The first weeks of life through the eyes of a preemie

By Amy Paradis, RN, MS, NNP-BC, CNS

Imagine you are floating in a warm, quiet place. The sounds of your mother’s constant heartbeat and her soft voice surround you. Nourishment from the long, winding umbilical cord drapes over you. Everything you need to grow, develop, and thrive encircles your tiny, fragile body.

Now imagine a quaking shift of the womb around you. Preterm labor has shaken your mother awake with pain and fear. Despite all efforts, you now find yourself pushed into a world of bright lights and strange, loud sounds and voices. Your tiny one-and-a-half-pound body is wet and feels instantly cold, as strange hands gently rub and poke and prod you. A stiff plastic tube has been put into your mouth and down into your lungs. Another tiny plastic tube has been put deep into your veins. Now a heated plastic box and tiny wires surround you. A constant whirl of beeps and alarms are the only sounds you hear. Your tiny body is fighting for life. You’re burning precious calories just to breathe and stay warm. How will you survive? How will you grow into the strong, healthy baby your mother hoped for?

Babies born early, especially those weighing less than 2 pounds 12 ounces (1250 grams), like you, have an enormous need for calories and energy, compared to term babies.

Their premature bodies begin burning calories at a rapid rate immediately after birth, and because they grow at a rapid pace, they also need more protein, minerals, and other nutrients.

This is difficult to manage when your immature gut is not ready to digest and tolerate food. Now that you’ve entered the world, your mother is faithfully pumping and storing her milk, knowing her milk is crucial to your survival, as nothing else provides the same benefits. Besides supplying vital nutrition, your mother’s milk supports your developing immune system and provides you with protection against infections.

The first precious drops you receive are your mother’s colostrum. Over the next few days, you receive increasing amounts of your mother’s milk but not nearly enough to grow. Because of your extraordinary energy and protein needs, you would need to consume more breastmilk than your tiny stomach could hold in order to get the proper nutrition to grow.

That’s why your medical team may decide to add a fortifier to your breastmilk feedings.

Fortifiers are intended to address a premature baby’s nutritional requirements by providing additional protein, calories, vitamins, and minerals.

Now your medical team must decide which fortifier to add to your feedings. Two choices are available to them: cow milk-based fortifiers or human milk-based fortifiers. However, there may be factors in cow milk products that may negatively affect the premature intestine.

Prolact+ H²MF® fortifier is the only human milk–based fortifier available for very-low-birth-weight babies. When used as part of 100% human milk diet, Prolact+ H²MF is clinically proven to improve health outcomes for critically ill, extremely premature infants in the NICU weighing between 500 and 1250 grams at birth, as compared to cow milk-based fortifier or preterm formula.

Prolact+ H²MF fortifier is made from breastmilk donated by mothers who want to help others. These mothers are healthy nursing women who have undergone extensive medical and social screening (similar to the blood donor screening process). When added to breastmilk, Prolact+ H²MF fortifier creates a “human milk protein shake” to nourish you in the coming weeks! Now you’re ready for the long road ahead! Let’s watch you grow and thrive!

References:

1. Neonatal weight gain and nutrition. https://medlineplus.gov/ency/article/007302.htm. Updated February 7, 2018. Accessed March 6, 2018.
2. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk [published online February 27, 2012]. Pediatrics. doi:10.1542/peds.2011-3552
3. Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi:10.1089/bfm.2014.0024.
4. Cristofalo EA, Schanler RJ, Blanco CL, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6):1592-1595. doi:10.1016/j.jpeds.2013.07.011.
5. Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567. doi:10.1016/j.jpeds.2009.10.040.