than 150 countries and employs approximately 73,000 people.

The material is for informational purposes only and is not intended to replace medical advice of a qualified healthcare professional.

Do you have experience in looking after a preemie? If you do, please share your useful tips with other parents by leaving a comment below.

Written by

Nalika Unantenne