Premature Babies: How Can They Gain Weight?
Being born premature is not limited to a matter of timing. It involves leaving the womb before you are ready to survive in the outside world. We speak of premature babies when we refer to those born before 37 weeks of gestation.
However, when generalizing, we assume that the difficulties associated with this condition will be the same in all cases. It is important to know that there are differences determined by the circumstances that led to the premature abandonment of the uterus.
Historically, these children were subclassified according to gestational age (GA) reached in utero (called post- conception ) and birth weight at that age. In this way, an attempt was made to frame the difficulties inherent to children of similar ages and that perhaps were not observed at another age.
One of the biggest challenges with these little ones will be to achieve a sufficient feeding level to maintain optimal postnatal growth. In the following lines we will tell you why gaining weight is so important in these children and how to improve their growth.
Loss of birth weight in babies
At birth there are changes in the composition of the body that lead us to eliminate a large amount of water. This translates into a weight loss between 7 and 20% with respect to the weight with which we are born. This phenomenon occurs within the first week of life and is expected to recover between the second and third.
Premature babies can experience even greater weight loss. This is explained because they have more water in their body and their skin is much thinner and unable to retain it inside.
Why can’t you gain weight?
As we explained before, it is not appropriate to generalize when we talk about the difficulties related to prematurity. The health complications to be expected for a 25-week-preterm (called extreme ) will undoubtedly be very different from those for a 35-week-preterm (called late ).
In terms of feeding and growth, one of the biggest differences will be in the ability to feed by sucking. It is estimated that by the 34th week of gestation, most babies will be able to maintain a sufficient rate and suction force to feed directly from their mother’s breast. And this is evidenced by this study published in Acta Pediátrica.
However, both the volume of milk obtained from sucking (child factor) and the availability in production (mother factor) may be insufficient to achieve a healthy growth rate.
Finally, the energy demands of each premature infant will have to be considered, depending on their clinical condition. It is known that the lower the gestational age, the greater the complications presented. This will require continuous monitoring and a feeding plan tailored to the child to ensure that the baby receives the necessary nutrients for every moment of his life and can gain weight.
What can I do about it?
In case you have chosen to breastfeed your baby, it is necessary that you seek advice and support from the day of birth. It is important that the necessary interventions to sustain breastfeeding are carried out from the first hours of life, since what happens in this critical period will be decisive.
It is recommended that in the first 6 hours after birth the extraction of milk from the breasts begins. The ideal scenario is with the child on the chest and in skin-to-skin contact , but this will only be possible when their clinical condition allows it. If not, the mother should be instructed in manual expression of milk and other techniques to stimulate lactation.
After the discharge of the child and his mother, it will be important to maintain regular check-ups with the neonatology team to check the following aspects:
- The rate of growth (usually with weight).
- Coloring of the skin (due to neonatal jaundice).
- Feeding practices (breastfeeding techniques and use of nutritional supplements).
All this will allow professionals to recalculate the strategies necessary to avoid the risk of illness in the baby.
How Much Weight Should a Premature Baby Gain?
Although there is no consensus on the rate of postnatal growth of premature babies, “it is considered optimal to be that which allows reaching a growth pattern similar to the one that the baby would have followed had it remained in its mother’s womb,” according to points out in this professional breastfeeding guide.
From world reports on the growth of premature infants, adapted follow-up curves for this population have been constructed. But since there are variabilities in the intrauterine growth rate according to the stage of gestation, the recommendations must be individualized. On average, after regaining birth weight, it is estimated that premature babies will gain 15-20 grams per kilo per day in the first trimester of postnatal life.
What is the best diet for a premature baby?
Without a doubt, the best food for babies is their mother’s milk. This is especially true for premature babies, as breast milk offers the following benefits:
- It will be the perfect food to nourish that immature organism.
- It will offer protection against infection.
- It will favor the prompt recovery of pathologies related to prematurity (respiratory distress syndrome).
- It will produce a faster maturation of the digestive tract.
In some cases the contribution of calories, protein, iron and vitamin D will be insufficient, so in particular cases it will be necessary to supplement breast milk with fortifiers specially designed for premature infants.
When breastfeeding is not a viable option, other alternatives such as donor mother’s milk or special formulas for premature babies can be used.
When it comes to gaining weight in premature babies …
In short, children born before term need special attention in order to guarantee them good conditions to complete their maturation outside the mother’s womb.
Although until now it has not been possible to exactly replicate what nature provides, great advances have been made to favor the survival of the smallest babies. Close monitoring of growth after discharge from hospital is an extremely useful strategy to prevent future health damage.
