Feeding Issues after the NICU

By Dianne I. Maroney, RN

A premature infant has come into the world with a different beginning. In his first few weeks or months he often faces many challenging obstacles that can take weeks, months, or even years to overcome. Learning to coordinating sucking, swallowing, and breathing is one of those important first obstacles. Accomplishing the difficult task of taking solids is next, and then taking solids with a variety of textures. There are many types of problems that can develop when a preemie attempts to learn these otherwise basic skills for many different reasons. A preemie may not be able to consume enough calories to gain weight because of his size or strength, he may not be able to swallow properly, feed himself adequately, he may take too long to eat, choke, gag, or vomit easily, and/or he may become very picky about what types of food he eats because of the texture of the food. Many of these problems are fairly common in former preemies. Some common cause might be: negative stimulation from the tubes, tastes, smells, etc. while in the NICU can teach a preemie that it’s unpleasant to have anything in or near his mouth; he may have some development differences that alter the way the muscles in his mouth work; and/or he may have some neurological problems that affect his ability to eat. Some feeding problems are directly related to medical problems such as Gastroesophageal Reflux.

There are some things parents can do to help their former preemies when they are at risk for developing feeding problems. First, it is very important to take away any painful or negative stimulation around the baby’s mouth, stomach, or intestines. For example, if your preemie has reflux, it’s extremely important that the reflux is under control and not causing any further pain that can be associated with eating. Second, concentrate on the feeding relationship between you and your baby (or child). So often, parents learn in the NICU that feeding is all about how much a preemie can consume at each feeding. Although the amount they consume is important, what’s equally important is the positive feeling a baby gets around feedings. Parents learn to parent through feeding their baby and babies learn about life initially through feeding. So concentrate as much as possible to keep the feelings around feeding time encouraging, relaxed, and fun (which may be very hard when things aren’t going well). Lastly, it’s important to support your preemie’s delays or problems with outside help. He may need an occupational therapist or speech/language pathologist to help him learn and develop appropriately. Ask your pediatrician or your local county early education programs about finding a therapist if you need one.

Because your preemie has had a different beginning he may need extra time to heal and grow. He may reflect this by having difficultly with eating. Be patient and support him nutritionally, physically, and psychologically so in time he can develop typical eating habits and you both can enjoy mealtimes together.

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