Feeding is the primary method of growth and development for preterm infants. This is important because, by and large, larger babies are generally healthier. Premature babies who continue to grow normally generally show that they are getting stronger and healthier every day. This article will describe the different ways to feed preterm infants (for optimal growth and health) and will also describe some of the complications that can affect feeding practices and growth. The purpose of feeding a preterm infant is to allow the infant to complete the process of physical development and weight gain that would have occurred in utero (the last 3 months of pregnancy). As the weight increases in body size, the head circumference becomes larger and the brain grows accordingly. In general, preterm infants can grow up to 1 cm in length and 0.7 cm in head circumference per week and gain up to 15 grams of weight per day. Premature infants need to be measured and weighed regularly to assess their growth and nutrient absorption. Parents can be involved in the feeding process. Regardless of the method used to feed the infant, it is beneficial for the parent or mother to be involved in the feeding process. Many neonatal intensive care units (NICUs) encourage parents to do so, as it promotes closeness and the health of the infant. There are many ways to feed a preemie other than just the type of food. The type of food and the way it is served depends on the baby’s condition and sometimes the mother’s condition. Feeding methods and nutritional requirements There are three ways to feed a preterm baby: intravenous nutrition, gastrostomy tube nasal feeding and direct oral feeding. There are also three different ways to absorb nutrition: total parenteral nutrition (TPN), breast milk, and formula designed for preterm infants. How preterm infants are fed and what they are fed depends on gestational age and the presence of gastrointestinal complications. Intravenous and parenteral nutrition The youngest preterm infants require direct delivery of nutrition into the infant’s blood vessels through an intravenous (IV) or central venous catheter for the initial period after birth. Catheters are used to deliver a solution called total parenteral nutrition (TPN) to preterm infants. Total parenteral nutrition contains protein, vitamins, minerals, sugars, fats, and water and can be given for several days or weeks, depending on the maturity of the preterm infant and his or her ability to accept other forms of feeding. After the preterm infant is stable and ready for enteral feeding, nasogastric tube (NG) feeding is initiated. A very thin tube is inserted through the baby’s nose or mouth and passed directly into the baby’s stomach. Afterwards, a small amount of expressed breast milk or formula is eased into the infant’s stomach. If the infant is able to absorb all of it, the amount can be slowly increased. Breastfeeding and bottle feeding Once the infant’s sucking and swallowing coordination is developed, the health care provider will advise and assist the parents in breastfeeding. It is recommended that most mothers use an electronic breast pump to express breast milk as soon as possible after delivery so that milk begins to flow and will continue to do so. If the baby is ready to start nasal cannula feeding, breastfeeding or bottle feeding, feed the breast milk that is sucked out to the baby. Many parents want to feed their children themselves as a way to take on more parental responsibility and to develop a bond with their children.