- Feeding a premature baby often starts gradually, sometimes with tube feeding before transitioning to breast or bottle.
- Breast milk offers benefits, but it’s not the only valid choice - babies thrive on formula or donor milk.
- Bottle feeding allows shared caregiving and is especially helpful if breastfeeding isn’t possible or desired.
- Combination feeding is common and can be tailored to fit your baby’s needs and your circumstances.
- Support matters. Lean on nurses, midwives and lactation consultants if needed.
Feeding a premature baby can often come with questions and concerns, especially in the early days. Our guide provides tips and answers to common concerns about feeding a preemie, from when they can start feeding to what kind of milk, and how to tell if they’re getting enough.
When can a premature baby start feeding?
When a baby is born prematurely, how many weeks along they are when they’re born can have an impact on their ability to do many things that full-term babies can do, such as bottle or breastfeeding.
As a parent, you're bound to worry about making sure your baby gets the nutrients they need to grow, and it can be upsetting to know that your role in feeding your baby is going to look drastically different than you planned.
It's important to remember that it's completely normal for a premature baby to have feeding difficulties, and you're not alone.
How to feed your baby in the NICU
While in the neonatal unit, your baby may be fed using a tube. In premature babies, the coordination of sucking, swallowing, and breathing needed for effective feeding is usually not fully established until about 34 to 36 weeks gestation, although this can vary from one baby to the next. Tube feeding helps them receive enough nutrition to grow and develop.
During tube feeding, breast milk or formula is given through a tube in your baby’s nose or mouth and into their stomach.
Tube Feeding (Gavage Feeding)
If your baby can’t yet suck or swallow effectively, milk will be delivered directly into their stomach through a thin tube (nasogastric or orogastric). This allows them to get vital nutrients without tiring themselves out.
Types of tube feeding include…
- Nasogastric tube feeding (also called an NG tube): Baby is fed through a small soft tube, which is placed in the nose and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.
- Orogastric tube feeding: Baby is fed through a small soft tube, which is placed in the mouth and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.
Very premature or sick babies are sometimes fed using parenteral nutrition (PN). This means that they're fed via an intravenous (IV) line to begin with and a fluid containing nutrients is fed straight into their vein.
If you’re planning on breastfeeding, you can begin to express your breast milk for them by hand or with a breast pump. Your milk is uniquely suited for your premature baby and can boost immunity and gut health.
Bottle or breastfeeding when baby is ready
As your baby grows stronger, they’ll begin to feed by mouth. This transition will be gradual and guided by their cues/medical guidance.
Skin-to-skin contact supports bonding and helps babies get used to the breast, so get as many bare-skin cuddles in as you can.
Fortified milk or premature baby formula
Premature babies need more calories, protein and minerals than full-term infants. Even breast milk may need fortifiers. Some babies will also need specialised formula if breast milk isn’t an option.
