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Common feeding problems in the NICU
By Kim Carmignani, MSN, RNC-NIC, CLC
Preterm birth has many effects on your baby’s health, development, and behavior – and feeding is no exception. Here are few feeding issues your preemie may encounter: Generally between 33 and 36 weeks is when your baby will begin to feed by breast, bottle or both. It takes a lot of patience, but just like everything else, your baby’s ability to eat comes with his/her systems maturing. No matter what the feeding issue is, rest assured your medical team will be there to help you and your baby!
- Problems establishing nipple feedings, at the breast or with the bottle is a common problem for preemies. This is because babies born before 34 weeks cannot yet coordinate sucking, swallowing and breathing, which are necessary for oral nutrition.1 These babies are fed through a tube that carries mom’s milk to the stomach. This tube allows babies to get the nutrition they need until they can manage to suck, swallow, and breathe in a coordinated way.
- Gastric residuals occur when babies don't completely empty their stomachs from a previous feeding. This is why in the beginning, preemies are fed slowly, and their feeds are increased gradually to make sure that they can tolerate the nutrition they are receiving.
- Gastroesophageal reflux occurs when small amounts of stomach content, including stomach acid, are regurgitated into the esophagus. This can be painful to a baby and when severe, may cause symptoms of distress, such as apnea, a condition in which a baby temporarily stops breathing. Many preemies get reflux and most outgrow it in the months after birth.
- Abdominal distension is when a baby’s stomach is swollen or abnormally enlarged. This can be a baby’s way of telling us to slow down on feedings. It can also be a sign of a more severe intestinal problem. Your baby’s care team will evaluate your baby and determine the next course of action.
References
- MedlinePlus.gov. Neonatal weight gain and nutrition. https://medlineplus.gov/ency/article/007302.htm. Accessed October 21, 2018.