Feeding Issues in the NICU

By Dianne I. Maroney, RN

Holding and feeding your premature infant should be one of the most precious moments you spend with your baby. Feeding is a symbol of parenting, an opportunity to make your child feel good and one where you can communicate with your child. But when a child is born premature, having these intimate feeding times can be challenging.

Learning to suck, swallow, and coordinate breathing while eating is a major milestone for any infant, but for a premature infant whose brain function and muscle strength is immature, it can be even more difficult. Typically a preemie is not developmentally ready to suck until 24 weeks, suck and swallow at 28 weeks, and coordinate both sucking and swallowing until 32-34 weeks. If there are any medical complications such as lung disease or reflux, these abilities can be delayed even further. Preemie parents are often surprised at the difficulty in getting their child to eat and many times they feel lost as to how to help their infants.

The most important part of the feeding process parents can participate in to help their preemie is to learn their infant’s behavior. Preemies will give certain cues as to when they are ready to eat such as been quiet and alert with their eyes open. They may not be ready to eat if they are sleepy and turning their heads away. Your preemie’s nurse can help you recognize your preemie’s special cues. Also, it’s easy as parents to get locked in to worrying only about how much your infant consumes at each feeding, especially when those are the messages you get from the nurse or doctor. However, it’s also important to understand that when you are feeding your preemie, you are forming a relationship that will affect your child in many ways. Feeding supports a child through developmental milestones and helps with important growth, but it also gives your preemie positive attitudes about him or herself and the world around him. It’s critical that you understand your role in forming a feeding relationship with your child and keep the relationship around feeding a positive and supportive one.

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