Feeding your Infant
If your infant is small and premature or very sick at birth, the initial feedings will begin slowly with tiny amounts. The premature bowel is very fragile and about the thickness of tissue paper, so we must be cautious. Infants who are very sick may have less bowel motility and may have a bowel that is also recovering from the stresses of delivery. As the feeding volume increases the intravenous volumes are decreased. If your child is very premature or very ill he/she will received total parenteral nutrition (TPN). The goal is to nourish your infant, providing the essential nutrients. We want your infant to begin to gain weight after the brief initial weight loss (all babies lose weight in the first few days of life). If your infant is small and tolerating feedings, human milk fortifier maybe added to your milk to optimize growth. It increases protein, calcium, phosphorus, mineral, and caloric contents to meet the requirements for growth. If your infant is not receiving human milk, a cow’s milk based premature formula will be used.
When feeding newborn infants mother’s milk is the gold standard. It supplies the very best nutrition and gastrointestinal protection for all infants. We want to encourage all mothers, who are able, to breast feed their infants. We want to support mothers in this endeavor every way possible. If your infant is very small and sick he/she maybe eating small amounts initially. These feedings are given by gavage, which means the feeds are given through a soft plastic tube which extends from the mouth to the stomach. Your infant in addition will received IV nutrition containing all the essential nutrients. We would like to encourage you to use an electric breast pump as soon as you are able and ask you to pump at regular intervals (every 3 hours), saving even the smallest amount of milk (colostrum) obtained. It is often a few days before your milk supply comes in. If your infant is not ready to eat immediately, we will ask you to label and freeze your milk. We will use it when your infant is ready to eat. If you are obtaining only small amounts this can often be used for your infant’s oral cares even if he/she is not being fed initially. If your infant is very premature, ready to eat and your milk has not come in with your consent we will use screened, pasteurized human donor milk from the Indiana Mother’s Milk Bank.
Research has demonstrated that human milk is very advantageous, to all infants, but especially the smallest infants. There appears to be a protective effect on the very fragile preterm gastrointestinal tract. If for some reason screen pasteurized human milk is not available we will use cow’s milk based formulas appropriate for your infant’s age and gestation until your milk is in. Your milk will always be our first choice when it is available.
Donor Breast Milk
Considerable research has confirmed multiple advantages of feeding infants human milk (see resources section for documentation). Our NICU has been fortunate to obtain a supply of frozen, screened, pasteurized Human Donor
milk for the smallest and sickest of our patients from the Indiana Mother’s MilkBank (IMMB).
For additional information concerning the treatment and safety of IMMB donor breast milk please visit the website for the Indiana Mother’s Milk Bank
If You Are Not Breast Feeding
Breast feeding is encouraged whenever possible. We realize that some mothers are unable to breast feed for a variety of reasons. If you are not breast feeding, and your infant is less than 32 weeks, donor human milk will be available on a limited basis. If your infant is greater than 34 weeks, we will use the best commercially available formula that is appropriate for your infant’s needs. These formulas are specially developed to support balanced growth for infants with a variety of problems in addition to prematurity and are the result of years of research.