Preterm baby feeding principles 1, breastfeeding Preterm baby to resume normal growth and development, must be supplemented with adequate nutrition, preterm baby’s physiological functions are not well developed, we must do everything possible with breastfeeding. Breast milk is rich in lactalbumin, amino acids can promote the growth of the baby, and breast milk contains a variety of antibodies, which are more valuable to the health of premature babies. Preterm babies who are breastfed are less likely to develop indigestible diarrhea and other infections, and they will gradually gain weight. Insufficient breastmilk, low weight preterm babies need to be fed with iron-fortified formula, which should also contain calcium, phosphorus, sodium and vitamins. 2, suck and then feed Preterm babies for nutrient needs higher than normal babies, but the physiological characteristics of preterm babies constrain the baby’s absorption of nutrients. Preterm baby’s sucking ability is poor, swallowing reflex is not sensitive, too much, too fast feeding is very easy to choke, for can’t suck or sucking weak baby, mother to suck milk on time with the sucking device, and then sucked out of the milk and then fed to the baby. 3, less food more meals premature baby’s stomach capacity is small, gastrointestinal tract digestion is not sound, too much milk may lead to gastric retention caused by overflow, serious cases will also cause indigestion, diarrhea. Smaller meals can effectively mediate the conflict between the baby’s physiological characteristics and nutritional needs. New mothers can shorten the interval when feeding the baby, the amount of milk from less to more gradually increased, so that the baby’s fragile digestive system has enough time for self-regulation. 4, reasonably add complementary food premature baby plus complementary food need to refer to the degree of physiological development, that is, the number of months after birth minus the number of months of premature birth. For example: the baby has now been born 6 months, but was originally born two months earlier, then its developmental age should be 4 months (six minus two). This means that the functional maturity of the organs in the body is comparable to that of a normal 4-month full-term baby, so the diet will be treated in a similar way. Normal full-term babies also start to add complementary foods after three or four months. Preterm baby correct supplement Preterm baby in the diet should pay attention to the basic principles, but also for preterm baby’s physical development of the nutrients needed to focus on supplementation. Preterm babies often encounter many obstacles to achieve the appropriate weight, such as swallowing ability, small intestine dysfunction, gastroesophageal reflux and malabsorption of fats, sugar digestion, etc., are caused by the lower utilization of energy. Preterm babies who are less isolated after coming out of the incubator use the calories needed for growth to maintain their body temperature with little energy storage, which also contributes to the reduction of subcutaneous fat and increases the rate of metabolism. Breastmilk + fortifiers In addition to feeding your baby enough milk every day, premature babies can be started after they are able to tolerate 100ml (100mL/kg.d) of breastmilk per kilogram of body weight per day, and before they reach full feeding (100mL/kg.d). Feeding your baby breastmilk fortification strengthens your baby’s energy absorption. Fortified breastmilk can have a caloric density of 80 kcal/dL (80 kilocalories per liter per day) if prepared as standard. However, if your baby has a chronic illness you should consult your doctor and may need to increase your breastmilk fortification because your baby needs more energy at this time. While fortifying breastmilk, it is also necessary to provide your baby with adequate protein. This is because even with fortified breastmilk, the intake of energy or protein is still less than expected due to the diverse composition of breastmilk. After the third month of pregnancy, the baby’s small intestine has established an active transport system for amino acids, while the liver is able to synthesize major plasma proteins. Therefore, preterm babies are capable of digesting and absorbing proteins. In addition to breastfeeding after the baby’s birth, you should also feed your baby preterm formula to replenish the baby’s protein in a timely manner. Breastmilk + Formula The components in preterm breastmilk are different from full-term breastmilk, and its nutritional value and biological functions are more suitable for the needs of preterm babies. Preterm breast milk has high protein content, which is favorable to the needs of rapid growth