Preterm baby is the term used for baby that born before 37 weeks of gestation. Nowadays, there are alot of special formula created for preterm baby or baby with low birth weight available in the market. But, what actually the premium nutrition for preterm baby?
As same as other full term babies, the premium nutrition for preterm baby is still ASI (breastmilk). For a preterm baby, ASI is especially important because it can prevent damage to baby’s immature digestive system. Breastmilk helps to promote good health in a way artificial milks cannot match (Australian Breastfeeding Association, 2012).
Doctors and scientists recommend breastmilk feeding for the following reasons:
- Your breastmilk is specifically tailored for your baby.
- It is easy to digest, so the preterm baby will gain the most nutrients with the least effort, even with her immature digestive capabilities.
- There is little waste with breastmilk and the elimination of this waste will not overtax immature kidneys.
- Breastmilk, especially the first milk (colostrum), is very important because it increases the baby’s resistance to many infections and diseases.
- The milk from mothers of preterm babies has special qualities which allow for optimum growth and development. ‘Preterm’ milk, although similar in many respects to full-term milk, contains higher concentrations of protein and some immunological components and minerals.
- Even the tiniest amounts of breastmilk contain very concentrated amounts of nutrients and immune components, so even if a mother is able to produce only a trickle of breastmilk, the baby still benefit
Below are the comparisons of nutritional breastmilk composition from mothers delivering preterm (PT) and full term (FT) infants:
| Nutrient |
Days postpartum |
||
|
2-5 |
14-17 |
||
| Protein (gm/dl) | PTFT | 11.95 ± 4.34 (20)10.88 ± 2.11 (30) | 13.17 ± 2.9311.65 ± 3.81 |
| Cholesterol (mg/dl) | PTFT | 127.9 ± 84.80 (20)186.10 ± 122.10 (30) | 330.1 ± 104.5250.30 ± 131.70 |
| Sodium (meq/dl) | PTFT | 33.15 ± 8.68 (20)21.63 ± 7.28 (30) | 17.35 ± 6.9114.81 ± 6.56 |
| Calcium (mg/dl) | PTFT | 22.18 ± 5.10 (20)20.76 ± 5.56 (30) | 22.26 ± 2.8922.80 ± 4.34 |
Nutrient composition of preterm and full term milk at 2 weeks postpartum
| Nutrient | FT (Full Term) | PT (Preterm) |
| Protein (gm/dl) | 1.2-1.7 | 1.71-2.17 |
| Lipid (gm/dl) | 3.06-4.01 | 3.42-4.40 |
| Sodium (mEq/l) | 25-29 | 31-54 |
| Calcium (mg/dl) | 26-28 | 22-28 |
Source: Pishva & Hemmati, 2004.
Other advantage of preterm breastmilk is higher content of lipase enzyme & antibody can be really useful for preterm baby. Those superiorities of preterm breastmilk especially applied for the first 6 months postpartum & after that period, the content of preterm breastmilk will be similar to full term breastmilk (Apriadji, 2012).
Nevertheless, breastfeeding can be a challenge if your baby is very small, or has other health problems. Most of Preterm babies, especially those are born before 32 weeks of gestation have difficulties of sucking because this reflex should be learned inside the womb at 32 weeks of pregnancy period (Mother & Baby, 2009). However, with perseverance, knowledge and help, you and your baby will soon learn all the skills you need. These are some tips for the mothers:
- Start expressing as soon as possible after the birth of your baby and begin to store your breastmilk in the freezer for stock.
- It may help your baby to get the idea if you hold him/her in the breastfeeding position, while being tube-fed.
- Try to experiment with different positions at the breast, always making sure your baby is attached properly.
- You may start your let-down reflex working before putting your baby to the breast by massage, hand expressing or putting a warm cloth or warm heat pack on your breast. This will make it easier for your baby and increases the amount of milk taken even though the period of sucking may be short.
- Relax, don’t be too concerned about your baby’s sucking during early attempts at breastfeeding. The attachment between you and your baby is more important than the volume of milk consumed. As your baby grows and becomes stronger you will see him begin to take more and suckle for longer.
Both pictures above are the same preterm baby, born at 32 weeks of gestation, with birth weight 1970 g, and have to spend 20 days in NICU before released to home. Those pictures were taken when she was 3 weeks (before) and 3 months (after). She was given exclusive breastmilk for the first 6 months of her life.
REFERENCES:
Australian Breastfeeding Association. Reviewed: October 2012.
Apriadji, W. H. 2012. Makanan Bayi Sehat Alami Cetakan I. Jakarta: Pustaka Bunda.
Mother & Baby magazine. ASI yang menyelamatkan. Edition: March 2009
Pishva, N & Hemmati, F. 2004. Comparison of Protein, Fat, Sodium and Calcium in the Milk of Mothers of Preterm and Full term Infants. Shiraz E-Medical Journal vol. 5.