of preterm babies; the proper ratio of whey protein and casein protein is also conducive to digestion and accelerated gastric emptying. But with the gradual recovery of the baby’s digestive system, the body grows faster gradually when the nutrition of breast milk will not keep up with the growth of premature babies, this time the mother can add some breast milk fortifier or preterm infant formula for babies. The protein content of preterm infant formula should be high, about 2.7 to 3.0/100kcal (2.7 to 3.0 per kilocalorie), this protein/energy ratio (P:E) is more conducive to preterm baby’s weight growth and body structure close to its intrauterine growth and development. In terms of protein composition, a whey to casein ratio of 60:40 or 70:30 is preferred. The amino acid composition of whey protein is more suitable for the physiological needs of preterm babies’ rapid growth, allowing preterm babies to absorb more protein. Lipids are a very important component in the composition of the fetal baby’s brain, the fetal baby’s brain development requires 60% lipids. Lipids include fatty acids and lipids, and lipids are mainly lecithin. Adequate lecithin is the key to the development of the baby’s brain, premature babies leave the mother’s body early, lipid supplementation can not keep up, which will affect the baby’s brain development, so premature babies should pay attention to lipid supplementation. Among fatty acids, medium-chain fatty acids (MCT) is an ideal source of lipids for preterm babies, and its absorption does not require the participation of bile salts. The content of medium-chain fatty acids in preterm formula should be around 40%, which is easy for babies to digest and absorb. The protein content of preterm infant formula should be high, about 2.7 to 3.0/100kcal (2.7 to 3.0 per kilocalorie). This protein/energy ratio (P:E) is more conducive to the weight gain of preterm babies and the body structure is close to that of their intrauterine growth and development. In terms of protein composition, a whey to casein ratio of 60:40 or 70:30 is preferred. The amino acid composition of whey protein is more suitable for the physiological needs of preterm babies’ rapid growth, allowing preterm babies to absorb more protein. Preterm babies cannot adequately digest lactose in the early postnatal period because lactase is the last of the disaccharidases to appear during fetal babyhood. Since the activity of lactase in the gut of a preterm baby is lower than that of a full-term baby, it is helpful to lower the proportion of lactose and replace it with other carbohydrates. Formula for preterm infants usually includes a carbohydrate blend of 40% to 50% lactose and 50% to 60% polydextrose, which, when combined with breast milk, supplies the baby’s caloric needs without increasing blood osmotic pressure. Lipids are a very important component in the brain composition of the fetus baby, the baby’s brain development requires 60% lipids. Lipids include fatty acids and lipids, which are mainly lecithin. Adequate lecithin is the key to the development of the baby’s brain, preterm babies leave the mother’s body early, lipid supplementation can not keep up, which will affect the baby’s brain development, so preterm babies should pay attention to lipid supplementation. Preterm babies are born with lower levels of vitamin accumulation and lower absorption rates, but have high demand and are prone to vitamin deficiencies. More minerals such as calcium, phosphorus, iron, sodium, copper and selenium are added to preterm baby formula to meet the needs of rapid growth. Preterm babies have lower kidney dilution and concentration capacity, a condition that can easily lead to dehydration if the water supply to the baby is insufficient. On the contrary when the daily fluid supply exceeds the baby’s kidney metabolic capacity, it will in turn cause fluid overload and affect the baby’s heart. Hydration is also an area that new mothers have to pay close attention to, when the baby’s weight is less than 2Kg, the amount of water needed should be 80-180ml/Kg. Although vitamin fortification has been carried out in preterm infant formula, in the first few weeks of life, due to the small amount of milk intake, it is not possible to satisfy the need for all the vitamins, especially vitamins A, D, K, E and folate, but the situation will slowly be improved. This situation improves slowly. Two thirds of the baby’s mineral reserves are made during the last two months of pregnancy. It is very difficult to achieve the same rate of mineral deposition in preterm babies as in the second trimester after birth, and when the supply of minerals is insufficient, this can lead to impaired growth and development.